Septic Shock
Conditions
Keywords
septic shock, cerebral oximetry, vasopressor, norepinephrine
Brief summary
The purpose of this study is to reveal if higher doses of vasopressors in septic shock patients correlates with cerebral vasoconstriction and lower cerebral oximetry.
Detailed description
The mortality with septic shock is high. Treatment includes antibiotics, intravenous fluid and drugs for circulatory support, especially the vasopressor norepinephrine. Fluids and drugs for circulatory support are to restore adequate organ perfusion. Inadequate oxygenation of the brain can give neurologic damage. Traditionally treatment is guided by surrogate markers like arterial and central venous pressure. Cerebral oximetry is a non-invasive method which measures cerebral saturation of oxygen, SCO2, and thereby expresses regional cerebral perfusion. By registering cerebral oxymetry on patients treated with vasopressors for septic shock we want to reveal if higher doses of vasopressor correlates with cerebral vasoconstriction and lower cerebral oximetry.
Interventions
None listed
Sponsors
Karl-Andre Wian
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years or older * Septic shock patients in ICU department requiring vasopressor therapy
Exclusion criteria
* Damage to the frontal lobes corresponding to the area where SCO2 is monitored * Patients in pharmacological studies * Patients with known intracranial vascular anomalies or cerebral aneurysms * Patients where vasoactive medication is started before cerebral oxymetry is established * Patients with known neurological disease * Patients with undergone cerebral insult, transient ischemic attack or carotid stenosis * Patients who have been resuscitated after cardiac arrest in connection with this hospital stay * Patients with a body temperature below 35 degrees Celsius when establishing monitoring
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of minutes of SCO2-values lower than 50 or reduced by 20% during 24 hours | 24 hours | SCO2 will be measured before initiating vasopressor therapy. Thereafter SCO2 are updated every 2 seconds and is measured for 24 hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Use of vasopressors/inotropes | Discharge from ICU, expected 5 days at average | Use of vasopressors/inotropes * norepinephrine * epinephrine * dopamine * dobutamine * vasopressin * nitroprusside * glyceryltrinitrate |
| Fluid balance | 24 hours | — |
| Incidence of acute myocardial infarction | Hospital discharge, expected 12 days at average | Incidence of acute myocardial infarction based on international criteria |
| Length of stay in hospital | Discharge from hospital, expected 10 days at average | — |
| Incidence of organ failure | Discharge from ICU, expected 5 days at average | Measuring Sequential Organ Failure Assessment, SOFA, score at inclusion and once daily during ICU-stay. |
| Length of stay in ICU | Discharge from ICU, expected 5 days at average | — |
Countries
Norway
Outcome results
None listed