Septic Shock
Conditions
Keywords
Sepsis, Sedation, Microcirculation, Dexmedetomidine
Brief summary
Dexmedetomidine was found might be beneficial to sepsis. Dexmedetomidine were found to improve microcirculation in sepsis animal studies and non-sepsis patients. However, the effect of dexmedetomidine on microcirculation in septic shock patients is unknown.
Detailed description
Septic shock is characterized by significant decline in vascular response and relative hypovolemia. Fluids and exogenous catecholamines are mainstay. However, even after initial resuscitation, microcirculatory dysfunctions still exist, and represent a direct physiologic link to organ failure and death. Therefore, therapeutic strategies aiming at improving microcirculation are performed. Dexmedetomidine was found might be beneficial to sepsis. Dexmedetomidine were found to improve microcirculation in sepsis animal studies and non-sepsis patients. However, the effect of dexmedetomidine on microcirculation in septic shock patients is unknown. Based on the hypothesis that dexmedetomidine might improve microcirculation in initial resuscitated septic shock patients, the study was to investigate the effects of dexmedetomidine on microcirculation in early septic shock patients despite initial resuscitation. Meanwhile, to observe the possible mechanism of the effect, the correlation between dexmedetomidine dose and microcirculatory parameters as well as catecholamine level were performed.
Interventions
DRUGDexmedetomidine 0.7 Mcg/kg/h
CIF 0.7mcg/kg/h
Sponsors
Southeast University, China
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Adult patients who met the following inclusion criteria were enrolled in the study: 1) With septic shock defined by the 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference for less than 24 hours. 2\) After initial fluid resuscitation but still requiring norepinephrine to maintain arterial pressure or hyperlactacidemia. 3\) Need ongoing analgesia and sedation. 4) Using advanced invasive hemodynamic monitoring techniques.
Exclusion criteria
were as follows: 1. age less than 18 years. 2. pregnancy. 3. heart rate less than 55 beats per minute. 4. acute hepatic failure 5. brain injury.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perfused vascular density | One hour | Perfused vascular density was calculated by multiplying vessel density by the proportion of perfused vessels |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Microcirculatory flow index | One hour | Based on the major type of flow in all quadrants were determined with a semi-quantitative methodology |
| Total vascular density | One hour | Vascular density was calculated by the number of vessels crossing these lines |
Countries
China
Outcome results
None listed