Intensive Care, Microcirculation, Very Old Intensive Care Patients
Conditions
Keywords
Microcirculation, Intensive Care, Critical care, shock, Very Old Intensive Care Patients, risk stratification, SDF-measurement
Brief summary
Shock is a frequent, etiologically heterogeneous and often lethal clinical condition of intensive care medicine. This is particularly true for very old intensive care patients (VIPs), who are among the fastest-growing subgroups of all intensive care unit (ICU) patients and who suffer from a significantly impaired outcome. In addition to the treatment of the causes of shock, current therapeutic approaches focus on the stabilization of vital parameters, which in general all reflect macrocirculatory measured values such as blood pressure. In contrast, a disturbance of the microcirculation (blood circulation of the smaller blood vessels \<100 µm) is only poorly measurable and delayed. The last generation of AVA-Software (MicroVisionMedical) will calculate different parameters about the capillary densitiv and perfusion in a user-independent way. VIPPER investigates whether a non-invasive measurement of microcirculation using the sublingual mucosa in very old intensive care patients in shock leads to faster recognition and specific treatment of organ dysfunctions. Secondly, this study checks whether this measurement predicts outcome.
Interventions
DIAGNOSTIC_TESTMeasurement of microcirculation
As a simple clinical test, every patient will receive the assessment capillary refill time and mottling-score. Additionally, repetitive measurements of lactate will be done. The SDF-camera (MicroVision Medical®, Amsterdam, Netherlands) will measure sublingual microcirculation at different time points (Admission and 24h).
Sponsors
Heinrich-Heine University, Duesseldorf
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
80 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥ 80 years * Acute ICU admission * Shock at the time point of admission to the ICU or in the first 3 hours defined as Lactate ≥ 2 mmol/l AND need for vasoactive substances to maintain a MAP ≥ 65 mmHg in the presence of adequate volume status
Exclusion criteria
* \< 80 years * Inaccessibility for sublingual measurement * no informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| bedside measurement of sublingual microcirculation | admission of the intensive care unit | measurement of sublingual microcirculation by using MicroScan® microscope |
Secondary
| Measure | Time frame |
|---|---|
| Mortality | after 30 days, 6 months and 12 months |
| Length of stay at ICU | tdays from admission of the intensive care unit until discharge |
| Use of Vasopressors and fluids | days from admission of the intensive care unit until discharge |
Countries
Germany
Outcome results
None listed