The Effect of Vasopressor Therapy on Renal Perfusion in Patients With Septic Shock - a Mechanistically Focussed Randomized Control Study

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Acute kidney injury (AKI) is a common complication of septic shock and together these conditions carry a high mortality risk. In septic patients who develop severe AKI renal cortical perfusion is deficient despite normal macrovascular organ blood flow. This intra-renal perfusion abnormality may be amenable to pharmacological manipulation, which may offer mechanistic insight into the pathophysiology of septic AKI. The aim of the current study is to investigate the effects of vasopressin and angiotensin II on renal microcirculatory perfusion in a cohort of patients with septic shock.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Within 48 hours of intensive care admission

• Evidence of suspected or confirmed infection

• Sequential Organ Failure (SOFA) score increase of 2 or more (assuming a baseline of 0 if no previous measures)

• Requirement for norepinephrine infusion as the sole vasopressor agent in a dose of \>0.1mcg/kg/min

• Lactate \>2mmol/L at any stage prior to randomisation

Locations
Other Locations
United Kingdom
King's College Hospital
RECRUITING
London
Contact Information
Primary
Sam Hutchings
sam.hutchings@nhs.net
02032994957
Time Frame
Start Date: 2024-01-05
Estimated Completion Date: 2026-07
Participants
Target number of participants: 45
Treatments
Experimental: Angiotensin II Infusion
Angiotensin II infusion commenced alongside standard care vasopressor therapy (norepinephrine). Angiotensin II up titrated in a protocolised manner to a target/maximum dose of 40 ng/kg/min whilst noradrenaline down titrated in order to achieve/maintain target mean arterial pressure (MAP) as directed by attending clinician.
Experimental: Vasopressin Infusion
Vasopressin infusion commenced alongside standard care vasopressor therapy (norepinephrine). Vasopressin up titrated in a protocolised manner to a target/maximum dose of 0.04 IU/min whilst noradrenaline down titrated in order to achieve/maintain target mean arterial pressure (MAP) as directed by attending clinician.
Active_comparator: Norepinephrine Infusion
Standard care vasopressor therapy which recruited participants already receiving, titrated to achieve/maintain target mean arterial pressure (MAP) as directed by attending clinician.
Related Therapeutic Areas
Sponsors
Leads: King's College Hospital NHS Trust
Collaborators: European Society of Intensive Care Medicine, Royal Centre for Defence Medicine

This content was sourced from clinicaltrials.gov