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Effects of Levosimendan on Cellular Metabolic Alterations in Patients With Septic Shock

Not Applicable
Conditions
Septic Shock
Interventions
Device: Microdialysis Probe (Muscle microdialysis)
Registration Number
NCT02963454
Lead Sponsor
Military Hospital of Tunis
Brief Summary

To investigate changes in the concentration of glucose, lactate, pyruvate and glycerol in the extracellular fluid of the skeletal muscle following levosimendan administration in patients with septic shock.

Detailed Description

The study was designed as a prospective, double-blind, controlled, clinical trial and performed in a multidisciplinary intensive care unit. After achieving normovolemia and a mean arterial pressure of at least 65 mmHg, 20 septic shock patients were randomized to receive either levosimendan 0.2 μg/kg/min, or dobutamine 5 μg/kg/min. Interstitial tissue concentrations of lactate, pyruvate, glucose and glycerol were obtained by using muscle microdialysis. All measurements, including data from right heart catheterization were obtained at baseline and every 6 hours for the following 72 hours after randomization.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
50
Inclusion Criteria
  • patients who fulfilled the criteria of septic shock that required norepinephrine (NE) to maintain a mean arterial pressure (MAP) of at least 65 mm Hg despite appropriate volume resuscitation (pulmonary arterial occlusion pressure [PAOP] = 12 to 18 mm Hg and central venous pressure [CVP] = 8 to 12 mm Hg)
Exclusion Criteria
  • pregnancy, uncontrolled hemorrhage, terminal heart failure, significant valvular heart disease, documented or suspected acute coronary syndrome, and a limitation on the use of inotropes: left ventricle outflow obstruction, systolic anterior motion of the mitral valve.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
levosimendan 0.2 μg/kg/minMicrodialysis Probe (Muscle microdialysis)Treatment with levosimendan 0.2 μg/kg/min 24h (without bolus). Muscle microdialysis was performed using a microdialysis probe inserted into the quadriceps femoris muscle.
dobutamine 5 μg/kg/minMicrodialysis Probe (Muscle microdialysis)Treatment with dobutamine 5 μg/kg/min. Dobutamine were administered during all the 72 hours study period. Muscle microdialysis was performed using a microdialysis probe inserted into the quadriceps femoris muscle.
levosimendan 0.2 μg/kg/minLevosimendanTreatment with levosimendan 0.2 μg/kg/min 24h (without bolus). Muscle microdialysis was performed using a microdialysis probe inserted into the quadriceps femoris muscle.
dobutamine 5 μg/kg/minDobutamineTreatment with dobutamine 5 μg/kg/min. Dobutamine were administered during all the 72 hours study period. Muscle microdialysis was performed using a microdialysis probe inserted into the quadriceps femoris muscle.
Primary Outcome Measures
NameTimeMethod
changes in the concentration of glycerol (µmol/l) in the extracellular fluid of the skeletal muscleAt baseline and then every six hours for the following 72 hours after randomization.
changes in the concentration of lactate(mmol/l) in the extracellular fluid of the skeletal muscleAt baseline and then every six hours for the following 72 hours after randomization.
changes in the concentration of glucose(mmol/l) in the extracellular fluid of the skeletal muscleAt baseline and then every six hours for the following 72 hours after randomization.
changes in the concentration of pyruvate (µmol/l) in the extracellular fluid of the skeletal muscleAt baseline and then every six hours for the following 72 hours after randomization.
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Military Hopital of Tunis

🇹🇳

Tunis, Tunisia

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