MR-Evaluation of Renal Function In Septic Patients
- Conditions
- Sepsis, SevereCOVID-19Acute Kidney Injury
- Interventions
- Other: Plasma expansion with Ringer's Acetate
- Registration Number
- NCT02765191
- Lead Sponsor
- Uppsala University
- Brief Summary
A study of renal blood flow and renal oxygenation measured by magnetic resonance after a standardized fluid challenge in critically ill, resuscitated, patients with sepsis due to COVID-19 or other agents.
- Detailed Description
Critically ill, septic patients with or without acute kidney injury (AKI) above 18 years of age who have been circulatory and respiratory stabilized will be screened for inclusion.
After the patients have been adequately treated with antimicrobial agents, source control and circulatory and respiratory stabilized, the patient will be moved to the Magnetic resonance imaging (MRI)-suite and placed in the MRI-camera. We plan to, at the same time, study renal blood flow (RBF) and oxygenation with 4 different MRI techniques; arterial spin labeling (ASL), Blood oxygen level dependent (BOLD)-technique, T(2) -Relaxation-Under-Spin-Tagging (TRUST) and Phase contrast at two conditions;
1. at baseline after stabilization
2. after intravenous infusion of 7,5 ml/kg mL Ringer's acetate
The following data will be registered:
1. Age, gender, length and weight,
2. concomitant diseases and treatment,
3. present disease and treatment,
4. source of admission - emergency department or ordinary ward,
5. daily laboratory reports,
6. results from other investigations, e.g. x-rays, cultures etc.,
7. recordings from the intensive care unit (ICU) monitors
8. Continuous renal replacement therapy (CRRT) - duration type, flow rate, replacement fluid, etc.
9. dead or alive at discharge and 90 days mortality,
10. renal function at discharge,
11. treatment restrictions,
12. if the patient has died, the results from a possible postmortem examination. As well as all data obtained during the MRI-examination.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 22
- Patients with clinical diagnosis sepsis (infection and organ dysfuncion) treated in intensive care.
- Manifest Acute kidney injury (AKI) or risk of AKI.
- 18 years of age or older
- Pregnancy
- Chronic kidney failure
- Renal Replacement Therapy
- Instability in vital parameters to a degree where MRI is not feasible
- Contraindications for MRI (implants, coils, pacemakers, etc)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Study group Plasma expansion with Ringer's Acetate Subjects investigated according to protocol after administration of bolus of Ringer's Acetate
- Primary Outcome Measures
Name Time Method Change in renal blood flow and renal oxygenation after standardized plasma expansion with fluid bolus When achieved according to protocol, approximately 3-10 minutes after intervention Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST), compared to baseline measurement
Descriptive renal oxygenation and blood flow in critical illness due to sepsis During Critical illness - at one time point Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST) during baseline measurement.
Descriptive renal oxygenation and blood flow in critical illness in no/low grade AKI or high grade AKI. During Critical illness - at one time point Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST) images stratified in groups in regards to KDIGO grade during exam.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Uppsala University Hospital
🇸🇪Uppsala, Sweden