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The Effect of Three Different Fluids(Albumin 5%, Normal Saline, Hydroxyethyl Starch 130 kD) on Microcirculation in Severe Sepsis/Septic Shock Patients

Completed
Conditions
Septic Shock
Microcirculation
Severe Sepsis
Registration Number
NCT01319630
Lead Sponsor
Mercy Research
Brief Summary

Major microvascular blood flow alterations have been documented in patients with severe sepsis. It was also demonstrated that the microcirculation improved in survivors of septic shock but failed to do so in patients dying from acute circulatory failure or with multiple organ failure after shock resolution. Early, effective fluid resuscitation is a key component in the management of patients with severe sepsis and septic shock with the goal of improving tissue perfusion. The best fluid in this early resuscitation phase has been and still is under debate. The aim of this study is to evaluate the effect of Three different Fluids(Albumin 5%, Normal Saline, HES 130 kD) on microcirculation in severe sepsis/septic shock patients using Sidestream Dark Field (SDF) Microscopy and Near-Infrared Spectroscopy (NIRS) analysis.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
45
Inclusion Criteria
  • Adult patients will be enrolled within 24 hrs of onset of severe sepsis/septic shock with an indication for fluid bolus administration.
Exclusion Criteria
  • Liver cirrhosis
  • shock from other causes
  • Oral injuries (precluding SDF imaging)
  • Severe peripheral vascular disease, dialysis fistula, or mastectomies precluding safe forearm occlusion
  • Age < 18 years

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Microcirculatory perfusion and flow variables1 hour after fluid bolus

obtained by Sidestream Dark Field (SDF) microscopy

change in microcirculatory and oxygenation variables1 hour after fluid bolus compared to baseline microcirculatory and oxygenation variables

obtained by both SDF and NIRS

Muscle tissue oxygenation and oxygen consumption1 hour after fluid bolus

using Near Infrared spectroscopy (NIRS)

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

St. John's Mercy Medical Center

🇺🇸

St. Louis, Missouri, United States

St. John's Mercy Medical Center
🇺🇸St. Louis, Missouri, United States

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