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
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Severe Sepsis
- Sponsor
- Mercy Research
- Enrollment
- 45
- Locations
- 1
- Primary Endpoint
- Microcirculatory perfusion and flow variables
- Status
- Completed
- Last Updated
- 9 years ago
Overview
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.
Investigators
Farid Sadaka, MD
Principal Investigator
Mercy Research
Eligibility Criteria
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
Outcomes
Primary Outcomes
Microcirculatory perfusion and flow variables
Time Frame: 1 hour after fluid bolus
obtained by Sidestream Dark Field (SDF) microscopy
change in microcirculatory and oxygenation variables
Time Frame: 1 hour after fluid bolus compared to baseline microcirculatory and oxygenation variables
obtained by both SDF and NIRS
Muscle tissue oxygenation and oxygen consumption
Time Frame: 1 hour after fluid bolus
using Near Infrared spectroscopy (NIRS)