Peripheral Tissue Perfusion in Intensive Care
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- Это наблюдательное исследование: исследуемое лечение участникам по протоколу не назначают.
- Кому может быть актуально
- Состояния в реестре: Acute Circulatory Failure. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Франция
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Effects of Therapeutic Hemodynamic Interventions on Peripheral Perfusion in Intensive Care
Обзор
Tissue perfusion has been identified as an early prognosis factor in patients admitted to intensive care. However, little is known about the effects of different hemodynamic interventions performed in clinical routine on peripheral tissue perfusion. The aim of this work is to study the kinetics of CRT and local skin blood flow following therapeutic intervention (fluid challenge, vasopressor or inotropic drug).
Подробное описание
Sepsis is today a major cause of morbidity and mortality worldwide. Septic shock, the most serious manifestation of the infection, affects 2 to 20% of intensive care patients. Despite appropriate antibiotic therapy and improved resuscitation strategies based on early treatment, volume expansion and rational use of vasopressors, the mortality rate of shock states remains too high, between 40 and 50%.
Over the past two decades, great advances have been made in the understanding the pathophysiology of septic shock. Microcirculatory abnormalities have been identified as the main cause of organ hypoperfusion and visceral failure leading to death. In addition, several studies in animals and humans have highlighted a discordance between systemic hemodynamic parameters and alterations of small vessels during shock suggesting that microvascular blood flow and tissue perfusion should be analyzed in patients with acute circulatory failure in association with blood pressure and cardiac output. Capillary refill time (CRT), is an easy-to-use, easy-to learn tool to evaluate peripheral tissue perfusion. CRT is a strong predictive factor of organ failure severity and poor outcome in critically ill patients with sepsis. A recent randomized trial reported promising results regarding the use of CRT to guide resuscitation. However, little is known about the impact of treatment on CRT. The aim of this work is to study the kinetics of CRT and local skin blood flow following therapeutic intervention (fluid challenge, vasopressor or inotropic drug).
Первичные конечные точки
- Skin blood flow variations [Срок оценки: continuous monitoring during 1 hour maximum starting just before intervention]
Вторичные конечные точки (5)
- Capillary refill time [Срок оценки: at baseline, 3 timepoints after starting interventions (10, 30 and 60 minutes)]
- Mottling score [Срок оценки: at baseline, 3 timepoints after starting interventions (10, 30 and 60 minutes)]
- correlation between Skin blood flow and CRT (baseline and variations) [Срок оценки: at baseline, at 10, 30 and 60 minutes after intervention]
- correlation between skin blood flow and Cardiac output [Срок оценки: at baseline, at 10, 30 and 60 minutes after intervention]
- correlation between skin blood flow and mean arterial pressure [Срок оценки: at baseline, at 10, 30 and 60 minutes after intervention]
Критерии участия
Критерии включения
- Patients in intensive care unit with acute circulatory failure related to sepsis or cardiac failure requiring therapeutic intervention
Критерии исключения
- Agitation
- Hemorrhagic shock
- Severe skin lesions
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Франция · 1 центр
- Saint -Antoine Hospital_Médecine Intensive Reanimation — Paris
Идентификаторы
NCT: NCT06384287 · APHP231342