The Effect of Vasopressor Therapy on Renal Perfusion in Septic Shock

Launched by KING'S COLLEGE HOSPITAL NHS TRUST · Jan 28, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how certain medications, specifically vasopressin and angiotensin II, affect blood flow to the kidneys in patients experiencing septic shock, a serious condition caused by infections that can lead to organ failure. Acute kidney injury (AKI) is a common complication in these patients, and this trial aims to understand if these medications can improve kidney blood flow, potentially leading to better outcomes.

To participate in this study, patients must be admitted to intensive care within the last 48 hours and show signs of infection, as well as have specific changes in their health status that indicate a worsening condition. They should also be receiving a specific dose of norepinephrine, a medication used to increase blood pressure. However, certain individuals, like those with severe chronic kidney disease or other serious heart and blood vessel conditions, are not eligible for this trial. Participants will receive treatment and monitoring as part of the study, helping researchers learn more about the relationship between these medications and kidney health in septic shock.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Within 48 hours of intensive care admission
• • Evidence of suspected or confirmed infection
• • Sequential Organ Failure (SOFA) score increase of 2 or more (assuming a baseline of 0 if no previous measures)
• • Requirement for norepinephrine infusion as the sole vasopressor agent in a dose of \>0.1mcg/kg/min
• • Lactate \>2mmol/L at any stage prior to randomisation
• Exclusion Criteria:
• • Known intolerance to Sonovue™ contrast medium, vasopressin or angiotensin II
• • Patients receiving other vasoactive drugs in addition to norepinephrine
• • Patients with known chronic kidney disease (CKD) stage 4 or 5 (baseline glomerular filtration rate (GFR) \<30mls/min)
• • Patients receiving extra corporal membrane oxygenation (ECMO)
• • Patients with acute occlusive coronary syndromes requiring intervention
• • Patients with mesenteric ischaemia
• • Patients with a history or presence of aortic dissection or abdominal aortic aneurysm
• • Patients with Raynaud's syndrome or acute vaso-occlusive conditions
• • Pregnancy