Effects of Fluid Therapy on Peripheral TIssse Perfusion During Sepsis/Septic Shock

Sepsis Clinical Trial

— REPTILOS  

Official title:

Effects of Fluid Therapy on Peripheral TIssue Perfusion During Sepsis/Septic Shock

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05094856
• Other study ID #: APHP210918
• Status: Completed
• Start date: February 23, 2022
• Est. completion date: March 16, 2023

Study information

• Verified date: June 2024
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Compare the effect of volume expansion by saline versus albumin on the correction of peripheral tissue hypoperfusion by measuring Index skin recoloration time (CRT) at H0 and H1

Description:

This is a transversal study allowing to compare the effect of volume expansion by saline versus albumin on the correction of peripheral tissue hypoperfusion Design: • A multicentric, open-label, transversal study Sample size : 60 patients Assessement: Between the admission to intensive care and 48 hours after admission, the patient will be included after collection of the non-opposition form. The patient will receive volume expansion either by 0.9% saline (500mL) or by 20% albumin (100mL) over 15 minutes. Repeated clinical measurements will be performed at H0, H0.5 and H1 (respectively at 0, 30 and 60 minutes). A blood sample will be taken just before the volume expansion and 4 hours after, at the same time as the samples usually taken as part of the treatment. No interim analysis is planned. Analysis will be performed at the end of the study after data review and freezing of data base.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 61
• Est. completion date: March 16, 2023
• Est. primary completion date: February 16, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age> 18 years old
• Sepsis or
• Septic shock within 24 hours of admission to intensive care with a stable dose of norepinephrine for at least 2 hours to maintain MAP> 65mmHg
• CRT index> 3 seconds despite the initial resuscitation (administration of antibiotics, volume expansion by crystalloids of 20 mL / Kg, noradrenaline started) between the admission to intensive care and H48 from admission to intensive care
• Non-opposition of the patient collected by the doctor in charge of the patient between H0 and H6 after admission if the patient is vigilant, otherwise a procedure for collecting non-opposition from relatives will be carried out with collection of the non-opposition of the patient once he is able to give it.
• Affiliation to a social security regimen (excluding AME)

Exclusion Criteria:

• Patient COVID-19 (+) with respiratory impairment
• Pregnant and lactating woman
• Patient under Guardianship / Curatorship
• Refusal to participate
• CRT not evaluable (dark or damaged skin)
• Moribund patient
• Estimated life expectancy less than 1 month
• Participation in another interventional research involving the human person or period of exclusion at the end of a previous research involving the human person

Related Conditions & MeSH terms

• Sepsis
• Septic Shock
• Shock
• Shock, Septic
• Toxemia

Locations

Country	Name	City	State
France	Intensive care department, Hôpital Saint Antoine	Paris

Sponsors (3)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris	Grifols (funder), Institut National de la Santé Et de la Recherche Médicale, France

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Compare the effect of volume expansion by saline versus albumin on the correction of peripheral tissue hypoperfusion by measuring Index skin recoloration time (CRT) at H0 and H1	Proportion of patients who normalized their cutaneous re-coloring time (CRT) measured at the index level, defined by a value <3 seconds at H1. The clinical measurement method has been standardized in the participating departments and has been used for several years in clinical practice.	1 hour
Secondary	CRT Measure	Clinical tissue perfusion parameters will be measured clinically every 30 minutes, as usual in patients with septis/septic shock.	4 hours
Secondary	mottling score measure	Clinical tissue perfusion parameters will be measured clinically every 30 minutes, as usual in patients with sepsis/septic shock.	4 hours
Secondary	Diuresis	Clinical tissue perfusion parameters will be measured clinically every 30 minutes, as usual in patients with sepsis/septic shock.	4 hours
Secondary	Variations in cardiac flow	Clinical tissue perfusion parameters will be measured clinically every 30 minutes, as usual in patients with sepsis/septic shock.	4 hours
Secondary	Variations in the biological parameters	Variations in the biological parameters between H0 and H4 will be analyzed from 5 ml of blood taken in addition, in accordance with the usual practice, in a sepsis/septic shock: IL-6, IL-1b, Il-8, TNFa, IL-10; Syndecan-1, heparan sulfat, hyaluronat; Circulating microparticles	4 hours