Severe Sepsis Clinical Trial
Official title:
Effects of Acute Systemic Inflammation on Arterial Stiffness and Microcirculation.
This study aims to assess the effect of acute inflammation on arterial stiffness and
microcirculation. Patients with severe sepsis will be compared with age-, sex- and
cardiovascular risk factors-matched controls.
The primary outcome is the carotid-femoral pulse wave velocity. The other outcome measures
are: systemic hemodynamics (systolic, diastolic, mean and pulse blood pressures, heart rate,
cardiac output, left ventricular ejection fraction, systemic vascular resistances), central
hemodynamics (aortic systolic, diastolic, mean and pulse pressures, and augmentation index),
thenar tissue oxygen saturation, biological makers of inflammation (plasma fibrinogen,
C-reactive protein, interleukin-6, matrix metalloproteinases -2, -9, tissue inhibitor of
metalloproteinase 1), and plasma catecholamine concentrations (epinephrine, norepinephrine).
In a model of acute inflammation induced by salmonella typhi vaccination in healthy
volunteers, it has been shown that acute systemic inflammation increased arterial stiffness.
Since increased arterial stiffness (assessed by carotid-femoral pulse wave velocity) is an
independent prognosis marker of cardiovascular risk in many chronic diseases such as
hypertension, renal failure or diabetes mellitus, it could also be a marker of severity in
acute inflammation states. Severe sepsis is a leading cause of hospitalisation in intensive
care units, and constitutes a state of acute inflammation. It remains however to confirm that
arterial stiffness is increased in this clinical conditions before evaluating its prognosis
value.
This study aims to assess the effect of severe sepsis on arterial stiffness and
microcirculation. Patients with severe sepsis will be compared with age-, sex- and
cardiovascular risk factors-matched controls.
The primary outcome is the carotid-femoral pulse wave velocity. The other outcome measures
are: systemic hemodynamics (systolic, diastolic, mean and pulse blood pressures, heart rate,
cardiac output, left ventricular ejection fraction, systemic vascular resistances), central
hemodynamics (aortic systolic, diastolic, mean and pulse pressures, and augmentation index),
thenar tissue oxygen saturation, biological makers of inflammation (plasma fibrinogen,
C-reactive protein, interleukin-6, matrix metalloproteinases -2, -9, tissue inhibitor of
metalloproteinase 1), and plasma catecholamine concentrations (epinephrine, norepinephrine).
;
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