REPERFUSE
Research type
Research Study
Full title
The effect of vasopressor therapy on renal perfusion in patients with septic shock – a mechanistically focussed randomized control study
IRAS ID
328797
Contact name
Sam Hutchings
Contact email
Sponsor organisation
Kings College Hospital NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Kidney injury is an important problem for the sickest patients leading to a significantly increased risk of death. Whilst we already know that the kidney is vulnerable to a reduction in blood flow that can come as a result of severe infection, we have less information about why some patients develop a prolonged kidney injury even after blood flow to the kidney has been seemingly restored. New and emerging techniques have allowed us to directly look at blood flow in the very small blood vessels inside the kidney using contrast enhanced ultrasound (CEUS). In addition innovative adaptation of technology allows us to look at the level of oxygen in the urine which could offer an insight into the health of the kidney without the need for complex user dependent tests.
Critically ill patients with severe sepsis receive drugs called vasopressors which maintain blood pressure and flow to key organs. The commonest drug is called noradrenaline but other drugs are also used. Data from experimental and clinical studies has suggested that specific vasopressor drugs differentially affect kidney blood flow and may change the risk of developing kidney injury
We propose a prospective randomised controlled study that uses two techniques (CEUS and urinary oxygen measurement) to test the impact of vasopressor therapy on kidney function in critically ill patients. In this interventional study we will randomise patients with severe infection to receive one of three drug combinations (Noradrenaline only , Vasopressin + Noradrenaline and Angiotensin II + Noradrenaline) and will assess the effects on kidney health and function.
REC name
London - South East Research Ethics Committee
REC reference
23/LO/0868
Date of REC Opinion
23 Oct 2023
REC opinion
Further Information Favourable Opinion