Mitochondrial Function in Septic Patients

• Status: Completed
• Trial end date: 2019-12-31
• Target enrollment: 0
• Participant gender: All

Summary

Aim #1 To investigate the prevalence, risk and correlation of the level of sepsis with mitochondrial dysfunction in sepsis patients Aim 1.1 To investigate the prevalence of mitochondria dysfunction among sepsis patients Aim 1.2 To investigate the risk associated with mitochondrial dysfunction in sepsis patients.

Aim 1.3 To investigate the association between sepsis severity (SOFA scoring system) and the degree of mitochondrial dysfunction Aim #2 To investigate the association of mitochondrial dysfunction in sepsis with ScvO2, lactate and ∆PCO2 Aim 3.1 To investigate the therapeutic efficacy of steroids on the improvement mitochondrial function in sepsis patients Aim 3.2. To investigate the efficacy of steroids on the reduction mortality rate in sepsis patients with norepinephrine-resistant hypotension

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Chiang Mai University
• Treatments: Cortisol succinate; Hydrocortisone; Hydrocortisone 17-butyrate 21-propionate; Hydrocortisone acetate

Criteria

Inclusion Criteria:

1. Adults (≥18 years of age)

2. Diagnosis of sepsis within 1 hour after presentation to the emergency department:

known or presumed infection and SOFA score > 2 (table1)

3. Norepinephrine-resistant hypotension (refractory hypotension and not response to norepinephrine dose ≥ 0.5 mcg/k/min)

Exclusion Criteria:

1. Known pregnancy

2. Primary diagnosis of:

1. acute cerebral vascular event

2. acute coronary syndrome

3. acute cardiogenic pulmonary edema

4. status asthmaticus

5. major cardiac arrhythmia (as part of primary diagnosis)

6. seizure

7. drug overdose

8. injury from burn or trauma

3. Hemodynamic instability due to active hemorrhage

4. Requirement for immediate surgery

5. Do-Not-Attempt-Resuscitation (DNAR) order

6. Advanced directives restricting implementation of the resuscitation protocol

7. Transferred from another in-hospital setting

8. Sepsis or septic shock is not final diagnosis

9. Known history of HIV infection with suspected or known Cluster of differentiation 4 (CD4) <100 /mm2

10. Contraindication to central venous catheterization

11. Contraindication to blood transfusion

12. Attending clinician deems aggressive resuscitation unsuitable

13. Known history of HIV infection with suspected or known CD4 <100 /mm2

14. Neurodegenerative disease (effected mitochondria function)

15. known case adrenal insufficiency or chronic steroid user (Patient in this group should receive Hydrocortisone)