About this trial
Acute kidney injury (AKI) is a common complication of septic shock and together these conditions carry a high mortality risk. In septic patients who develop severe AKI renal cortical perfusion is deficient despite normal macrovascular organ blood flow. This intra-renal perfusion abnormality may be amenable to pharmacological manipulation, which may offer mechanistic insight into the pathophysiology of septic AKI. The aim of the current study is to investigate the effects of vasopressin and angiotensin II on renal microcirculatory perfusion in a cohort of patients with septic shock.
Eligibility criteria
Qualifiers
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
Disqualifiers
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)
Trial design
Treatments tested in this trial
- Angiotensin II
- Vasopressin
- Norepinephrine
Treatment groups
Sponsors and collaborators
King's College Hospital NHS Trust
Lead sponsor
European Society of Intensive Care Medicine
Collaborator
Royal Centre for Defence Medicine
Collaborator