The Effect of Vasopressor Therapy on Renal Perfusion in Septic Shock

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorKing's College Hospital NHS Trust

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

45 Participants
are divided into 3 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