NT-proBNP in ICU Postoperative/Posttraumatic Patients With Shock (NICUPS)
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Purpose
The purpose of this study is to determine the course of NT-proBNP plasma concentrations in the context of confounding parameters in postoperative/posttraumatic critically ill patients with severe SIRS/sepsis and shock.
| Condition |
|---|
|
SIRS Sepsis Shock Critically Ill Multiple Organ Dysfunction Syndrome |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | NT-proBNP in Postoperative/Posttraumatic Critically Ill Patients With Severe SIRS/Sepsis and Shock |
- Association between NT-proBNP and myocardial dysfunction [ Time Frame: First days with SIRS/shock with relation to distinct norepinephrine and epinephrine drug concentrations ] [ Designated as safety issue: No ]
- Pattern of NT-proBNP, biomarkers and surface markers on leukocytes [ Time Frame: First days with and without severe SIRS/sepsis or shock dependent on distinct norepinephrine and epinephrine drug concentrations, before demission from ICU or death ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples With DNA
Whole blood, serum, white blood cells
| Enrollment: | 51 |
| Study Start Date: | August 2008 |
| Study Completion Date: | December 2012 |
| Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
A
Postoperative/posttraumatic critically ill patients with severe SIRS/sepsis and shock
|
Detailed Description:
In the recent sepsis-definitions, myocardial depression is included in the definition of severe sepsis, indicated as lowered cardiac index or echocardiographically documented cardiac dysfunction. Myocardial dysfunction occurs in greater than 50% of patients with severe sepsis and septic shock. In this context, B-type natriuretic peptid (BNP) from ventricular myocytes may serve as a surrogate biomarker for the evaluation and quantification of myocardial dysfunction. Biologically active BNP is cleaved into inactive NT-proBNP, which is supposed to be a better marker of myocardial dysfunction and prognosis in patients with severe sepsis and septic shock. However, severity of illness dependent association of myocardial dysfunction, especially left ventricular diastolic function, dosage of norepinephrine, NT-proBNP and biomarker plasma concentrations has not been systematically investigated in postoperative/posttraumatic patients in septic shock or volume-deficiency/hemorrhagic shock. Moreover, data regarding NT-proBNP plasma concentrations and renal function in postoperative/posttraumatic patients are sparse. Therefore, this prospective observational study will enroll n= 200 postoperative/posttraumatic patients to monitor longitudinally NT-proBNP, biomarkers, and cell surface markers on leukocytes to find out whether there is a discriminating pattern of myocardial dysfunction, NT-proBNP and biomarkers in patients with non-septic or septic shock, respectively, and with beneficial or harmful outcome.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Postoperative/posttraumatic critically ill patients admitted to the intensive care unit
Inclusion Criteria:
- Critically ill, postoperative/posttraumatic patients with severe systemic inflammatory response syndrome (SIRS) or severe sepsis
Exclusion Criteria:
- Life expectancy < 24 hours
- Participation in other trials
- Known or suspected pregnancy
- Contraindications for transesophageal echocardiography (TEE): severe disease of the esophagus (hernia, strictures, esophageal resection, severe bleeding disorders)
Contacts and Locations| Germany | |
| Clinic of Anesthesiology | |
| Ulm, Germany, 89070 | |
| Principal Investigator: | Manfred Weiss, MD, MBA | Clinic of Anesthesiology, University Hospital Medical School, Steinhoevelstrasse 9, 89070 Ulm, Germany |
More Information
No publications provided
| Responsible Party: | Manfred Weiss, Professor, MD, MBA, University of Ulm |
| ClinicalTrials.gov Identifier: | NCT00736723 History of Changes |
| Other Study ID Numbers: | Anae_ICU_Ulm_NT-proBNP |
| Study First Received: | August 14, 2008 |
| Last Updated: | February 5, 2013 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by University of Ulm:
|
NT-proBNP myocardial dysfunction humans patients polytrauma complement inflammation inflammatory response biomarkers cytokines cell surface markers functional polymorphisms infections systemic inflammatory response syndrome |
SIRS sepsis severe sepsis shock organ dysfunctions SOFA severity of disease APACHEII SAPSII SPAPS3 length of stay outcome mortality |
Additional relevant MeSH terms:
|
Critical Illness Multiple Organ Failure Sepsis Toxemia Shock |
Disease Attributes Pathologic Processes Infection Systemic Inflammatory Response Syndrome Inflammation |
ClinicalTrials.gov processed this record on June 17, 2013