Hu Lirong, Leng Bo, Wu Changxue, Xue Yuting
ICU, Affiliated Hospital of Southwest Medical University.
Department of General Surgery, Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University.
Medicine (Baltimore). 2020 May;99(20):e20235. doi: 10.1097/MD.0000000000020235.
The evaluation of the functional status of blood vessels, especially the arterial system, plays a very important role in the judgment of the condition of septic shock patients and the guidance of resuscitation programs and the judgment of the therapeutic effect. We aimed to design an observational study protocol to explore the correlation of peripheral arterial pulse/resistance index, organ function and inflammation in patients with septic shock.
A total of 60 patients with septic shock in the Affiliated Hospital of Southwest Medical University from June 2020 to September 2020 and 20 healthy volunteers will be enrolled. Total of 60 patients with septic shock will be randomly divided into 20 groups by lot method. Group 1: fluid resuscitation; Group 2: fluid resuscitation + norepinephrine; Group 3: fluid resuscitation + norepinephrine + ulinastatin; Group 4: healthy control group. Fluid resuscitation is an early goal-directed fluid resuscitation in which norepinephrine is adjusted by a senior intensive care unit specialist for clinical presentation and ulinastatin is pumped at 20,000 U/h. Index including vascular ultrasound, inflammatory factors, organ function will be collected and analyzed.
Existing studies on septic shock focus on hemodynamics of the heart, brain, and kidney, while the differences in blood flow between peripheral blood vessels and protective renal vessels may be consistent, and imaging analysis is still lacking. This study protocol aims to explore the correlation of peripheral arterial pulsation index/resistance index, organ function, and inflammation in patients with septic shock.
Chinese Clinical trial registry: ChiCTR2000031565.
血管功能状态的评估，尤其是动脉系统，在脓毒性休克患者病情判断、复苏方案指导及治疗效果判断中起着非常重要的作用。我们旨在设计一项观察性研究方案，以探讨脓毒性休克患者外周动脉脉搏/阻力指数、器官功能与炎症之间的相关性。
2020年6月至2020年9月，西南医科大学附属医院将招募60例脓毒性休克患者和20名健康志愿者。60例脓毒性休克患者将通过抽签法随机分为20组。第1组：液体复苏；第2组：液体复苏+去甲肾上腺素；第3组：液体复苏+去甲肾上腺素+乌司他丁；第4组：健康对照组。液体复苏采用早期目标导向性液体复苏，由重症监护病房资深专家根据临床表现调整去甲肾上腺素用量，乌司他丁以20000U/h的速度泵入。将收集并分析包括血管超声、炎症因子、器官功能等指标。
现有的关于脓毒性休克的研究主要集中在心脏、大脑和肾脏的血流动力学方面，而外周血管与肾脏保护性血管之间的血流差异可能具有一致性，且仍缺乏影像学分析。本研究方案旨在探讨脓毒性休克患者外周动脉搏动指数/阻力指数、器官功能与炎症之间的相关性。
中国临床试验注册中心：ChiCTR2000031565。
