Garrity Kevin, Docherty Christie, Mangion Kenneth, Woodward Rosie, Shaw Martin, Roditi Giles, Shelley Benjamin, Quasim Tara, McCall Philip, McPeake Joanne
Academic Unit of Anaesthesia, Critical Care and Peri-Operative Medicine, University of Glasgow, Glasgow.
Glasgow Royal Infirmary, NHS Greater Glasgow & Clyde, Glasgow.
CHEST Crit Care. 2024 Mar;2(1):100050. doi: 10.1016/j.chstcc.2024.100050.
Sepsis is one of the most common reasons for ICU admission and a leading cause of mortality worldwide. More than one-half of survivors experience significant physical, psychological, or cognitive impairments, often termed post-intensive care syndrome (PICS). Sepsis is recognized increasingly as being associated with a risk of adverse cardiovascular events that is comparable with other major cardiovascular risk factors. It is plausible that sepsis survivors may be at risk of unidentified cardiovascular disease, and this may play a role in functional impairments seen after ICU discharge.
What is the prevalence of myocardial dysfunction after an ICU admission with sepsis and to what extent might it be associated with physical impairments in PICS?
Characterisation of Cardiovascular Function in ICU Survivors of Sepsis (CONDUCT-ICU) is a prospective, multicenter, pilot study characterizing cardiovascular function and functional impairments in survivors of sepsis taking place in the west of Scotland. Survivors of sepsis will be recruited at ICU discharge and followed up 6 to 10 weeks after hospital discharge. Biomarkers of myocardial injury or dysfunction (high sensitivity troponin and N-terminal pro B-type natriuretic peptide) and systemic inflammation (C-reactive protein, IL-1β, IL-6, IL-10, and tumor necrosis factor alpha) will be measured in 69 patients at recruitment and at follow-up. In addition, a cardiovascular magnetic resonance substudy will be performed at follow-up in 35 patients. We will explore associations between cardiovascular magenetic resonance indexes of cardiac function, biomarkers of cardiac dysfunction and inflammation, and patient-reported outcome measures.
CONDUCT-ICU will provide data regarding the cause and prevalence of cardiac dysfunction in survivors of sepsis and will explore associations with functional impairment. It will provide feasibility data and operational learning for larger studies investigating mechanisms of functional impairment after ICU admission and the association between sepsis and adverse cardiovascular events.
ClinicalTrials.gov; No.: NCT05633290; URL: www.clinicaltrials.gov.
脓毒症是重症监护病房（ICU）收治患者的最常见原因之一，也是全球范围内主要的死亡原因。超过一半的幸存者会出现严重的身体、心理或认知障碍，通常称为重症监护后综合征（PICS）。脓毒症越来越被认为与不良心血管事件风险相关，这一风险与其他主要心血管危险因素相当。脓毒症幸存者可能存在未被识别的心血管疾病风险，这可能在ICU出院后出现的功能障碍中起作用。
因脓毒症入住ICU后心肌功能障碍的患病率是多少，以及它在多大程度上可能与PICS中的身体障碍相关？
脓毒症ICU幸存者心血管功能特征研究（CONDUCT-ICU）是一项前瞻性、多中心的试点研究，旨在对苏格兰西部脓毒症幸存者的心血管功能和功能障碍进行特征描述。脓毒症幸存者将在ICU出院时招募，并在出院后6至10周进行随访。在招募时和随访时，将对69名患者测量心肌损伤或功能障碍的生物标志物（高敏肌钙蛋白和N末端B型利钠肽原）以及全身炎症（C反应蛋白、白细胞介素-1β、白细胞介素-6、白细胞介素-10和肿瘤坏死因子α）。此外，将在35名患者随访时进行心血管磁共振亚研究。我们将探讨心脏功能的心血管磁共振指标、心脏功能障碍和炎症的生物标志物与患者报告的结局指标之间的关联。
CONDUCT-ICU将提供有关脓毒症幸存者心脏功能障碍的原因和患病率的数据，并将探讨与功能障碍的关联。它将为调查ICU入院后功能障碍机制以及脓毒症与不良心血管事件之间关联的更大规模研究提供可行性数据和操作经验。
ClinicalTrials.gov；编号：NCT05633290；网址：www.clinicaltrials.gov 。
