MICRORESUS
Research type
Research Study
Full title
Microcirculatory guided goal directed fluid therapy in septic shock; a feasibility study
IRAS ID
252182
Contact name
Sam Hutchings
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Patients with severe infection (septic shock) often exhibit failure to supply vital oxygen and substrate to cells due, in part, to deficiencies in their circulatory system. These problems are multi factorial and include disturbances in the heart and both large and small blood vessels. This problem is often associated with fluid loss from the circulation and an inherent part of the treatment of such patents is the administration of fluid to the circulation. As under and over administration of such fluid is potential harmful, such fluid resuscitation is usually targeted at specific end points. These end points are usually reflective of the responses of the heart and large blood vessels, due to ease of measurement. However, as the ultimate outcome of fluid resuscitation in septic shock is the restoration of oxygen and substrate delivery to tissues and cells a technique that can more directly assess flow at the level of very small blood vessels would potentially be of greater benefit in directing this therapy. Such a technique exists - Sublingual Incident Dark Field Video microscopy (The Cytocam video microscope (Braedius Medical, Huizen, The Netherlands) CE marked equipment being used for its intended purpose )- but is largely confined to use as a research tool, not yet established in regular clinical practice. We have devised a novel point of care score to enable the technique to be translated to use at the bedside as part of an integrated goal directed therapy protocol and wish to assess the feasibility of such an approach. Should the technique prove feasible, we would aim to move to a larger interventional trial powered to assess the efficacy of such an approach.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
19/SC/0010
Date of REC Opinion
18 Jan 2019
REC opinion
Favourable Opinion