PERTAKI
Research type
Research Study
Full title
Renal perfusion and the development of AKI following traumatic injury – A longitudinal observational cohort study
IRAS ID
334289
Contact name
Sam Hutchings
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Trauma is a leading cause of death worldwide. Some early deaths occur due to uncontrolled blood loss, whilst others occur later as a result of multiple organ dysfunction syndrome (MODS). In these patients the kidney is frequently affected, sometimes to the point of failure.
Significant trauma causes profound effects on the blood flow to the organs with effects on the overall circulating blood volume as well as the tone and integrity of the blood vessels. Furthermore, recent increases in our knowledge of the dynamics of blood flow in very small blood vessels, termed the microcirculation, has led us to the realisation that disturbances in flow through these vessels is associated with the development of MODS. Although harder to measure than the flow in large blood vessels, recently introduced hand-held microscopes have enabled such assessment to take place at the bedside.
The kidney is one of the most vulnerable organs to changes in blood flow and volume. Traditional teaching has focussed on the maintenance of circulating blood volume and tone in an attempt to ameliorate these effects but this almost certainly oversimplifies what is a complex situation. Furthermore, the administration of large volumes of blood or fluid has been shown to adversely effect patient outcomes following significant trauma. What is required is more intelligent targeting of resuscitation at the levels of the small and large blood vessels of the kidney and to do this we require more evidence as to how these blood vessels respond.
Using novel, minimally invasive monitoring the proposed study will examine both small and large blood vessels in the kidney, the heart and the general circulation as well as kidney tissue oxygenation in patients with significant trauma. We will use this data to shape future treatments with the aim of improving outcomes for patients.
REC name
London - South East Research Ethics Committee
REC reference
24/LO/0157
Date of REC Opinion
18 Mar 2024
REC opinion
Further Information Favourable Opinion