Tissue metabolism and blood flow in critically ill patients

• Research type

  Research Study

• Full title

  An observational study in critically ill patients of the relationship between tissue blood flow and metabolism and their severity of disease and outcomes

• IRAS ID

  159977

• Contact name

  Daniel Martin

• Contact email

  daniel.martin@ucl.ac.uk

• Sponsor organisation

  Royal Free Hospital

• Duration of Study in the UK

  1 years, 11 months, 18 days

• Research summary

  There remains much to be learnt regarding what determines favourable survival in critically ill patients. Traditional teaching of maintaining adequate delivery of oxygen to organs and tissues becomes ever less important as disease progresses. As our understanding of tissue metabolism and the interaction of complex cellular systems improves a concept has developed that may explain why measures of oxygen delivery frequently fail to differentiate those patients with good outcomes from those who ultimately fail to recover.

  The aim of our observational study of critically ill patients admitted to intensive care is to characterise three key physiological characteristics that we believe are likely to be closely interrelated and may have a significant influence on tissue oxygen balance. These mechanisms have been selected from our previous studies in which healthy volunteers were exposed to low levels of oxygen at high altitude.

  We aim to quantify:

  i) Nitric oxide activity – a naturally occurring molecule that plays an important role in regulating tissue function when oxygen levels are low
  ii) Blood flow in the microcirculation – these are the smallest blood vessels in the body where oxygen enters the tissues
  iii) Mitochondrial metabolism – the part of every cell in the body that uses oxygen to generate energy

  These physiological measures will be correlated to disease severity, the degree of organ failure present and survival. Mechanisms underlying organ failure may be elucidated through the interaction of the measured phenotypes.

  A further aim is to demonstrate the feasibility of collecting complex physiological measures in critically ill patients. Findings from the study will be used along with other data from our research group to develop a subsequent interventional study.
  
  Newly developed methods for quantifying tissue physiology in association with novel biomarkers could improve outcomes in critical illness by permitting an individualised approach to clinical interventions.

• REC name

  London - Camden & Kings Cross Research Ethics Committee

• REC reference

  14/LO/1832

• Date of REC Opinion

  23 Feb 2015

• REC opinion

  Further Information Favourable Opinion