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| Name | Class |
|---|---|
| University Medical Center Groningen | OTHER |
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This study investigates the differens in sodium storage in skin between normal subjects, patients after cardiac surgery and septic patients.
According to the current paradigm ICU-acquired hypernatremia is mainly an iatrogenic problem, caused by sodium overload or water deficit. In spite of several interventions to reduce sodium intake and optimize fluid balance, critically ill patients still develop hypernatremia. These patients also seem to have an inability to excrete sodium, hence develop a positive sodium balance. In animals sodium storage in the third compartment was found. Our hypothesis is that sodium storage in the third compartment is different in critically ill patients and this difference could play a role in the development of ICU-acquired hypernatremia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Septic patients | Patients admitted to the ICU that fulfill the criteria for the systemic inflammatory response syndrome in the presence of a(n expected) new infection. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation. |
| |
| CABG patients | Patients admitted to the ICU after coronary artery bypass grafting. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation. |
| |
| Patients before hip replacement | Patients that will undergo a hip replacement because of arthrosis. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Skin biopsies | Procedure | 2 3mm skin biopsies will be taken |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difference in sodium concentration in skin biopsy between groups | Skin biopsies will be taken within the described time frame, analysis will take place after all biopsies of all subjects are included | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| Measure | Description | Time Frame |
|---|---|---|
| Immunohistochemistry: outcomes of proteoglycans | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients | |
| Immunohistochemistry: binding capacity of proteoglycans | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christiaan Boerma, MD PhD | medical center leeuwarden | Principal Investigator |
| Jaap van den Born, PhD | University Medical Center Groningen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medisch Centrum Leeuwarden | Leeuwarden | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10397213 | Background | Polderman KH, Schreuder WO, Strack van Schijndel RJ, Thijs LG. Hypernatremia in the intensive care unit: an indicator of quality of care? Crit Care Med. 1999 Jun;27(6):1105-8. doi: 10.1097/00003246-199906000-00029. | |
| 23369520 | Background | Waite MD, Fuhrman SA, Badawi O, Zuckerman IH, Franey CS. Intensive care unit-acquired hypernatremia is an independent predictor of increased mortality and length of stay. J Crit Care. 2013 Aug;28(4):405-12. doi: 10.1016/j.jcrc.2012.11.013. Epub 2013 Jan 29. |
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Depending on the requests of the magazine involved.
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| ID | Term |
|---|---|
| D006955 | Hypernatremia |
| ID | Term |
|---|---|
| D014883 | Water-Electrolyte Imbalance |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| D016482 | Urinalysis |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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Slides for microscopic investigations, containing slices of the skin biopsies. These biopsies are only diagnostic and these are specific and only for study properties. Study involvement will not influence diagnostic or therapeutic interventions that are due to common treatment.
| Blood and urine analysis | Other | Measurement of sodium, potassium and kidneyfunction in blood and urine. |
|
| Blood collection for RNA-investigation | Other | A blood sample that, in case of relevant differences between groups, could be used for RNA-profiling. |
|
| Immunohistochemistry: density of lymph capillaries | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| Immunohistochemistry: presence of macrophage influx | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| Quantification of different matrix components / proteoglycans: decorine - if enough tissue is available | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| Quantification of different matrix components / proteoglycans: versican (if enough tissue is available) | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| Quantification of different matrix components / proteoglycans: biglycan- if enough tissue is available | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| mRNA profiling of proteoglycans and synthesizing enzymes by way of RNA-isolation - if enough tissue is available | Different for the separate groups: before hip replacement, within 2 hours after CABG and within 12 hours after admission for septic patients |
| 21468200 | Background | Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolyte Blood Press. 2010 Dec;8(2):72-81. doi: 10.5049/EBP.2010.8.2.72. Epub 2010 Dec 31. |
| 12060595 | Background | Titze J, Krause H, Hecht H, Dietsch P, Rittweger J, Lang R, Kirsch KA, Hilgers KF. Reduced osmotically inactive Na storage capacity and hypertension in the Dahl model. Am J Physiol Renal Physiol. 2002 Jul;283(1):F134-41. doi: 10.1152/ajprenal.00323.2001. |
| 12888617 | Background | Titze J, Lang R, Ilies C, Schwind KH, Kirsch KA, Dietsch P, Luft FC, Hilgers KF. Osmotically inactive skin Na+ storage in rats. Am J Physiol Renal Physiol. 2003 Dec;285(6):F1108-17. doi: 10.1152/ajprenal.00200.2003. Epub 2003 Jul 29. |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |
| D019963 | Clinical Chemistry Tests |
| D003950 | Diagnostic Techniques, Urological |