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Acute kidney injury (AKI) is a complication of traumatic haemorrhagic shock (THS) and together these conditions increase mortality risk. Although septic shock patients who develop severe AKI are known to develop hypoperfusion of the renal cortex, little is known regarding intra-renal perfusion changes in THS. The aim of the current study is to investigate the effects of THS on renal microcirculatory perfusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Traumatic haemorrhagic shock |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound (including contrast enhanced ultrasound) | Device | Ultrasound measures: contrast enhanced ultrasound (CEUS) of the kidney, venous excess ultrasound (VExUS), echocardiography |
| Measure | Description | Time Frame |
|---|---|---|
| Cortical mean transit time (mTT) measured in seconds | Contrast enhanced ultrasound measure of renal cortical tissue blood flow | Measured at enrollment, +24 hours and + 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Cortical perfusion index (PI) measured in arbitrary units | Contrast enhanced ultrasound measures of renal cortical tissue blood flow | Measured at enrollment, +24 hours and + 48 hours |
| Cortical wash in rate (WiR) measured in arbitrary units |
| Measure | Description | Time Frame |
|---|---|---|
| Perfused vessel density (PVD) measured in millimetres per square millimetre | Incident dark field video microscopy measures of the systemic microcirculation | Measured at enrollment, +24 hours and + 48 hours |
| Microvascular flow index (MFI) (unitless score from 0 to 3 where 3 is the value see in health) |
Inclusion Criteria:
Exclusion Criteria:
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Patients admitted to critical care with traumatic haemorrhagic shock who fulfill the inclusion and do no meet any exclusion criteria.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sam Hutchings | Contact | +442032994957 | sam.hutchings@nhs.net |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| King's College Hospital | Recruiting | London | SE5 9RS | United Kingdom |
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Plasma / serum / urine
| Sublingual incident dark field videomicroscopy | Device | Sublingual incident dark field (IDF) videomicroscopy |
|
| Urinary oxygen tension. | Device | Continuous urinary oxygen tension |
|
Contrast enhanced ultrasound measures of renal cortical tissue blood flow
| Measured at enrollment, +24 hours and + 48 hours |
| Urinary oxygen tension (pO2) across 24 hours study period measured in millimetres of mercury (mmHg) | Mean urinary pO2 | Across 48 hour study period |
Incident dark field video microscopy measures of the systemic microcirculation |
| Measured at enrollment, +24 hours and + 48 hours |
| Syndecan 1, angiopoietin 1 & 2, Interleukin 6 & 8 (IL-6, IL-8) and tissue necrosis factor (TNF). All measured in nanograms per millilitre (ng/ml) | Biomarker analysis - markers of inflammation and endothelial activation/function | Measured at enrollment and + 48 hours |
| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D014463 | Ultrasonography |
| ID | Term |
|---|---|
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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