A prospective observational study to explore the correlation of peripheral arterial pulse/resistance index, organ function, and inflammation in patients with septic shock

Abstract

Introduction: The evaluation of the functional status of blood vessels, especially the arterial system, plays a very important role in the judgment of the condition of septic shock patients and the guidance of resuscitation programs and the judgment of the therapeutic effect. We aimed to design an observational study protocol to explore the correlation of peripheral arterial pulse/resistance index, organ function and inflammation in patients with septic shock. Methods and analysis: A total of 60 patients with septic shock in the Affiliated Hospital of Southwest Medical University from June 2020 to September 2020 and 20 healthy volunteers will be enrolled. Total of 60 patients with septic shock will be randomly divided into 20 groups by lot method. Group 1: fluid resuscitation; Group 2: fluid resuscitation + norepinephrine; Group 3: fluid resuscitation + norepinephrine + ulinastatin; Group 4: healthy control group. Fluid resuscitation is an early goal-directed fluid resuscitation in which norepinephrine is adjusted by a senior intensive care unit specialist for clinical presentation and ulinastatin is pumped at 20,000 U/h. Index including vascular ultrasound, inflammatory factors, organ function will be collected and analyzed. Discussion: Existing studies on septic shock focus on hemodynamics of the heart, brain, and kidney, while the differences in blood flow between peripheral blood vessels and protective renal vessels may be consistent, and imaging analysis is still lacking. This study protocol aims to explore the correlation of peripheral arterial pulsation index/resistance index, organ function, and inflammation in patients with septic shock. Trial registration: Chinese Clinical trial registry: ChiCTR2000031565

Clinical efficacy of ulinastatin in the treatment of unliquefied pyogenic liver abscess complicated by septic shock: A randomized controlled trial

“…This finding confirms the effectiveness of UTI in controlling infections and suppressing inflammatory responses with good efficacy, including endotoxin, which is consistent with previous studies on UTI efficacy in treating pulmonary, urinary, and post‐traumatic infections 30,31 . Patients in the study group showed subjective improvement in inflammation control, as indicated by a reduction in the ICU stay, duration of fever, and maintenance of vasoactive drugs, when compared to the control group, by 16−24 h. This result is consistent with the findings reported by Hu et al 44 …”

“…This finding confirms the effectiveness of UTI in controlling infections and suppressing inflammatory responses with good efficacy, including endotoxin, which is consistent with previous studies on UTI efficacy in treating pulmonary, urinary, and post-traumatic infections. 30,31 Patients in the study group showed subjective improvement in inflammation control, as indicated by a reduction in the ICU stay, duration of fever, and maintenance of vasoactive drugs, when compared to the control group, by 16−24 h. This result is consistent with the findings reported by Hu et al 44 The liver of patients with an unliquefied bacterial LA, combined with infectious shock, is one of the more heavily involved target organs in these patients, and the production of large amounts of inflammatory mediators in the body during SIRS easily induces apoptosis of hepatocytes, which together with tissue ischemia-reperfusion injury and microthrombus formation, can easily lead to acute liver injury and even liver failure. 7,15,17,18 Changes in indices, such as TBil, ALT, and AST, reflect the severity of damage to liver function, and some studies have linked hyperbilirubinemia to eventual death from PLA.…”

Efficacy of Etimicin Sulfate Combined with Cefotaxime Sodium in the Treatment of Patients with Septic Shock and Effect on Serum Inflammatory Factor Levels and Immune Function

“…The pathogenic microorganisms in the infected lesions and the endotoxins and exotoxins released can activate complement and stimulate neutrophils and macrophages to release a large amount of IL-6, TNF- α , and other inflammatory factors which participate in the inflammatory response [ 17 , 18 ]. PCT in the human body is at a very low level under normal circumstances, and it will increase significantly when the body has a serious infection or sepsis, which is an important indicator for observing the infection of the body [ 19 ].…”