Intravenous iloprost to recruit the microcirculation in septic shock patients?

Dépret, François; Sitbon, Alexandre; Soussi, Sabri; Tymowski, Christian de; Blet, Alice; Fratani, Alexandre; Legrand, Matthieu

doi:10.1007/s00134-017-4935-5

Cited by 22 publications

(12 citation statements)

References 4 publications

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“…This effect was well demonstrated during septic shock [12], but in patients whose macrocirculatory function was already restored, and this effect was not confirmed in a randomised controlled trial [13]. Depret and co-workers interestingly reported three cases of septic shock with severe skin vasoconstriction in which iloprost improved local perfusion without altering cardiac output and arterial pressure [14]. Nevertheless, in this study, macrohaemodynamics had been optimised before starting the treatment.…”

Section: Does the Assessment Of The Microcirculation Trigger Specificmentioning

confidence: 83%

Could resuscitation be based on microcirculation data? We are not sure

Monnet

Saugel

2018

Intensive Care Med

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Section: Does the Assessment Of The Microcirculation Trigger Specificmentioning

confidence: 83%

Could resuscitation be based on microcirculation data? We are not sure

Monnet

Saugel

2018

Intensive Care Med

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“…In this context, the analysis of ventilator-free days or time on ECMO may reveal important information. Further on, intravenous application of iloprost may improve microcirculation, resulting in better kidney recovery in patients with sepsis [37,38]. Patients with ARDS frequently show multiorgan failure.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo trial): a prospective, randomized, multicenter phase II study

Haeberle

Prohaska

Martus

et al. 2020

Trials

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Background: Acute respiratory distress syndrome (ARDS) is caused by rapid-onset (within hours) acute inflammatory processes in lung tissue, and it is a life-threatening condition with high mortality. The treatment of ARDS to date is focused on the prevention of further iatrogenic damage of the lung rather than the treatment of the initial inflammatory process. Several preclinical studies have revealed a beneficial effect of iloprost on the control of pulmonary inflammation, and in a small number of patients with ARDS, iloprost treatment resulted in improved oxygenation. Therefore, we plan to conduct a large multicenter trial to evaluate the effect of iloprost on ARDS. Methods: The Therapeutic Iloprost during ARDS trial (ThIlo trial) is a multicenter, randomized, single blinded, clinical phase II trial assessing the efficacy of inhaled iloprost for the prevention of the development and progression of ARDS in critically ill patients. One hundred fifty critically ill patients suffering from acute ARDS will be treated either by nebulized iloprost or NaCl 0.9% for 5 days. Blood samples will be drawn at defined time points to elucidate the serum levels of iloprost and inflammatory markers during treatment. Mechanical ventilation will be standardized. In follow-up visits at days 28 and 90 as well as 6 months after enrollment, functional status according to the Barthel Index and a health care-related questionnaire, and frailty (Vulnerable Elders Survey) will be evaluated. The primary endpoint is the improvement of oxygenation, defined as the ratio of PaO 2 /FiO 2 . Secondary endpoints include 90day all-cause mortality, Sequential Organ Failure Assessment scores during the study period up to day 90, the duration of mechanical ventilation, the length of intensive care unit (ICU) stay, ventilator-associated pneumonia, delirium, ICU-acquired weakness, and discharge localization. The study will be conducted in three university ARDS centers in Germany. Discussion: The results of the ThIlo trial will highlight the anti-inflammatory effect of iloprost on early inflammatory processes during ARDS, resulting in the improvement of outcome parameters in patients with ARDS.

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“…In this context the analysis of ventilator free days or time on ECMO may reveal important information. Further on, intravenous application of iloprost may improve microcirculation resulting in better kidney recovery in septic patients (37,38).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo-Trial): a prospective, randomized, multicenter phase II study

Haeberle

Prohaska

Martus

et al. 2020

Preprint

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Background Acute respiratory distress syndrome (ARDS) is caused by rapid onset (within hours) acute inflammatory processes in lung tissue, and it is a life-threatening condition with high mortality. The treatment of ARDS to date is focused on the prevention of further iatrogenic damage of the lung rather than the treatment of the initial inflammatory process. Several preclinical studies have revealed a beneficial effect of iloprost on the control of pulmonary inflammation, and in a small number of ARDS patients, iloprost treatment resulted in improved oxygenation. Therefore, we plan to conduct a large multicenter trial to evaluate the effect of iloprost on ARDS. Methods The Therapeutic Iloprost during ARDS ( ThIIo-Trial) is a multicenter, randomized, clinical phase II trial assessing the efficacy of inhaled Iloprost for the prevention of the development and progression of ARDS in critically ill patients. One hundred fifty critically ill patients suffering from acute ARDS will be treated either by nebulized iloprost or NaCl 0.9% for 5 days. Blood samples will be drawn at defined time points to elucidate the serum levels of iloprost and inflammatory markers during treatment. Mechanical ventilation will be standardized. In follow-up visits at days 28 and 90 as well as 6 months after enrollment, functional status according to the Barthel Index, a health care-related questionnaire and frailty (Vulnerable Elderly Survey) will be evaluated. The primary endpoint is the improvement of oxygenation, defined as the ratio of PaO 2 /FiO 2 . Secondary endpoints include 90-day all-cause mortality, SOFA scores during the study period up to day 90, the duration of mechanical ventilation, the length of ICU stay, ventilator-associated pneumonia, delirium, ICU-acquired weakness and discharge localization. The study will be conducted in three university ARDS centers in Germany. Discussion The results of the ThIlo-Trial will highlight the anti-inflammatory effect of iloprost on early inflammatory processes during ARDS, resulting in the improvement of outcome parameters in ARDS patients.

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Intravenous iloprost to recruit the microcirculation in septic shock patients?

Cited by 22 publications

References 4 publications

Could resuscitation be based on microcirculation data? We are not sure

Could resuscitation be based on microcirculation data? We are not sure

Therapeutic iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo trial): a prospective, randomized, multicenter phase II study

Therapeutic Iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo-Trial): a prospective, randomized, multicenter phase II study

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