Vasodilatory therapy with nitroglyceryn in patients with septic shock

• Grant number: 14/11120-0
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2015
• End date: January 31, 2017
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Eliezer Silva
• Grantee: Eliezer Silva
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil
• Associated researchers: Adriano José Pereira ; Ana Paula Metran Nascente Pereira ; Thiago Domingos Correa

Abstract

Rationale: Recent clinical studies have shown a relationship between abnormalities in peripheral perfusion and unfavorable outcome in patients with septic shock. Nitroglycerin may be effective to restore alterations in microcirculatory blood flow. This study is aimed to investigate whether nitroglycerin administration could correct the abnormalities on peripheral circulation of resuscitated septic shock patients and improve the outcomes.Objective: Seventy adult septic shock patients with sustained clinical parameters of abnormal peripheral perfusion despite adequate resuscitation (central venous pressure, mean arterial blood pressure and central venous oxygen saturation) will be randomized to receive intravenous nitroglycerin (intervention group) or placebo (control group). We hypothesize that stepwise doses of intravenous infusion of nitroglycerin, administered within the first 48 hours after stabilization of macrohemodynamic parameters, can reduce the incidence of organ failure quantified by the SOFA score and reverse the abnormalities in microcirculation. The microcirculation will be adressed by direct visualization with the Sidestream Dark-field (SDF) technique. Study design: Prospective phase II clinical trial, multicenter, exploratory, randomized, placebo-controlled, double-blinded, with concealed allocation and intention-to-treat analysis. In Brazil, this study will be performed at the Intensive Care Unit of the Hospital Israelita Albert Einstein. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

RABELLO FILHO, ROBERTO; DE FREITAS CHAVES, RENATO CARNEIRO; CESAR ASSUNCAO, MURILLO SANTUCCI; NETO, ARY SERPA; DE FREITAS, FLAVIA MANFREDI; ROMAGNOLI, MARIA LAURA; SILVA, ELIEZER; LATTANZIO, BERNARDO; DUBIN, ARNALDO; DOMINGOS CORREA, THIAGO. Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods. JOURNAL OF CLINICAL MONITORING AND COMPUTING, v. 34, n. 6, p. 10-pg., 2019-11-21. (14/11120-0)

RABELLO FILHO, ROBERTO; DE FREITAS CHAVES, RENATO CARNEIRO; CESAR ASSUNCAO, MURILLO SANTUCCI; NETO, ARY SERPA; DE FREITAS, FLAVIA MANFREDI; ROMAGNOLI, MARIA LAURA; SILVA, ELIEZER; LATTANZIO, BERNARDO; DUBIN, ARNALDO; DOMINGOS CORREA, THIAGO. Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods. JOURNAL OF CLINICAL MONITORING AND COMPUTING, NOV 2019. (14/11120-0)

CORREA, THIAGO DOMINGOS; RABELLO FILHO, ROBERTO; CESAR ASSUNCAO, MURILLO SANTUCCI; SILVA, ELIEZER; LIMA, ALEXANDRE. Vasodilators in Septic Shock Resuscitation: A Clinical Perspective. Shock, v. 47, n. 3, p. 269-275, MAR 2017. (14/11120-0)