Clinical Trial: Neurological Outcome in Surgical and Non-surgical Septic Patients

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Prospective Observational Study: Comparison of Neurological Outcome in Septic Surgical, Septic Non-surgical and Non-septic Patients on ICU

Brief Summary:

Systemic inflammation and sepsis cause multi organ failure including severe neurologic impairment in the course of disease. Neurologic failure typically presents as critical-illness-polyneuropathy/-myopathy and septic encephalopathy during sepsis and is associated with an increased mortality rate.

Clinical parameters to determine the neurologic entities during the course of sepsis are heterogeneous. Further research for an association of clinical parameters and the patients' outcome is needed.

The study aims toward differences in the clinical and neurological outcome of surgical and non-surgical septic patients in comparison to non-septic patients on ICU. The aim of the study is to identify clinical and diagnostic outcome predictors in septic patients.


Detailed Summary:

All patients with severe sepsis and septic shock and fulfilling the inclusion criteria should be screened for the study on two surgical (septic surgical patients), one medical intensive care unit (septic non-surgical patients) and one neurological intensive care unit (non-septic patients) at the university hospital of Rostock, Germany.

The inclusion of patients will be started if written informed consent was obtained from all participants or their representatives (if direct consent could not be obtained).

The aim of the study is to determine differences in the neurological outcome of surgical and non-surgical septic patients (incidence, severity and length of critical-illness-polyneuropathy/-myopathy and septic encephalopathy). The main interest of the study is to find parameters associated with an improved neurological outcome in septic patients within an observation time of 100 days.

The main criterion is the incidence, severity and length of septic encephalopathy and critical-illness-polyneuropathy and -myopathy on days 7 and 28.

From all patients basic demographic data, illness severity scores (APACHE-II, SOFA) and delirium scores for the assessment of septic encephalopathy (CAM-ICU, ICDSC), laboratory, cerebrospinal fluid and microbiological results, electrophysiological (electroneurography(ENG)), electroencephalography (EEG), cranial MRI results, pre-morbidity data and clinical outcome for the study cohort will be recorded. At the days 1, 3, 7 and 28 the patients will be screened for clinical and laboratory/immunological data: hemodynamic, inflammation, coagulation, organ function, blood parameters including cytokines.

Neurological examination and EEG will be performed
Sponsor: University of Rostock

Current Primary Outcome:

  • Septic Encephalopathy [ Time Frame: day 7 ]
    EEG, MRT, CSF (cerebrospinal fluid)
  • Critical-Illness-Polyneuropathy and -myopathy [ Time Frame: day 7 ]
    ENG
  • Septic Encephalopathy (28) [ Time Frame: day 28 ]
    Clinical observation.
  • Critical-Illness-Polyneuropathy and -myopathy (28) [ Time Frame: day 28 ]
    Clinical observation.


Original Primary Outcome:

  • Septic Encephalopathy [ Time Frame: day 7 ]
  • Critical-Illness-Polyneuropathy and -myopathy [ Time Frame: day 7 ]
  • Septic Encephalopathy (28) [ Time Frame: day 28 ]
  • Critical-Illness-Polyneuropathy and -myopathy (28) [ Time Frame: day 28 ]


Current Secondary Outcome:

  • - 28-day survival (observation time 100 days) [ Time Frame: day 28 ]
    Survival after 28 days.
  • - Time of respirator-therapy [ Time Frame: 1 year ]
    In days cumulative.
  • - Dosage of vasopressors (cumulative) [ Time Frame: observation time 100 days ]
    In days cumulative.
  • - 100 day survival [ Time Frame: day 100 ]
    Survival after 100 days.


Original Secondary Outcome:

  • - 28-day survival (observation time 100 days) [ Time Frame: day 28 ]
  • - Time of respirator-therapy [ Time Frame: 1 year ]
  • - Dosage of vasopressors (cumulative) [ Time Frame: observation time 100 days ]
  • - 100 day survival [ Time Frame: day 100 ]


Information By: University of Rostock

Dates:
Date Received: April 29, 2015
Date Started: November 2012
Date Completion:
Last Updated: April 19, 2017
Last Verified: April 2017