ArticlePloS one2024
The REPERFUSE study protocol: The effects of vasopressor therapy on renal perfusion in patients with septic shock-A mechanistically focused randomised control trial.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06234592 (The Effect of Vasopressor Therapy on Renal Perfusion in Patients With Septic Shock - a Mechanistically Focussed Randomized Control Study), which is not on this map. Cited by 9 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Vasopressor Therapy on Renal Perfusion in Patients With Septic Shock - a Mechanistically Focussed Randomized Control Study
Who cites it
9 citing papers in PubMed.
- Rationale and design of a pilot randomized control trial of permissive hypotension after cardiac surgery: The PHACS trial.American heart journal plus : cardiology research and practice · 2026Article
- Development and evaluation of machine learning-based prediction-modelling for initial vancomycin serum concentrations in septic ICU patients using clinical health record data.Intensive care medicine experimental · 2026Article
- Preliminary exploration of quantitative analysis parameters of renal cortical blood perfusion by contrast-enhanced ultrasound in hypertensive patients.Quantitative imaging in medicine and surgery · 2026Article
- Targeting the TLR4/NF-κB/TNF-α/MMP axis with dexamethasone attenuates glycocalyx degradation and restores microcirculatory perfusion in septic kidneys.Scientific reports · 2026Article
- New Kidneys Do Not Tolerate Hypotension.Anesthesiology open · 2026Article
- Contrast-enhanced ultrasound in critical care: a problem-solving approach.Frontiers in medicine · 2026Review
- Analysis of the effect of arterial embolization combined with external fixation in the treatment of unstable pelvic fracture with hemorrhagic shock.Scientific reports · 2025Article
- Myocardial blood flow in patients with sepsis.Physiological reports · 2025Article
- Vasopressin and its analogues in patients with septic shock: holy Grail or unfulfilled promise?Critical care (London, England) · 2025Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute kidney injury (AKI) is a common complication of septic shock and together these conditions carry a high mortality risk. In septic patients who develop severe AKI, renal cortical perfusion is deficient despite normal macrovascular organ blood flow. This intra-renal perfusion abnormality may be amenable to pharmacological manipulation, which may offer mechanistic insight into the pathophysiology of septic AKI. The aim of the current study is to investigate the effects of vasopressin and angiotensin II on renal microcirculatory perfusion in a cohort of patients with septic shock. METHODS AND ANALYSIS: In this single centre, mechanistically focussed, randomised controlled study, 45 patients with septic shock will be randomly allocated to either of the study vasopressors (vasopressin or angiotensin II) or standard therapy (norepinephrine). Infusions will be titrated to maintain a mean arterial pressure (MAP) target set by the attending clinician. Renal microcirculatory assessment will be performed for the cortex and medulla using contrast-enhanced ultrasound (CEUS) and urinary oxygen tension (pO2), respectively. Renal macrovascular flow will be assessed via renal artery ultrasound. Measurement of systemic macrovascular flow will be performed through transthoracic echocardiography (TTE) and microvascular flow via sublingual incident dark field (IDF) video microscopy. Measures will be taken at baseline, +1 and +24hrs following infusion of the study drug commencing. Blood and urine samples will also be collected at the measurement time points. Longitudinal data will be compared between groups and over time. DISCUSSION: Vasopressors are integral to the management of patients with septic shock. This study aims to further understanding of the relationship between this therapy, renal perfusion and the development of AKI. In addition, using CEUS and urinary pO2, we hope to build a more complete picture of renal perfusion in septic shock by interrogation of the constituent parts of the kidney. Results will be published in peer-reviewed journals and presented at academic meetings.
trial registrationThe REPERFUSE study was registered on Clinical Trials.gov (NCT06234592) on the 30th Jan 24.
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