Very Old Intensive Care Patients - Perfusion

Study Overview
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Brief Summary
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Shock is a frequent, etiologically heterogeneous and often lethal clinical condition of intensive care medicine. This is particularly true for very old intensive care patients (VIPs), who are among the fastest-growing subgroups of all intensive care unit (ICU) patients and who suffer from a significantly impaired outcome. In addition to the treatment of the causes of shock, current therapeutic approaches focus on the stabilization of vital parameters, which in general all reflect macrocirculatory measured values such as blood pressure. In contrast, a disturbance of the microcirculation (blood circulation of the smaller blood vessels <100 µm) is only poorly measurable and delayed. The last generation of AVA-Software (MicroVisionMedical) will calculate different parameters about the capillary densitiv and perfusion in a user-independent way. VIPPER investigates whether a non-invasive measurement of microcirculation using the sublingual mucosa in very old intensive care patients in shock leads to faster recognition and specific treatment of organ dysfunctions. Secondly, this study checks whether this measurement predicts outcome.

Official Title
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Very Old Intensive Care Patients - Perfusion (VIPPER)

Conditions
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Microcirculation, Intensive Care, Very Old Intensive Care Patients

Intervention / Treatment
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* Diagnostic Test: Measurement of microcirculation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 80 years Acute ICU admission Shock at the time point of admission to the ICU or in the first 3 hours defined as Lactate ≥ 2 mmol/l AND need for vasoactive substances to maintain a MAP ≥ 65 mmHg in the presence of adequate volume status Exclusion Criteria: < 80 years Inaccessibility for sublingual measurement no informed consent

Ages Eligible for Study
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Minimum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Measurement of microcirculation|As a simple clinical test, every patient will receive the assessment capillary refill time and mottling-score. Additionally, repetitive measurements of lactate will be done. The SDF-camera (MicroVision Medical®, Amsterdam, Netherlands) will measure sublingual microcirculation at different time points (Admission and 24h).|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bedside measurement of sublingual microcirculation | measurement of sublingual microcirculation by using MicroScan® microscope | admission of the intensive care unit | 
| bedside measurement of sublingual microcirculation | measurement of sublingual microcirculation by using MicroScan® microscope | after 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality |  | after 30 days, 6 months and 12 months | 
| Length of stay at ICU |  | tdays from admission of the intensive care unit until discharge | 
| Use of Vasopressors and fluids |  | days from admission of the intensive care unit until discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Microcirculation, Intensive Care, Critical care, shock, Very Old Intensive Care Patients, risk stratification, SDF-measurement