Microcirculation and Oxidative Stress in Critical Ill Patients in Surgical Intensive Care Unit

Study Overview
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Brief Summary
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As medicine advances, many lives can be saved in the intensive care unit. However, when multiple organ failure occurs, the mortality rate of patients increases dramatically. Therefore, the major goal in the intensive care unit is to prevent the occurrence of multiple organ failure. The sepsis protocol and early goal directed treatment have great effects to reduce development of multiple organ failure and to decrease the mortality rate. However, sometime the condition of patient deteriorated in spite of both the mean blood pressure and mixed venous oxygen saturation are normal. Some experts recognize that there might be microcirculatory dysfunction of tissue or organ. The dysfunction of microcirculation might due to vasoconstriction or microthrombosis. Vasoconstriction might result from systemic inflammation, reactive oxygen species, or dysfunction of synthesis of NO (nitric oxide). Microthrombosis might result from systemic inflammation, reactive oxygen species, imbalance of coagulatory system, or damage of endothelial cell. In clinical practice, the oxidative stress is related to circulatory shock, sepsis, acute lung injury, and acute respiratory distress syndrome. This study tries to investigate the relation between oxidative stress and microcirculation. Furthermore, the investigators will try to investigate the correlation between the severity of oxidative stress and microcirculatory dysfunction and the severity of disease and prognosis. The investigators hope this study will help them to figure out the picture of disease progression of patients. It may conduct further study to modulate the oxidative stress, to improve the microcirculatory function, and finally to improve the outcome of patients.

Official Title
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Microcirculation and Oxidative Stress in Critically Ill Patients in Surgical Intensive Care Unit

Conditions
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Sepsis, ARDS, Liver Failure, Renal Failure, Brain Death

Intervention / Treatment
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* Other: Critical care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: > 18 y/o Related diagnosis made within 24h Group 1 - Sepsis Group 2 - Postoperative care Group 3 - ARDS Group 4 - Renal failure Group 5 - Liver failure Group 6 - Brain death Exclusion Criteria: Pregnant patients Related diagnosis made longer than 24h Patients who have received antioxidants within 24h Patients who have received hyperbaric oxygen therapy Patients who have a hemoglobin value less than 9 g/dl Patients who have received NO

Ages Eligible for Study
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Minimum Age: 18 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Patients with sepsis | Other: Critical care<br>* Standard care for each group of patients<br>|
| 2<br>Patient admitted for postoperative care | Other: Critical care<br>* Standard care for each group of patients<br>|
| 3<br>Patients with ARDS | Other: Critical care<br>* Standard care for each group of patients<br>|
| 4<br>Patients with ARF | Other: Critical care<br>* Standard care for each group of patients<br>|
| 5<br>Patients who receive liver support treatment | Other: Critical care<br>* Standard care for each group of patients<br>|
| 6<br>Patients wiht brain death | Other: Critical care<br>* Standard care for each group of patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality Severity of Organ Failure |  | 28 days |