Tryptophan, Serotonin and Kynurenine in Septic Shock

Study Overview
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Brief Summary
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Septic shock is a major cause of mortality and morbidity worldwide. Serotonin (5-HT) is released by activated platelets into the circulation, and is mediator of endothelial dysfunction. 5-HT metabolism is known in immune system via specific 5-HT receptor, also in effects on the peripheral nervous system. Kinetic of 5-HT, tryptophan, kynurenine, MAO activity and IDO activity in human septic shock was never investigated.

Official Title
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Tryptophan, Serotonin and Kynurenine in Septic Shock

Conditions
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Shock, Septic

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age above or equal to 18 years Strong presumption clinical sepsis Need for mechanical ventilation Body temperature above 38°C or below 36°C Heart rate above 90 bpm Systolic blood pressure of <90mm Hg despite adequate fluid replacement or a need for vasopressors less than 3 hours Presence of at least one of the following criteria: Ratio of arterial oxygen tension over inspired fraction of oxygen of less than 300 mm Hg Urinary output below 0.5 mL per kg of bodyweight per h or below 30 mL/h (for at least 1 h) Arterial lactate concentration above 2 mmol/L Consent signed Exclusion Criteria: Age below 18 years Pregnancy Underlying disease with a poor prognosis, a life expectancy of less than 24 hours Depression or melancholy Neuropsychiatric diseases: Seizure, manic psychosis, Migraine, or Drug addiction Neuroendocrine tumors Obstructive cardiomyopathy or acute myocardial ischaemia Pulmonary embolism Advanced stage cancer, malignant haemopathy, or AIDS with a decision to withhold or withdraw aggressive therapies Inclusion in another clinical trial Patient who receive before inclusion one of the following treatment known to modify serotonin level: almotriptan, amitriptyline, amoxapine, citalopram, clomipramine, clozapine, desipramine, dihydroergotamine, dolasetron, dosulepin, doxepin, eletriptan, ergotamine, flunarizine, fluoxetine, fluvoxamine, granisetron, imipramine, indoramin, interferon Alfa, interferon alfacon-1, interferon beta, iproniazid, maprotiline, methysergide, mianserin, Milnacipran, mirtazapine, moclobemide, naratriptan, olanzapine, ondansetron, oxetorone, paroxetine, pizotifen, risperidone, sertraline, sumatriptan, tianeptine, trimipramine, tropisetron, venlafaxine,viloxazine, zolmitriptan. No consent

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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinetics of 5-HT, 5-HIAA, kynurenine, tryptophan, HVA, VMA, DOPAC, Oestradiol, Cotinine and vasopressors |  | Day-1, Day-2, Day-3, Day-7 and Day-14 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality |  | 28-day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tryptophan, septic shock, shock, serotonin, kynurenine