Start date
06/01/2011
Primary investigator
Gary Vercruysse
gary.vercruysse@emory.edu
(404) 251-8737
69 Jesse Hill Jr. Dr. SE Suite 312a
Atlant, GA 30303
Number of sites
20
Existing site names
Grady Memorial Hospital
Sponsoring organization
None
Abstract
Critically injured trauma patients characteristically present to the emergency department with hypotension. A subset of these patients develop irreversible shock, characterized by low systemic vascular resistance despite hypotension and unresponsiveness to fluid resuscitation and inotropic support. Virtually all such patients die, as no effective treatment exists to reverse this end-stage process. In recent porcine studies, severe hypovolemic shock has been associated with low vasopressin levels. When such animals were given vasopressin, 89% recovered, in contrast to the death of all control animals given other vasoactive agents and/or fluid resuscitation. Although studied in animals, the role of vasopressin in human trauma has not been well-defined. Serum vasopressin levels are not routinely measured in humans as a part of clinical care. At Grady Health System, severe hemorrhagic shock continues to be a leading cause of death for many trauma patients. This study is designed to describe the continuum of vasopressin levels during severe hemorrhagic shock, and to determine how well serum vasopressin levels during severe hemorrhagic shock predict three adverse outcomesirreversible shock and death, Acute Respiratory Distress Syndrome, and sepsis. If this study demonstrates a significant relationship between vasopressin levels and any of these three outcomes, it will lead to an intervention study of the use of vasopressin during severe hemorrhagic shock as adjuvant therapy to standard care (e.g., fluid resuscitation and surgical control of bleeding).