Allostasis and sedation practices in intensive care evaluation: an observational pilot study
John P R Moore1,2, Chris Anstey3,4,5, Lauren Murray3
1Sunshine Coast University Hospital, Birtinya, QLD, 4575, Australia. john.moore@health.qld.gov.au.
Intensive Care Medicine Experimental
|June 22, 2018
Summary
This pilot study shows that investigating stress response markers in critically ill, ventilated patients is feasible. Blood samples revealed an elevated stress response that normalized over five days, supporting further research.
Area of Science:
- Critical care medicine
- Endocrinology
- Physiology
Background:
- A dysregulated stress response is linked to critical illness pathogenesis.
- Sedative agents may negatively impact the stress response and organ function in critically ill patients.
Purpose of the Study:
- To assess the feasibility of investigating stress response components in critically ill patients.
- To evaluate the potential for a larger sub-study within the SPICE-III trial (NCT01728558).
Main Methods:
- Pilot observational cohort study in a single ICU.
- Enrolled mechanically ventilated patients receiving sedation (<12h initiation, >24h expected ventilation).
- Collected blood samples at 12-hour intervals over 5 days for stress axis marker analysis.
Main Results:
- Recruited 12 patients, mirroring the SPICE-III pilot population.
- Successfully obtained 89% of planned blood samples within 0.3 hours of target times.
- Observed elevated stress biomarkers at baseline, normalizing over 5 days; noradrenaline correlated with norepinephrine dosage.
Conclusions:
- A larger sub-study of SPICE-III is feasible.
- Demonstrated predictable trends in stress markers during critical illness evolution.
- Supports multiple sampling time points for future studies.
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