Sepsis is an acute life-threatening illness. Specific aims of this study are to demonstrate the efficacy of combination therapy using vitamin C, thiamine and corticosteroids to reduce the duration of cardiovascular and respiratory organ dysfunction in critically ill patients with sepsis. Additionally, this research study aims to demonstrate the efficacy of combination therapy using vitamin C, thiamine and corticosteroids to reduce 30-day mortality in critically ill patients with sepsis.
This is a research study of different ways to use intravenous fluids (fluids given through a small tube placed in the vein) and vasopressors (medicines used to raise blood pressure) to treat sepsis, which is a serious infection. We are asking you to be in this study because: a) you have been diagnosed with low blood pressure due to an infection and b) your blood pressure has stayed low after your doctors gave you fluids. We do not know which approach is better in this situation: a)starting medicines to raise blood pressure first and then giving more fluids (if needed), or b) giving a larger amount of fluids first and then giving medicines to raise blood pressure if needed. Right now, the choice of approach is left to the doctors. Some doctors use medicines to raise blood pressure followed by extra fluids, and others use extra fluids followed by medicines to raise blood pressure. Some doctors use a combination of the two. This treatment part of the study will last for 24 hours, and then we will follow you until you go back to where you live. We want to find out whether one of these approaches compared to the other can improve a patient's chances of survival.
The Acute Respiratory Distress Syndrome (ARDS) is a major cause of mortality and morbidity in critically ill patients. There are no proven effective pharmacologic therapies for the syndrome in part because the current understanding of the causes of ARDS is limited. The aims of this study are to examine the role that extracellular micro RNA play in the endothelial and epithelial dysfunction which occurs in ARDS.
Disparities in sepsis incidence and outcomes have been identified between blacks and whites. While some of these disparities can likely be attributed to socio-demographic factors including socio-economic status, education level, and access to healthcare, existing data suggests that other factors, including biological differences, may contribute to the observed disparities. The innate immune system is an integral component of the body's mechanism for fighting off infection and has been identified as a site for numerous racial heterogeneities. The RADIUS study seeks to identify both black and white patients admitted in an intensive care unit with sepsis. A single blood sample will be collected from each enrolled subject to be used for quantitative analysis of cytokine levels as well as for genotyping for a specific single nucleotide polymoprhism. These cytokines and the polymorphism are related to the innate immune system response to infection. Simultaneously, clinical and demographic information will be recorded from each enrolled subject so that cytokine levels and polymorphism presence can be correlated with clinical outcomes while controlling for socio-demographic variables.