A study of renal blood flow and renal oxygenation measured by magnetic resonance after a standardized fluid challenge in critically ill, resuscitated, patients with sepsis due to COVID-19 or other agents.
Critically ill, septic patients with or without acute kidney injury (AKI) above 18 years of age who have been circulatory and respiratory stabilized will be screened for inclusion. After the patients have been adequately treated with antimicrobial agents, source control and circulatory and respiratory stabilized, the patient will be moved to the Magnetic resonance imaging (MRI)-suite and placed in the MRI-camera. We plan to, at the same time, study renal blood flow (RBF) and oxygenation with 4 different MRI techniques; arterial spin labeling (ASL), Blood oxygen level dependent (BOLD)-technique, T(2) -Relaxation-Under-Spin-Tagging (TRUST) and Phase contrast at two conditions; 1. at baseline after stabilization 2. after intravenous infusion of 7,5 ml/kg mL Ringer's acetate The following data will be registered: 1. Age, gender, length and weight, 2. concomitant diseases and treatment, 3. present disease and treatment, 4. source of admission - emergency department or ordinary ward, 5. daily laboratory reports, 6. results from other investigations, e.g. x-rays, cultures etc., 7. recordings from the intensive care unit (ICU) monitors 8. Continuous renal replacement therapy (CRRT) - duration type, flow rate, replacement fluid, etc. 9. dead or alive at discharge and 90 days mortality, 10. renal function at discharge, 11. treatment restrictions, 12. if the patient has died, the results from a possible postmortem examination. As well as all data obtained during the MRI-examination.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
22
7,5 ml/kg mL Ringer's acetate during 5-10 minutes will be administered intravenously
Uppsala University Hospital
Uppsala, Sweden
Change in renal blood flow and renal oxygenation after standardized plasma expansion with fluid bolus
Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST), compared to baseline measurement
Time frame: When achieved according to protocol, approximately 3-10 minutes after intervention
Descriptive renal oxygenation and blood flow in critical illness due to sepsis
Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST) during baseline measurement.
Time frame: During Critical illness - at one time point
Descriptive renal oxygenation and blood flow in critical illness in no/low grade AKI or high grade AKI.
Measured with arterial spin labelling (ASL), Phase Contras, Blood oxygenation level dependent (BOLD) and T(2) -Relaxation-Under-Spin-Tagging (TRUST) images stratified in groups in regards to KDIGO grade during exam.
Time frame: During Critical illness - at one time point
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