It is known that septic shock is characterized by arterial hypotension, decreased peripheral vascular resistance and hyporeactivity to vasoconstrictor agents, with NO being an important mediator of this organ dysfunction. Data in the literature have shown that hyporeactivity to catecholamines is associated with a decrease in the density of α and ß receptors in the aorta and heart, respectively, as well as an increase in GRK2 levels and that NO contributes to the increase of this kinase in sepsis . Based on this, it is hypothesized that cardiac dysfunction and decreased peripheral vascular resistance observed in sepsis may result from an increase in GRK2 activity and/or expression and its inhibition may be a relevant therapeutic target in septic shock patients. Based on this line, a measurable clinical benefit of paroxetine through the regulation of GRK2 expression in patients with septic shock is postulated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
92
Paroxetine, 40mg/day, once a day, for 05 consecutive days or 24 hours after shock resolution
Hospital Maternidade São José de Colatina
Colatina, Espírito Santo, Brazil
RECRUITINGHospital São José
Criciúma, Santa Catarina, Brazil
RECRUITINGTime to vasopressor discontinuation
Discontinuation of all vasopressors for at least 48 consecutive hours
Time frame: 28 days of enrollment
Cumulative vasopressor dose in the first 48 hours after randomization Translation results Cumulative vasopressor dose in the first 48 hours after randomization
Dose of infused norephineprine and/or vasopressin during the first 48 hours after randomization
Time frame: 48 hours
Variation in cardiovascular sequential organ failure assessment score score 24 to 120 hours after randomization
Variation of the cardiovascular sequential organ failure assessment score score between baseline daily until 120 hours later. Cardiovascular sequential organ failure assessment score varies between 0 and +4 points, higher scores meaning worse cardiovascular dysfunction
Time frame: 120 hours
Cumulative vasopressor dose for 120 hours after randomization
Dose of infused norephineprine and/or vasopressin during 120 hours after randomization
Time frame: 120 hours
Total sequential organ failure assessment score score variation 24 to 120 hours after randomization
Variation of the total sequential organ failure assessment score score between baseline daily until 120 hours later. Total sequential organ failure assessment score varies between 0 and +24 points, higher scores meaning worse organ dysfunction
Time frame: 120 hours
Length of stay in the ICU
time spent in ICU
Time frame: 90 days
Mortality during ICU stay
Mortality in the ICU
Time frame: 90 daus
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.