Improving Kidney Outcomes for Critically Ill Patients with Vasodilatory Shock

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  Principal Investigator
  Dr Emily See

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Project Details

Improving Kidney Outcomes for Critically Ill Patients with Vasodilatory Shock Through Personalised Vasopressor Therapy

Background:

‘Vasodilatory shock’ is a life-threatening medical emergency characterised by low blood pressure and impaired delivery of oxygen to vital organs. It is one of the most common causes of 'acute kidney injury', the term used to describe an abrupt reduction in kidney function.

Acute kidney injury is a dangerous complication of vasodilatory shock, since it causes accumulation of toxins and fluid in the body. Even with timely intervention, up to 50% of patients with vasodilatory shock and acute kidney injury will die within 30 days, while survivors are at high risk of permanent kidney damage.

As the underlying cause of vasodilatory shock is identified and treated, supportive care is initiated with the aim of reestablishing blood flow to the kidneys and other organs.
This typically involves the administration of fluids and medications that increase blood pressure (‘vasopressors’).

Trials comparing different types of vasopressors have failed to show any difference in acute kidney injury risk or patient survival between or within vasopressor classes.

This research program will test the effectiveness of a new vasopressor (angiotensin II) compared to existing vasopressors in terms of kidney outcomes prioritised by patients, caregivers, and doctors. It will investigate pathways that may underlie any benefit, and identify important differences between patients in terms of their response. It will then test the feasibility of personalising choice of vasopressor.

This work has the potential to fundamentally change the management of vasodilatory shock on a global scale, while focusing on impacting the outcomes that matter most to key stakeholders.

Funding

2024 Jacquot Research Establishment Fellowship ($90,000)