Investigation on Differences in Skin Sodium Content Between Normal Subjects and ICU-patients (InCa)

Medical Centre Leeuwarden

Status: Completed

Conditions: Hypernatremia

Treatments: Procedure: Skin biopsies; Other: Blood collection for RNA-investigation; Other: Blood and urine analysis

Study type: Observational

Funder types: Other

Identifiers

NCT02912299

NL 56729.099.16

Details and patient eligibility

About

This study investigates the differens in sodium storage in skin between normal subjects, patients after cardiac surgery and septic patients.

Full description

According to the current paradigm ICU-acquired hypernatremia is mainly an iatrogenic problem, caused by sodium overload or water deficit. In spite of several interventions to reduce sodium intake and optimize fluid balance, critically ill patients still develop hypernatremia. These patients also seem to have an inability to excrete sodium, hence develop a positive sodium balance. In animals sodium storage in the third compartment was found. Our hypothesis is that sodium storage in the third compartment is different in critically ill patients and this difference could play a role in the development of ICU-acquired hypernatremia.

Enrollment: 45 patients

Sex: All

Ages: 45 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 50-80 years (septic patients), 45-85 years (CABG and hip replacement-patients)
• Patients undergoing hip replacement: no relevant medical history (i.e. chronic and/or systemic diseases with a suspected influence on sodium / sodium handling)
• Septic patients: fulfilling the criteria for the systemic inflammatory response syndrome in the presence of a(n expected) new infection

Exclusion criteria

• Absence of both upper legs
• Skin disease that makes skin biopsies in healthy skin impossible
• Subjects with in their history formation of exaggerated scar tissue
• Subjects suffering from psoriasis or lichen ruber
• Use of skin corticosteroids on all skin of both upper legs < 2 weeks before inclusion
• Tattoos covering the whole surface of both upper legs
• Use of diuretics in the past month
• Current renal replacement therapy
• Septic patients: not being sedated
• Patients undergoing hip replacement: hip replacement because of an inflammatory disease

Trial design

45 participants in 3 patient groups

Septic patients

Description:

Patients admitted to the ICU that fulfill the criteria for the systemic inflammatory response syndrome in the presence of a(n expected) new infection. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation.

Treatment:

Other: Blood collection for RNA-investigation

Other: Blood and urine analysis

Procedure: Skin biopsies

CABG patients

Description:

Patients admitted to the ICU after coronary artery bypass grafting. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation.

Treatment:

Other: Blood collection for RNA-investigation

Other: Blood and urine analysis

Procedure: Skin biopsies

Patients before hip replacement

Description:

Patients that will undergo a hip replacement because of arthrosis. 2 3mm skin biopsies will be taken, blood and urine analysis will take place and also blood collection for RNA-investigation.

Treatment:

Other: Blood collection for RNA-investigation

Other: Blood and urine analysis

Procedure: Skin biopsies