ACME Cat

ACME Cat

Evaluation of volume response in septic shock: Metabolic Cluster Analysis

Welcome to ACMECat

The project ACME Cat approaches the study of the detection of tissue hypoxia in the initial hours of handling critical patients with cardiovascular failure caused by a infectious process hard.

The presence and/or persistence over time ofhypoxia of cardiovascular cause in the tissues is directly linked to one increase in the morbidity and mortality of patients and therefore its detection and implementation of actions to reverse it are fundamental.

Today, we have different blood markers that provide information on the overall metabolic state of the body. Each of these markers has demonstrated its value in the detection and management of tissue hypoxia, but all of them have their own limitations.

El Hemodynamics, microcirculation and tissue oxygenation research group in the critical patient (MiTOCrit) has previously worked on the integration of classic markers and in the incorporation of new to improve detection capability, and has preliminarily described the existence of some certain patterns that allow more precisely establish the presence of tissue hypoxia, as well as the detection of states of dysoxia, where the tissues show an inability to use the oxygen that reaches them. This situation is of particular interest due to the fact that carrying out hemodynamic interventions intended to improve the supply of oxygen to the tissues would not have metabolic benefits, and would be linked to deleterious effects of the treatments.

The ACMECat project, with its multicentric nature, and the inclusion of a large number of patients, aims deepen the ability to discriminate between these pathological metabolic states, thus helping to improve the therapeutic approach of critically ill patients.

Financing: Catalan Society of Intensive and Critical Medicine (SOCMIC)

Study registration number: ClinicalTrials.gov NCT06500156

Coordinating centers

Parc Taulí University Hospital
Parc Taulí Research and Innovation Institute (I3PT)

Principal Investigators

  • Jaume Mesquida February
    Intensivist doctor at Parc Taulí and head of the Hemodynamics, microcirculation and tissue oxygenation in the critically ill patient (MiTOCrit) research group of the I3PT
  • Ferran Oller Sánchez
    Intensivist physician in training at Parc Taulí and researcher of the MiTOCrit research group of the I3PT

Participating centers

Principal Investigators

  • Lara bielsa 
    Intensivist doctor at Germans Trias i Pujol Hospital
  • Paula Perello
    Intensivist doctor at the Manresa Hospital – Althaia Foundation
  • Clara Vila
    Intensivist doctor at the Hospital del Mar
  • Juan Arturo Mendez
    Intensivist doctor at Hospital de Mataró
  • Anna Perez
    Intensivist doctor at the Terrassa Mutual Hospital
  • Luis Zapata
    Intensivist doctor at the Hospital de la Santa Creu i Sant Pau
  • Christian Villavicencio
    Intensivist doctor at the Joan XXIII Hospital in Tarragona
  • Edgard Moglia
    Intensivist doctor at Quirón-Teknon Hospital
  • Aurora Gil
    Intensivist doctor at Vall d'Hebron University Hospital

hypothesis

main hypothesis

The integration of the different metabolic variables used to guide the resuscitation of patients in septic shock will improve the ability to detect tissue hypoxia, defined as VO2/DO2 dependence (alteration in the VO2 which improves with increasing DO2 resulting from the administration of a volume load).

Secondary hypothesis

Those patients who present patterns of dysoxia in the initial phases of the disease will have a worse evolution, in terms of organ failures and mortality in the ICU.

Objectives and methodology

Main objective
  • To evaluate the value of the integration of the different metabolic variables in the detection of tissue hypoxia.
Secondary objectives
  • Evaluate the value of the changes in the different parameters, in response to the volume load, to detect those who have been metabolic responders.
  • Analyze the association of the different clusters, as well as their evolution in response to treatment, with the patients' prognosis.

Documents

Project report
[Coming soon]

Approval of the Medicines Research Ethics Committee (CEIm) of the coordinating center
[Coming soon]

REDChap

REDCap (Research Electronic Data Capture) is a secure web application for online databases and surveys for research purposes.

Contact

Do you have any questions or suggestions? Write to us!

Project coordination

foller@tauli.cat
✉ jmesquida@tauli.cat

SOCMIC Secretariat

✉ xaviernieves@academia.cat

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