Format

Send to

Choose Destination
J Crit Care. 2015 Dec;30(6):1156-62. doi: 10.1016/j.jcrc.2015.07.004. Epub 2015 Jul 17.

Effects of ketanserin on microcirculatory alterations in septic shock: An open-label pilot study.

Author information

1
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands; Department of Translational Physiology, Academic Medical Center, Amsterdam, the Netherlands.
2
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
3
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands. Electronic address: matty.koopmans@gmail.com.
4
Department of Clinical Pharmacy and Pharmacology, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
5
Department of Translational Physiology, Academic Medical Center, Amsterdam, the Netherlands.

Abstract

INTRODUCTION:

Microcirculatory alterations in sepsis are associated with increased morbidity and mortality. These alterations occur despite macrohemodynamic resuscitation. Alternative pro-microcirculatory strategies, including vasodilatory drugs, have been suggested to improve capillary blood flow. Ketanserin, a serotonin receptor antagonist, is an attractive candidate because of its vasodilatory, antithrombotic, and anti-inflammatory effects.

METHODS:

This is an open-label pilot study on the effect of ketanserin administration on microcirculatory alterations in septic shock, defined as microvascular flow index (MFI)≤2.5 after a strict macrohemodynamic resuscitation protocol. Sidestream dark-field imaging was applied to assess the microcirculation. A stepwise incremental dose regiment was applied until an MFI>2.9, the primary end point, was reached.

RESULTS:

Ten patients (Acute Physiology and Chronic Health Evaluation IV scores of 115 [100-136]) were included. Baseline MFI was 1.71 (1.31-2.32) and was significantly increasing to 2.96 (2.54-3.00; P=.021) during the ketanserin infusion. The total ketanserin dose was 0.09 (0.08-0.13) mg/kg per patient in 60 (30-60) minutes. In 3 patients (30%), the ketanserin infusion was discontinued due to refractory hypotension.

CONCLUSION:

An improvement in microcirculatory perfusion was observed during ketanserin administration in patients with septic shock after macrohemodynamic resuscitation. This finding needs further exploration in a placebo-controlled setting.

KEYWORDS:

Ketanserin; Microcirculatory alterations; Septic shock; Sidestream dark-field images

PMID:
26264259
DOI:
10.1016/j.jcrc.2015.07.004
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center