Adjuvant Use of Neostigmine in Sepsis and Septic Shock.
Status:
Unknown status
Trial end date:
2020-06-01
Target enrollment:
Participant gender:
Summary
The inflammatory response represents an important, central component of sepsis. Therefore, it
is believed that blunting inflammation will decrease mortality. In vivo test series with mice
that had undergone cecal ligation and puncture (recognized sepsis model), physostigmine
salicylate significantly inhibited the release of various cytokines (tumor necrosis factor α,
interleukin1β, and interleukin 6). These results were similar to those obtained by vagus
nerve stimulation.
In animal sepsis model using physostigmine not only decreased inflammation but also,
diminished the decrease in blood pressure following infection.
Animals treated with the peripheral choline esterase inhibitor neostigmine showed no
difference compared with physostigmine-treated animals. Therefore, this study aims to
investigate the efficacy of choline esterase inhibitors as adjuvant therapy in patients with
sepsis or septic shock. Outcome measures include: percentage reduction in procalcitonin blood
level, percentage of patients achieving significant reduction in procalcitonin levels, Mean
Sequential Organ Failure Assessment score, percentage decrease in lactate dehydrogenase blood
level, length of stay in hospital intensive care unit, and in hospital mortality.