NCT04695119

Sepsis in the ICU-II

Active, enrolled Last updated 17 March 2026

What this trial tests

trial testing Exposure is septic shock (defined according to Sepsis-III) and standard treatment according to departmental protocols. in Septic Shock in 379 participants. Participants enrolled and being followed up; not accepting new ones.

Timeline

17 September 2018

Primary endpoint
11 February 2026

31 December 2027

Quick facts

Lead sponsor	Linkoeping University
Status	Active, enrolled
Study type	OBSERVATIONAL
Enrollment	379
Start date	17 September 2018
Primary completion	11 February 2026
Estimated completion	31 December 2027
Sites	4 locations across France, Sweden

Drugs / interventions tested

• Exposure is septic shock (defined according to Sepsis-III) and standard treatment according to departmental protocols.

Conditions studied

• Septic Shock — all drugs for Septic Shock →
• Sepsis — all drugs for Sepsis →
• Cardiomyopathies — all drugs for Cardiomyopathies →
• Organ Failure, Multiple — all drugs for Organ Failure, Multiple →

Sponsor

Linkoeping University

Who can join

18 and older, any sex, with Septic Shock or Sepsis. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Sepsis-induced cardiac dysfunction (SIMD) is a well-known phenomenon yet its diagnosis remains elusive with no accepted definition, or defining pathophysiological mechanism associated with this disease. Systolic dysfunction occurs in 20-70% of patients, and may be severe, yet does not appear to have any prognostic value for mortality. Diastolic function has also been variably described and seems to be related to short-term mortality. However, the contribution of left ventricular systolic and diastolic dysfunction to mortality in sepsis are still far from clear, with uncertain contribution from previous cardiovascular disease, vasopressor and inotropic drugs and mechanical ventilation. Another poorly investigated area is right ventricular dysfunction. Cor pulmonale occurs in up to 25% of patients with septic shock, and is invariably related to pulmonary haemodynamics and mechanical ventilation, yet very little is known about how this affects prognosis. Finally, although the outcome of disease is a function of multiple parameters, septic cardiomyopathy is most frequently characterized based on individual echocardiographic parameters, without considering their interactions or placing them in the context of biomarkers and clinically available haemodynamic data. Available relevant studies are often monocentric, and many fail to consider the various confounders that influence the clinical outcome in sepsis. Therefore, the diagnostic and prognostic value of combinations of clinical, biochemical and haemodynamic variables remains to be established.

Accordingly, the purpose of this study is to identify biomarkers and echocardiographic and haemodynamic signatures characteristic of specific outcomes in SIMD to support the diagnosis and prognosis in SIMD. Specific aims are:

1. To determine the association between left ventricular systolic and diastolic dysfunction, and adverse outcome in SIMD;
2. To determine the association between right ventricular systolic and diastolic dysfunction, and adverse outcome in SIMD;
3. To determine the association between novel biomarkers and adverse outcome in SIMD;
4. To determine the combined value of biomarker, echocardiographic, and haemodynamic variables for predicting adverse outcomes in SIMD;
5. To explore if there are different phenotypes of SIMD using unsupervised machine learning algorithms, and whether they are associated with adverse outcomes.

50 patients will be enrolled in a feasibility study to evaluate the logistical setup for acute echocardiography and biobanking facilities. A further 280 patients will be enrolled with inclusion from peripheral centers once feasibility is confirmed.

Note 15 Mar 2026: typing mistake noted in prior text, the sample size was originally for 330 patients (i.e. 50 + 280), not 350 (50 + 300) patients.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

1. Therapeutic S100A8/A9 blockade inhibits myocardial and systemic inflammation and mitigates sepsis-induced myocardial dysfunction.
   Jakobsson G, Papareddy P, Andersson H, Mulholland M, et al · · 2023 · cited 48× · PMID 37773186 · DOI 10.1186/s13054-023-04652-x
2. Association between left ventricular systolic function parameters and myocardial injury, organ failure and mortality in patients with septic shock.
   Blixt PJ, Nguyen M, Cholley B, Hammarskjöld F, et al · · 2024 · cited 9× · PMID 38236316 · DOI 10.1186/s13613-023-01235-5
3. The Olfactomedin-4-Defined Human Neutrophil Subsets Differ in Proteomic Profile in Healthy Individuals and Patients with Septic Shock.
   Lundquist H, Andersson H, Chew MS, Das J, et al · · 2023 · cited 4× · PMID 36450268 · DOI 10.1159/000527649
4. ESICM LIVES 2022: part 2.
   · 2022 · cited 3× · PMID 36258052 · DOI 10.1186/s40635-022-00469-0