Early Use of Polymyxin B Hemoperfusion in Abdominal Sepsis (EUPHAS)

This study has been completed.
Sponsor:
Information provided by:
St. Bortolo Hospital
ClinicalTrials.gov Identifier:
NCT00629382
First received: February 26, 2008
Last updated: December 1, 2008
Last verified: April 2008
  Purpose

This clinical study designed as a prospective, open labelled, multi-centre, RCT will be carried out to evaluate if direct hemoperfusion with polymyxin B immobilized fiber column (PMX) is superior to conventional medical therapy for sepsis, for patients with sepsis arising from abdominal cavity infection, accompanied by the failure of one or more organs. 120 patients (60 treatment/60 control) will be considered in this study. Those patients fulfilling inclusion criteria and not having exclusion criteria will be randomly allocated to one of two study groups. One group will be treated with PMX (PMX group) and the other will receive a "standard therapy" for sepsis (control group). All patients will receive full intensive care management, including fluid resuscitation, vasopressors, antimicrobial chemotherapy, ventilatory support, and renal replacement therapy, if required. Each patient will be followed up for 28 days after study entry.


Condition Intervention Phase
Gram-Negative Bacterial Infections
Sepsis
Septic Shock
Device: Polymyxin B immobilized fiber column
Other: Conventional medical therapy in the ICU
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Dispositivo Adsorbente Con Polymyxina B Immobilizzata Nello Shock Settico - Studio Clinico Randomizzato e Prospettico, Multicentrico

Resource links provided by NLM:


Further study details as provided by St. Bortolo Hospital:

Primary Outcome Measures:
  • Blood pressure and use of vasopressors [ Time Frame: 48-72 hrs ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • PaO2/ FiO2 ratio [ Time Frame: 48-72 hrs ] [ Designated as safety issue: No ]
  • Change in SOFA score [ Time Frame: 48-72 hrs ] [ Designated as safety issue: No ]
  • ICU survival [ Time Frame: 28 days ] [ Designated as safety issue: No ]

Enrollment: 70
Study Start Date: December 2004
Study Completion Date: April 2008
Primary Completion Date: April 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1 Device: Polymyxin B immobilized fiber column
Hemoperfusion with PMX will be performed in ICU. The 1st PMX treatment (day 0) will be carried out for 2 hours and ideally within 24 hours but not later than 48 hours after diagnosis of severe sepsis. The second PMX treatment has to be performed 24 to 48 hours after the end of the first PMX treatment, ideally after 24 hours. Hemoperfusion therapy will be performed in addition to conventional medical therapy in the ICU.
Other Name: Toraymyxin
Other: Conventional medical therapy in the ICU
Including, but not limited to: antibiotic therapy, nutrition, administration of gamma-globulins, vasopressors, hemodynamic monitoring, organ support in the ICU including mechanical ventilation, corrective measures for metabolic abnormalities, renal replacement therapy when appropriate.
2 Other: Conventional medical therapy in the ICU
Including, but not limited to: antibiotic therapy, nutrition, administration of gamma-globulins, vasopressors, hemodynamic monitoring, organ support in the ICU including mechanical ventilation, corrective measures for metabolic abnormalities, renal replacement therapy when appropriate.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with severe sepsis due to intra-abdominal cavity infection after emergency surgery with at least 2 SIRS criteria and 1 organ dysfunction (as defined by SCCM)

Exclusion Criteria:

  • Less than 18 years of age
  • Females with a positive pregnancy test
  • Treated with another investigational drug or device within the 30 days immediately preceding enrolment in this study
  • Undergone organ transplantation during the past one year
  • Documented history of sensitivity to Polymyxin-B, anticoagulant (heparin)
  • Terminally ill, including metastases or hematological malignancy, with a life expectancy less than 30 days (as assessed by the attending physician) or have been classified as "Do Not Resuscitate"
  • Diagnosed with HIV
  • Previous history of end stage chronic organ failure(s)
  • Uncontrolled hemorrhage within the last 24 h
  • Diagnosed with granulocytopenia (leukocyte count of less than 500 cells/mm3) and/or thrombocytopenia (platelet count of less than 30,000 cells/mm3)
  • More than 4 failed organs at entry
  • An APACHE II score of more than 30 at entry to the study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00629382

Locations
Italy
St Bortolo Hospital
Vicenza, Italy, 36100
Sponsors and Collaborators
St. Bortolo Hospital
  More Information

Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Claudio Ronco, MD, International Renal Research Institute Vicenza (IRRIV),
ClinicalTrials.gov Identifier: NCT00629382     History of Changes
Other Study ID Numbers: TM05
Study First Received: February 26, 2008
Last Updated: December 1, 2008
Health Authority: Italy: Ministry of Health

Keywords provided by St. Bortolo Hospital:
abdominal sepsis
abdominal surgery
septic shock
polymyxin B
hemoperfusion
Endotoxins

Additional relevant MeSH terms:
Sepsis
Toxemia
Shock
Shock, Septic
Bacterial Infections
Gram-Negative Bacterial Infections
Infection
Systemic Inflammatory Response Syndrome
Inflammation
Pathologic Processes
Polymyxin B
Polymyxins
Anti-Bacterial Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on October 01, 2014