Pro-inflammatory Cytokines Profile and Mortality Rate of Critically Ill Septic Patients Following Plasmapheresis

The recruitment status of this study is unknown because the information has not been verified recently.
Verified November 2010 by Tehran University of Medical Sciences.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
Tehran University of Medical Sciences
ClinicalTrials.gov Identifier:
NCT01249222
First received: November 22, 2010
Last updated: November 26, 2010
Last verified: November 2010
  Purpose

Sepsis is one of the most prevalent and fatal diseases in intensive care units .unfortunately, therapeutic approach to sepsis has remained unchanged for many years. Nowadays, the role of cytokines in pathogenesis of sepsis is obvious. Continuous elevated levels of various cytokines in severe sepsis could result in uncontrolled inflammation status. Breaking of inflammatory cascade may lead to improvement in survival. It seems that modulation of inflammation is one of the strategic plans to conquest sepsis. Therefore, elimination of bacterial toxins and pro-inflammatory cytokines from the systemic circulation by plasmapheresis supposed to be rational approach.

Researchers have done several attempts to clarify the efficacy of plasmapheresis in sepsis treatment. However because of inconsistent results, routine use of this procedure in patients with severe sepsis remains controversial.

The aim of the present survey is to determine the effect of plasmapheresis on plasma levels of main pro-inflammatory cytokines and evaluate its therapeutic efficacy in improvement of outcome and treatment of severe sepsis.


Condition Intervention
Severe Sepsis
Procedure: plasmapheresis
Other: plasmapheresis

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Pro-inflammatory Cytokines Profile and Mortality Rate of Critically Ill Septic Patients Following Plasma Therapeutic Exchange

Resource links provided by NLM:


Further study details as provided by Tehran University of Medical Sciences:

Primary Outcome Measures:
  • mortality [ Time Frame: 28 days ] [ Designated as safety issue: No ]

Estimated Enrollment: 27
Study Start Date: November 2008
Estimated Study Completion Date: February 2011
Estimated Primary Completion Date: February 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: conventional treatment Other: plasmapheresis
plasmapheresis 5 times every 24-48 hours. the apheresis volume will be 30 ml/kg.
Other Name: plasma exchange
Experimental: Plasmapheresis Procedure: plasmapheresis
Plasmapheresis was done every 24-48 hours and continues up to five times. Blood samples were collected 30 minutes before and after each session of plasmapheresis to determine sequential changes in plasma levels of IL-1β, IL-6 and TNF-α. During each exchange session a volume of 25-30 ml/kg bodyweight of patient's plasma was exchanged with equal volume of 20% human albumin diluted with normal saline solution. Before and after plasmapheresis, prothrombin time, activated partial thromboplastin time (aPTT), platelet count and serum calcium level were checked. calcium gluconate 10% (10 ml) was administered even if patient had normal serum calcium in order to prevent hypocalcaemia due to administration of citrate. All drugs except for vasopressors were stopped during procedure.
Other Name: plasma exchange
Other: plasmapheresis
plasmapheresis 5 times every 24-48 hours. the apheresis volume will be 30 ml/kg.
Other Name: plasma exchange

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Severe sepsis criteria which were defined by the ACCP/SCCM consensus conference

Exclusion Criteria:

  • Post CPR, pregnant and under 16 years old patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01249222

Contacts
Contact: mojtaba mojtahedzadeh, Ph.D 009821-6695-9090 Mojtahed@sina.tums.ac.ir

Locations
Iran, Islamic Republic of
Tehran University of Medical sciences, Imam hospital Recruiting
Tehran, Iran, Islamic Republic of, 1417653761
Contact: Mojtaba Mojtahedzadeh, Ph.D    009821-6695-9090    Mojtahed@sina.tums.ac.ir   
Principal Investigator: Hadi Hamishehkar, Pharm.D         
Principal Investigator: Mohammad taghi Beigmohammadi, MD         
Sponsors and Collaborators
Tehran University of Medical Sciences
Investigators
Study Chair: Mojtaba Mojtahedzadeh, Ph.D 1Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  More Information

No publications provided

Responsible Party: Pharmaceutical Science research center, PSRC
ClinicalTrials.gov Identifier: NCT01249222     History of Changes
Other Study ID Numbers: D-230-402
Study First Received: November 22, 2010
Last Updated: November 26, 2010
Health Authority: Iran: Ethics Committee

Additional relevant MeSH terms:
Critical Illness
Sepsis
Disease Attributes
Pathologic Processes
Infection
Systemic Inflammatory Response Syndrome
Inflammation

ClinicalTrials.gov processed this record on April 17, 2014