Antithrombin III in Infants With Cardiopulmonary Bypass (CPB)
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Purpose
The purpose of this study is to discern whether supplementation of Antithrombin III will decrease coagulation and inflammation associated with cardiopulmonary bypass in infants undergoing cardiac surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Congenital Heart Disease |
Drug: Antithrombin III Drug: Placebo |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | Antithrombin III Supplementation for Infants Undergoing Cardiac Surgery With Cardiopulmonary Bypass. |
- The primary hypothesis is that treatment with ATIII before bypass will decrease the activation of inflammation during CPB as measured by plasma neutrophil elastase. [ Time Frame: Expected average of 24 months ] [ Designated as safety issue: Yes ]Patients treated with ATIII as standard of care (good clinical practice) will remain in the study and be analyzed by their intention to treat group. Review of our clinical experience shows that treatment with ATIII for heparin resistance occurs in 2-3% of cases. If there are more than two patients so treated, we will also perform an "as-treated" analysis.
- p-selectin [ Time Frame: expected average of 24 months ] [ Designated as safety issue: Yes ]
- interleukin-6 [ Time Frame: Expected average of 24 months ] [ Designated as safety issue: Yes ]
- prothrombin fragment 1.2 [ Time Frame: expected average of 24 months ] [ Designated as safety issue: Yes ]
- 24 hour blood loss [ Time Frame: 24 hours post surgery ] [ Designated as safety issue: Yes ]
- ICU length of stay [ Time Frame: Expected average of 3 days ] [ Designated as safety issue: Yes ]
- Hospital length of stay [ Time Frame: Expected average of 3 weeks ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 40 |
| Study Start Date: | July 2012 |
| Estimated Study Completion Date: | August 2014 |
| Estimated Primary Completion Date: | August 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Antithrombin III
Product- Antithrombin III is derived from pooled human plasma ATIII will be dosed using the formula recommended by the manufacturer: (goal activity - baseline activity) x weight (kg) x .714 (Assume: start with 35% activity [7], goal 120% activity[18], so dose = 120-35 x wt (kg) x .714, e.g. 5 kg infant: 85 x 5 x .714 = 303 units) a. |
Drug: Placebo
placebo (normal saline) after induction of anesthesia and before commencement of bypass. ATIII will be dosed using the formula recommended by the manufacturer: (goal activity - baseline activity) x weight (kg) x .714 (Assume: start with 35% activity [7], goal 120% activity[18], so dose = 120-35 x wt (kg) x .714, e.g. 5 kg infant: 85 x 5 x .714 = 303 units)
Other Name: Normal Saline
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|
Placebo Comparator: Placebo
placebo (normal saline)
|
Drug: Antithrombin III
ATIII will be dosed using the formula recommended by the manufacturer: (goal activity - baseline activity) x weight (kg) x .714 (Assume: start with 35% activity [7], goal 120% activity[18], so dose = 120-35 x wt (kg) x .714, e.g. 5 kg infant: 85 x 5 x .714 = 303 units) Other Name: Thrombate
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | up to 180 Days |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subjects will be included if they are presenting for elective cardiac surgery using cardiopulmonary bypass and are 180 days of age or less.
Exclusion Criteria:
Sensitivity to ATIII product (Thrombate, Grifols, Los Angeles, CA)
- Known inherited or acquired coagulation defect
- Current or prior treatment with pro-or anticoagulant medication within past 30 days (except aspirin or a single dose of heparin, e.g. for catheterization)
- Known central venous thrombosis
- Recent (30 days) transfusion with hemostatic blood products (fresh-frozen plasma, platelets, cryoprecipitate, whole blood)
- wt less than 3000g
Contacts and Locations| Contact: Michael Eaton, MD | 585-275-2141 | Michael_eaton@urmc.rochester.edu |
| Contact: Suzanne Donahue, RN | 585-275-1650 | suzanne_donahue@urmc.rochester.edu |
| United States, New York | |
| Michael Eaton, MD | Recruiting |
| Rochester, New York, United States, 14642 | |
| Contact: Suzanne Donahue, RN 585-275-1650 suzanne_donahue@urmc.rochester.edu | |
| Contact: Tammy Ortiz 585-273-2972 tammy_ortiz@urmc.rochester.edu | |
| Principal Investigator: | Michael Eaton, MD | University of Rochester |
More Information
No publications provided
| Responsible Party: | Michael Eaton, Principal Investigator, University of Rochester |
| ClinicalTrials.gov Identifier: | NCT01698567 History of Changes |
| Other Study ID Numbers: | 38402 |
| Study First Received: | September 4, 2012 |
| Last Updated: | October 3, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Rochester:
|
Infants Cardiopulmonary bypass anticoaglution |
Additional relevant MeSH terms:
|
Heart Diseases Heart Defects, Congenital Cardiovascular Diseases Cardiovascular Abnormalities Congenital Abnormalities Antithrombins Antithrombin III Antithrombin Proteins |
Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Anticoagulants Hematologic Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 17, 2013