Septic ShockPhase 2/3NCT00995839
Terlipressin in Septic Shock: Effects on Microcirculation
A Phase 2/3 study testing continuous infusion of terlipressin, Arginine vasopressin and terlipressin bolus administration in people with Septic Shock and Sepsis, run by University of Roma La Sapienza at 1 site in Italy.
Trial summary
The present study was conducted as a prospective, randomized study to investigate the effects of vasopressin receptor agonists terlipressin and vasopressin on systemic hemodynamics and microcirculation in patients with catecholamine-dependent septic shock. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Septic Shock, Sepsis
- What is being tested?
- continuous infusion of terlipressin, Arginine vasopressin and terlipressin bolus administration
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteItaly
- Study dates
- Nov 2008to Feb 2010
- Phase
- Phase 2/3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Clinical diagnosis of septic shock
- Vasopressor support to maintain mean arterial pressure (MAP) between 65 and 75 mmHg despite adequate volume resuscitation (pulmonary artery occlusion pressure = 13-18 mmHg and central venous pressure = 8-12 mmHg)
Who cannot join
- Pregnancy
- Age < 18 years
- Present or suspected acute mesenteric ischemia
- Vasospastic diathesis (e.g. Raynaud's syndrome or related diseases)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Vasopressin Receptor Agonists in Septic Shock: Effects on Microcirculation
The present study was conducted as a prospective, randomized study to investigate the effects of vasopressin receptor agonists terlipressin and vasopressin on systemic hemodynamics and microcirculation in patients with catecholamine-dependent septic shock.
Read the detailed description
60 septic shock patients requiring norepinephrine to maintain mean arterial pressure between 65 and 75 mmHg despite adequate volume resuscitation will be enrolled in the study. After an initial hemodynamic resuscitation aimed at achieve a mean arterial pressure between 65 and 75 mmHg and normovolemia, patients will be randomly allocated to be treated with either a) intravenous administration of terlipressin 1 µg∙kg-1∙h-1 for 6 hrs, b) intravenous administration of arginine vasopressin 0.04 UI∙min-1 for 6 hrs, c) intravenous administration of terlipressin bolus dose of 0.5 mg (each n = 20). In all groups open label norepinephrine will be additionally administered to maintain a mean arterial pressure (MAP) between 65 and 75 mmHg, if necessary. Data from right heart catheterization and sublingual microvascular network will be obtained just before randomization (baseline) and then after 6 hours in the vasopressin, terlipressin infusion and terlipressin bolus groups.
The sublingual microvascular network will be studied using the sidestream dark field (SDF)imaging. The device will be applied on the lateral side of the tongue, in an area approximately 2-4 cm from the tip of the tongue. Sequences of 10 secs from eight adjacent areas will be recorded on disk using a personal computer. These sequences will be later analyzed by an investigator blinded to the patient's diagnosis and therapy.
- Conditions
- Septic Shock, Sepsis
- Being tested
- continuous infusion of terlipressin, Arginine vasopressin, terlipressin bolus administration
- Keywords
- terlipressin, vasopressin, sepsis, septic shock, norepinephrine
- Medical subject headings
- Shock, Septic, Sepsis, Diabetes Insipidus
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
continuous infusion of terlipressinDrug
Intravenous continuous infusion of terlipressin 1 µg•kg-1•h-1 for 6 hrs
Arginine vasopressinDrug
Intravenous continuous infusion of arginine vasopressin 0.04 UI•min-1 for 6 hrs
terlipressin bolus administrationDrug
intravenous terlipressin bolus administration at the dose of 0.5 mg
| Study group | Role | What they receive |
|---|---|---|
| continuous terlipressin | Experimental | Not described Receives: Drug: continuous infusion of terlipressin |
| vasopressin | Experimental | Not described Receives: Drug: Arginine vasopressin |
| terlipressin bolus dose | Experimental | Not described Receives: Drug: terlipressin bolus administration |
What is being measured
The primary outcome is the main question the study is designed to answer.
Systemic hemodynamic and Microcirculatory flow index of small and medium vessels (MFI)
Measured: over a period of 6 hrs from the time of randomization
Oxygen transport variables
Measured: over a period of 6 from the time of randomization
Secondary outcomes (5)
Acid-base homeostasis
Measured: over a period of 6 hrs from the time of randomization
Functional capillary density (mm/mm2) (FCD)
Measured: over a period of 6 hrs from the time of randomization
De Backer score
Measured: over a period of 6 hrs from the time of randomization
Perfused Vessel Density (PVD) (mm/mm2)
Measured: over a period of 6 hrs from the time of randomization
Proportion of Perfused vessels (%) (PPV)
Measured: over a period of 6 hrs from the time of randomization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Oct 2009 (estimated)
- Study startNov 2008
- Primary completionFeb 2010
- Study completionFeb 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Septic ShockStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Roma La Sapienza
- Sponsor type
- University, hospital or other
- Investigators
- Andrea Morelli, MD, Principal investigator, University of Rome "La Sapienza", Department of Anesthesiology and Intensive Care
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00995839
- Sponsor's protocol ID
- 1065
- Status last verified
- Oct 2009
- First submitted
- 14 Oct 2009
- Last updated
- 4 Feb 2010
- Results posted
- No
- Data monitoring committee
- No
Publications
Morelli A, Donati A, Ertmer C, Rehberg S, Kampmeier T, Orecchioni A, Di Russo A, D'Egidio A, Landoni G, Lombrano MR, Botticelli L, Valentini A, Zangrillo A, Pietropaoli P, Westphal M. Effects of vasopressinergic receptor agonists on sublingual microcirculation in norepinephrine-dependent septic shock. Crit Care. 2011;15(5):R217. doi: 10.1186/cc10453. Epub 2011 Sep 19.
PubMed 21929764
Study at a glance
From the registry record, last updated by the sponsor on 4 Feb 2010. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Vasopressin Receptor Agonists in Septic Shock: Effects on Microcirculation
- ClinicalTrials.gov ID
- NCT00995839
- Acronym / sponsor ID
- 1065
- Conditions
- Septic Shock, Sepsis
- Keywords
- terlipressin, vasopressin, sepsis, septic shock, norepinephrine
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- University of Roma La SapienzaUniversity, hospital or other
- Study start
- Nov 2008
- Primary completion
- Feb 2010 (actual)
- Study completion
- Feb 2010 (actual)
- First posted
- 15 Oct 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The present study was conducted as a prospective, randomized study to investigate the effects of vasopressin receptor agonists terlipressin and vasopressin on systemic hemodynamics and microcirculation in patients with catecholamine-dependent septic shock.
Detailed description
60 septic shock patients requiring norepinephrine to maintain mean arterial pressure between 65 and 75 mmHg despite adequate volume resuscitation will be enrolled in the study. After an initial hemodynamic resuscitation aimed at achieve a mean arterial pressure between 65 and 75 mmHg and normovolemia, patients will be randomly allocated to be treated with either a) intravenous administration of terlipressin 1 µg∙kg-1∙h-1 for 6 hrs, b) intravenous administration of arginine vasopressin 0.04 UI∙min-1 for 6 hrs, c) intravenous administration of terlipressin bolus dose of 0.5 mg (each n = 20). In all groups open label norepinephrine will be additionally administered to maintain a mean arterial pressure (MAP) between 65 and 75 mmHg, if necessary. Data from right heart catheterization and sublingual microvascular network will be obtained just before randomization (baseline) and then after 6 hours in the vasopressin, terlipressin infusion and terlipressin bolus groups.
The sublingual microvascular network will be studied using the sidestream dark field (SDF)imaging. The device will be applied on the lateral side of the tongue, in an area approximately 2-4 cm from the tip of the tongue. Sequences of 10 secs from eight adjacent areas will be recorded on disk using a personal computer. These sequences will be later analyzed by an investigator blinded to the patient's diagnosis and therapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| continuous terlipressin | Experimental | Drug: continuous infusion of terlipressin |
| vasopressin | Experimental | Drug: Arginine vasopressin |
| terlipressin bolus dose | Experimental | Drug: terlipressin bolus administration |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Clinical diagnosis of septic shock
- Vasopressor support to maintain mean arterial pressure (MAP) between 65 and 75 mmHg despite adequate volume resuscitation (pulmonary artery occlusion pressure = 13-18 mmHg and central venous pressure = 8-12 mmHg)
Key exclusion criteria (4 listed)
- Pregnancy
- Age < 18 years
- Present or suspected acute mesenteric ischemia
- Vasospastic diathesis (e.g. Raynaud's syndrome or related diseases)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| continuous infusion of terlipressinIntravenous continuous infusion of terlipressin 1 µg•kg-1•h-1 for 6 hrs | Drug | continuous terlipressin |
| Arginine vasopressinIntravenous continuous infusion of arginine vasopressin 0.04 UI•min-1 for 6 hrs | Drug | vasopressin |
| terlipressin bolus administrationintravenous terlipressin bolus administration at the dose of 0.5 mg | Drug | terlipressin bolus dose |
Primary outcome
Systemic hemodynamic and Microcirculatory flow index of small and medium vessels (MFI)
Time frame: over a period of 6 hrs from the time of randomization
Oxygen transport variables
Time frame: over a period of 6 from the time of randomization
5 secondary outcomes
Acid-base homeostasis
Time frame: over a period of 6 hrs from the time of randomization
Functional capillary density (mm/mm2) (FCD)
Time frame: over a period of 6 hrs from the time of randomization
De Backer score
Time frame: over a period of 6 hrs from the time of randomization
Perfused Vessel Density (PVD) (mm/mm2)
Time frame: over a period of 6 hrs from the time of randomization
Proportion of Perfused vessels (%) (PPV)
Time frame: over a period of 6 hrs from the time of randomization
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Feb 2010.
- Derived from this study: PubMed 21929764Morelli A, Donati A, Ertmer C, Rehberg S, Kampmeier T, Orecchioni A, Di Russo A, D'Egidio A, Landoni G, Lombrano MR, Botticelli L, Valentini A, Zangrillo A, Pietropaoli P, Westphal M. Effects of vasopressinergic receptor agonists on sublingual microcirculation in norepinephrine-dependent septic shock. Crit Care. 2011;15(5):R217. doi: 10.1186/cc10453. Epub 2011 Sep 19.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Andrea Morelli, MD principal investigator
University of Rome "La Sapienza", Department of Anesthesiology and Intensive Care
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing continuous infusion of terlipressin, Arginine vasopressin and terlipressin bolus administration in people with Septic Shock and Sepsis, run by University of Roma La Sapienza at 1 site in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Feb 2010. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Systemic hemodynamic and Microcirculatory flow index of small and medium vessels (MFI) (time frame: over a period of 6 hrs from the time of randomization). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00995839, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2010.