Septic ShockNCT02750683
Norepinephrine Exerts an Inotropic Effect at the Early Phase of Human Septic Shock
An observational study of Septic Shock, run by Hopital Antoine Beclere.
Trial summary
Norepinephrine (NE) is a potent vasopressor used in septic shock to reverse hypotension. Early infusion of NE was associated with a favorable clinical outcome in a large cohort of patients . When administered early, NE increases cardiac output (CO) in patients with septic shock . Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Septic Shock
- How many people
- 38 participants
- Where
- No sites listed yet
- Study dates
- Oct 2014to Jan 2016
- Phase
- Observational
- 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
Study population: Patients with an age of more than 18 years old, admitted to intensive care unit with septic shock and a mean arterial pressure of less than 65mmHg.
Who may be able to join
- Age more than 18 years old
- Septic shock
- Mean arterial pressure<65mmHg
Who cannot join
- Age less than 18 yeras old
- Pregnancy
- moribond patients
About this study
Official title: Norepinephrine Exerts an Inotropic Effect at the Early Phase of Human Septic
Norepinephrine (NE) is a potent vasopressor used in septic shock to reverse hypotension. Early infusion of NE was associated with a favorable clinical outcome in a large cohort of patients . When administered early, NE increases cardiac output (CO) in patients with septic shock . This effect was suggested to be mainly related to an increased cardiac preload via the α-adrenergic-mediated decrease in systemic venous capacitance . Whether NE exerts a positive effect on cardiac contractility through β1-adrenergic stimulation is unclear. On the one hand, the sensitivity of β1-adrenergic receptors can be abnormally reduced in septic conditions. On the other hand, such a sepsis-induced down-regulation of β1-adrenergic receptors may occur relatively late and thus, might not be observed when NE is administered early. Our study was designed to examine the inotropic effects of NE when administered in the early phase of human septic shock
Read the detailed description
It is a prospective observational study, in two 15-bed intensive care units, including adult patients with septic shock who have a mean arterial pressure (MAP) < 65 mmHg within the first three hours after the start of resuscitation. For every patient, the physician taking care of the patient should have already decided to initiate NE or to increase its dose in order to achieve a MAP value of at least 65mmHg without any other change of the associated therapy (fluid administration, ventilator settings, other drugs). The study was approved by the institutional review board of our institution (Comité de Protection des Personnes, Paris-Ile-de-France VII). Informed patient (or next-of-kin) consent was obtained from all patients.
Data collection: demographic and clinical information (origin of sepsis, major elements of the clinical history) were collected. The volume of fluids administered before inclusion, the use of mechanical ventilation and the interval time between the start of resuscitation and inclusion (T0) were also recorded.
Hemodynamic data: At T0 and at T1, defined as the time a MAP value of at least 65 mmHg was reached after initiating NE (or increasing its dose), heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), MAP and blood lactate concentration were collected.
Transthoracic echocardiographic data: Echocardiographic measurements were performed at T0 and T1.
Transthoracic echocardiographic (TTE) examination were performed with 3.75 MHZ probe using a CX50 Philips and a Vivid i (GE Healthcare) machine. Patients were on supine flat or lateral supine positions depending on their respiratory tolerance. A four- and five-chamber apical views were used in order to collect the following variables: left ventricular ejection fraction (LVEF) calculated by the biplane method of disks summation (modified Simpson's rule), velocity-time integral (VTI) of the sub-aortic flow, tissue Doppler imaging of tricuspid annular motion (Sa), tricuspid annular plane systolic excursion (TAPSE) measured by M-mode echocardiography, the peak early (E) and late (A) transmitral flow velocity, the mean early diastolic velocity (Ea) of the lateral mitral annulus, the ratios E/A and E/Ea and tissue Doppler imaging of mean systolic velocity of the lateral mitral annulus (Sm). All the parameters were averaged over three beats or five beats in case of atrial fibrillation.
- Conditions
- Septic Shock
- Keywords
- inotropic effect, norepinephrine, septic shock,
- Medical subject headings
- Shock, Septic
What is being measured
The primary outcome is the main question the study is designed to answer.
The changes in left ventricular ejection fraction
Measured: 2 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Apr 2016 (estimated)
- Study startOct 2014
- Primary completionJan 2016
- Study completionJan 2016
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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 38 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hopital Antoine Beclere
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hamzaoui Olfa, Hopital Antoine Beclere
- Investigators
- Olfa Hamzaoui, MD, Principal investigator, Hopital Antoine Beclere
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02750683
- Sponsor's protocol ID
- 2011-A-01230-41
- Status last verified
- Apr 2016
- First submitted
- 21 Apr 2016
- Last updated
- 26 Apr 2016
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Hamzaoui O, Jozwiak M, Geffriaud T, Sztrymf B, Prat D, Jacobs F, Monnet X, Trouiller P, Richard C, Teboul JL. Norepinephrine exerts an inotropic effect during the early phase of human septic shock. Br J Anaesth. 2018 Mar;120(3):517-524. doi: 10.1016/j.bja.2017.11.065. Epub 2017 Nov 21.
PubMed 29452808
Study at a glance
From the registry record, last updated by the sponsor on 26 Apr 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Norepinephrine Exerts an Inotropic Effect at the Early Phase of Human Septic
- ClinicalTrials.gov ID
- NCT02750683
- Acronym / sponsor ID
- 2011-A-01230-41
- Conditions
- Septic Shock
- Keywords
- inotropic effect, norepinephrine, septic shock,
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 38 participants (actual)
- Lead sponsor
- Hopital Antoine BeclereUniversity, hospital or other
- Study start
- Oct 2014
- Primary completion
- Jan 2016 (actual)
- Study completion
- Jan 2016 (actual)
- First posted
- 25 Apr 2016 (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.
Norepinephrine (NE) is a potent vasopressor used in septic shock to reverse hypotension. Early infusion of NE was associated with a favorable clinical outcome in a large cohort of patients . When administered early, NE increases cardiac output (CO) in patients with septic shock . This effect was suggested to be mainly related to an increased cardiac preload via the α-adrenergic-mediated decrease in systemic venous capacitance . Whether NE exerts a positive effect on cardiac contractility through β1-adrenergic stimulation is unclear. On the one hand, the sensitivity of β1-adrenergic receptors can be abnormally reduced in septic conditions. On the other hand, such a sepsis-induced down-regulation of β1-adrenergic receptors may occur relatively late and thus, might not be observed when NE is administered early. Our study was designed to examine the inotropic effects of NE when administered in the early phase of human septic shock
Detailed description
It is a prospective observational study, in two 15-bed intensive care units, including adult patients with septic shock who have a mean arterial pressure (MAP) < 65 mmHg within the first three hours after the start of resuscitation. For every patient, the physician taking care of the patient should have already decided to initiate NE or to increase its dose in order to achieve a MAP value of at least 65mmHg without any other change of the associated therapy (fluid administration, ventilator settings, other drugs). The study was approved by the institutional review board of our institution (Comité de Protection des Personnes, Paris-Ile-de-France VII). Informed patient (or next-of-kin) consent was obtained from all patients.
Data collection: demographic and clinical information (origin of sepsis, major elements of the clinical history) were collected. The volume of fluids administered before inclusion, the use of mechanical ventilation and the interval time between the start of resuscitation and inclusion (T0) were also recorded.
Hemodynamic data: At T0 and at T1, defined as the time a MAP value of at least 65 mmHg was reached after initiating NE (or increasing its dose), heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), MAP and blood lactate concentration were collected.
Transthoracic echocardiographic data: Echocardiographic measurements were performed at T0 and T1.
Transthoracic echocardiographic (TTE) examination were performed with 3.75 MHZ probe using a CX50 Philips and a Vivid i (GE Healthcare) machine. Patients were on supine flat or lateral supine positions depending on their respiratory tolerance. A four- and five-chamber apical views were used in order to collect the following variables: left ventricular ejection fraction (LVEF) calculated by the biplane method of disks summation (modified Simpson's rule), velocity-time integral (VTI) of the sub-aortic flow, tissue Doppler imaging of tricuspid annular motion (Sa), tricuspid annular plane systolic excursion (TAPSE) measured by M-mode echocardiography, the peak early (E) and late (A) transmitral flow velocity, the mean early diastolic velocity (Ea) of the lateral mitral annulus, the ratios E/A and E/Ea and tissue Doppler imaging of mean systolic velocity of the lateral mitral annulus (Sm). All the parameters were averaged over three beats or five beats in case of atrial fibrillation.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with an age of more than 18 years old, admitted to intensive care unit with septic shock and a mean arterial pressure of less than 65mmHg.
Key inclusion criteria (3 listed)
- Age more than 18 years old
- Septic shock
- Mean arterial pressure<65mmHg
Key exclusion criteria (3 listed)
- Age less than 18 yeras old
- Pregnancy
- moribond patients
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
The changes in left ventricular ejection fraction
Time frame: 2 hours
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 26 Apr 2016.
- Derived from this study: PubMed 29452808Hamzaoui O, Jozwiak M, Geffriaud T, Sztrymf B, Prat D, Jacobs F, Monnet X, Trouiller P, Richard C, Teboul JL. Norepinephrine exerts an inotropic effect during the early phase of human septic shock. Br J Anaesth. 2018 Mar;120(3):517-524. doi: 10.1016/j.bja.2017.11.065. Epub 2017 Nov 21.
- Individual participant dataSharing planned: No
Related trials for Septic Shock
Not yet recruitingObservational study
Longitudinal Trajectories of Myocardial Work in Patients With Sepsis
Sepsis, Septic Shock Hyperdynamic
RecruitingObservational study
Immunothrombosis With Septic Shock Undergoing Renal Replacement Therapy With the OXIRIS Membrane
Sepsis
RecruitingPhase 3
A Trial of Adjunctive Fludrocortisone (50mcg, 100mcg or Placebo) in Critically Ill Patients With Septic Shock Receiving Hydrocortisone, Evaluating Survival and Functional Recovery and the Influence of Transcriptomic Response
Septic Shock
Not yet recruitingObservational study
Serum GDF-15 and LGALS3BP as Prognostic Biomarkers in Sepsis
Sepsis, Septic Shock
RecruitingObservational study
Clinical Value of EMR3 in Sepsis Diagnosis, Monitoring, and Prognosis: A Multicenter Prospective Observational Study
Sepsis
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.
Olfa Hamzaoui, MD principal investigator
Hopital Antoine Beclere
Questions about this trial
What is this clinical trial studying?
An observational study of Septic Shock, run by Hopital Antoine Beclere.
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 3 inclusion and 3 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 26 Apr 2016. Status can change between updates, so confirm with the study contact before making plans.
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.
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?
The changes in left ventricular ejection fraction (time frame: 2 hours). 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 NCT02750683, 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 26 Apr 2016.