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Acute on Chronic Systolic Congestive Heart FailureNEUTRALIZE-CRSNCT03836482

Feasibility of the SCD in Cardiorenal Syndrome Patients Awaiting LVAD

A study testing Selective Cytopheretic Device in people with Acute on Chronic Systolic Congestive Heart Failure and Cardiorenal Syndrome, run by SeaStar Medical at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Cardiovascular disease is the leading cause of mortality in the US, accounting for 45% of all deaths. Chronic Heart Failure (CHF) is now understood to be a multi-system disease process involving not only the cardiovascular system but also the renal, neuroendocrine, and immune systems. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Selective Cytopheretic Device
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
2 Oct 2025to Aug 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Age of 18 years and older.
  • Evidence of systemic inflammation: blood CRP ≥ 4.5 mg/L or IL-6 ≥ 5.0 pg/ml or neutrophil to lymphocyte ratio ≥3.0.
  • Primary hospitalization for acute decompensated chronic systolic heart failure.
  • Potential LVAD candidate with:
  • Left ventricular ejection fraction ≤25% (for potential destination therapy) or ≤ 35% (for potential bridge to transplantation) as confirmed by baseline imaging procedure b) NYHA class IIIB or IV chronic (≤ 90 days) systolic heart failure, with failure to respond to optimal medical therapy (beta blocker, ACE inhibitor or ARB or valsartan/sacubitril, aldosterone antagonist, SGLT2i, unless not tolerated or contraindicated, and loop diuretic, as needed) for 45 of the last 60 days c) Known previous peak exercise oxygen consumption < 14 mL/Kg/min or if unable to exercise, dependent on an intra-aortic balloon pump, short-term mechanical circulatory support device or intravenous inotropes unless inotropes contraindicated for clinical reasons (e.g., ventricular arrhythmias)
  • Baseline eGFR** ≥ 40 ml/min/1.73 m2 (baseline defined as the highest known eGFR within 90 days of study enrollment)
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  • At least one of the following two criteria:
  • Severe right ventricular failure (RVF), defined as meeting at least 2 of the following 4 criteria -Central venous pressure > 16 mmHg
  • -Central venous pressure/Pulmonary wedge pressure >0.65
  • -Right ventricular stroke work index < 300 mmHg ml/m2
  • -Pulmonary artery pulsatility index (PAPi) < 2,
  • Worsening renal failure (WRF), defined for the purposes of this study as -Increase serum creatinine ≥ 0.5 mg/dL from baseline (baseline defined as the lowest known serum creatinine within 90 days of study enrollment) AND
  • eGFR ≤ 30 ml/min/1.73 m2 based on serum creatinine at enrollment* AND
  • Cardiorenal syndrome is the most likely explanation for WRF AND
  • Intolerant or inadequately responsive to standard of care diuretic therapy, defined as persistent signs and/or symptoms of congestion (e.g., peripheral edema, dyspnea, pulmonary rales, neck vein distension) or minimal net volume removal in a 24-hour period despite optimal medical therapy including intravenous diuretic therapy and an estimated need for >5kg fluid removal.
  • Optimal intravenous diuretic therapy is defined as:
  • Furosemide equivalent total daily dose of 240mg
  • Furosemide equivalent dose given either as a single or multiple intravenous bolus or continuous infusion
  • A furosemide equivalent total daily dose <240mg if the dose has resulted in >3000 mL urine output/24 hours.
  • PA catheter in place at the time of enrollment
  • PCW ≥ 20 mmHg
  • eGFR calculated using the CKD-EPI Creatinine Equation *** Recognizing that this is not a steady state creatinine

Who cannot join

  • Any clear contraindication to LVAD therapy that is unlikely to resolve with improvement in renal function and volume status
  • Prior sensitivity to dialysis device components
  • Active bacteremia
  • Temperature ≥ 101.5 F or WBC ≥ 10,000 K/uL or any patient with suspected systemic infection.
  • Metastatic malignancy requiring palliative chemo, biologic, or radiation
  • Need for intravenous vasopressor (i.e., phenylephrine, vasopressin), intravenous vasoconstricting inotrope (i.e., norepinephrine or epinephrine) or dopamine > 3 mcg/kg/min. (Note: use of vasodilating inotropes [i.e., dobutamine and milrinone] or dopamine at ≤ 3 mcg/kg/min will not preclude study inclusion)
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  • Patients requiring mechanical ventilatory support
  • Patients requiring total parenteral nutrition during the treatment period
  • Persistent SBP < 80 mmHg
  • WBC < 4000 K/uL
  • Platelets < 100,000K/uL
  • Serum creatinine > 4 mg/dL or receiving dialysis / CRRT
  • Acute coronary syndrome within the past month
  • Women who are pregnant, breastfeeding a child, or trying to become pregnant
  • Concurrent enrollment in another interventional clinical trial. Patients enrolled in clinical studies where only measurements and/or samples are taken (i.e., no test device or test drug used) are allowed to participate
  • Use of any other investigational drug or device within the previous 30 days. Patients who participated in a clinical study where only measurements and/or samples are taken (i.e., no test device or drug used) are allowed to participate.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • University of Michigan

    Ann Arbor, Michigan, 48109

    Abbas Bitar, MD, 317-554-7788

    Recruiting

Other trials in United States

About this study

Official title: Feasibility Study to Assess the Safety and Efficacy of a Selective Cytopheretic Device (SCD) to Treat ICU Patients With Acute on Chronic Systolic Heart Failure With Worsening Renal Function Due to Cardiorenal Syndrome or Severe Right Ventricular Failure Awaiting Left Ventricular Assist Device Implantation

Cardiovascular disease is the leading cause of mortality in the US, accounting for 45% of all deaths. Chronic Heart Failure (CHF) is now understood to be a multi-system disease process involving not only the cardiovascular system but also the renal, neuroendocrine, and immune systems. No effective therapy is currently available to treat the most severe subset of CHF patients that have progressed to acute decompensated HF. An innovative approach to reduce the cardio-depressant effects associated with the chronic inflammatory state of CHF may provide a breakthrough for this disorder. This proposal will evaluate the safety and probable benefit to improve cardiac or renal function with an immunomodulatory device to bridge patients to Left Ventricular Assist Device (LVAD) implantation who were previously deemed ineligible for this life sustaining procedure. The Selective Cytopheretic Device (SCD) is an immuno-regulating, extracorporeal membrane device targeted to modulate the cardiodepressant effects assocaited with CHF. SCD is a platform technology focused on immunomodulation of acute and chronic inflammation associated with acute and chronic organ dysfunction. SCD membranes selectively sequester activated systemic leukocytes as they flow through the cartridge via an extracorporeal circuit. Pre-clinical results show that SCD treatment results in a 25% improvement in ejection fraction in a canine CHF model.

This study will enroll 20 patients across up to 5 clinical sites to evaluate the safety and initial efficacy data of SCD treatment in this indication. Patients will receive 4-hour daily SCD treatment for up to 6 days, followed by 6 months of follow up.

Being tested
Selective Cytopheretic Device
Keywords
Awaiting Left ventricular assist device implantation, Hospitalized, Selective Cytopheretic Device, SCD, LVAD, CRS
Medical subject headings
Cardio-Renal Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Selective Cytopheretic DeviceDevice

    Treatment will be delivered for 4 hours a day for up to 6 consecutive days.

Study groups in NCT03836482
Study groupRoleWhat they receive
Selective Cytopheretic DeviceExperimentalNot described
Receives: Device: Selective Cytopheretic Device

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Need for continuous IV vasopressor support

    Need for continuous IV vasopressor support with >5 total norepinephrine equivalents and/or >3 vasopressor agents >4 hours following termination of daily SCD therapy session to maintain a MAP >60 mmHg, with norepinephrine equivalents defined as:

    1. 1 x epinephrine (ug/kg/min)
    2. 001 x dopamine (ug/kg/min)
    3. 0.06 x phenylephrine (ug/kg/min)
    4. 2.5 x vasopressin (U/min) (Note that use of inotropes (i.e., dobutamine and milrinone) or dopamine at ≤3 mcg/kg/min are not components of this measure.)

    Measured: measured daily, at or after 4 hours after termination of daily SCD therapy

  2. Acute myocardial infarction

    Acute myocardial infarction as evidenced by elevated cardiac enzymes, with electrocardiographic or imaging findings consistent with myocardial damage and confirmed by Cardiology.

    Measured: up to 6 months following SCD treatment initiation

  3. Mortality

    Death

    Measured: up to 6 months following SCD treatment initiation

  4. Percentage of subjects with reversal of WRF and increase eGFR and PCW

    Among patients with WRF, the percentage of subjects with reversal of WRF (≥ 0.5 mg/dL reduction of serum creatinine from level at study entry), and achieving an eGFR > 30 ml/min/1.73 m2 and PCWP at or below level at study entry at termination of SCD therapy.

    Measured: up to 6 days after initiation of SCD therapy

  5. Percentage of subjects who no longer have severe right ventricular failure

    Among subjects with severe RVF, the percentage of subjects who no longer have severe right ventricular failure, as evidenced by absence of 3 or more of the following 4 indicators of right ventricular failure:

    1. CVP > 16 mmHg
    2. CVP/PCWP > 0.65
    3. RVSWI < 300 mmHg * mL/m
    4. PAPi < 2

    Measured: up to 6 days after initiation of SCD therapy

  6. Adverse Events

    Adverse Events due to SCD, hemodialysis catheter, KRT pump, circuit, and hemofilter

    Measured: up to 6 days after initiation of SCD therapy

Secondary outcomes (16)
  1. Percentage of subject receiving a left ventricular assist device

    Measured: up to 30 days after the last SCD

  2. Change in 24 hour urine volume

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  3. Change in urine sodium

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  4. Change in urine creatinine

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  5. Change in urine urea

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  6. Change in creatinine clearance

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  7. Change in urine urea clearance

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  8. Change in Pulmonary Capillary Wedge Pressure (PCWP)

    If PCWP cannot be obtained, Pulmonary Artery Diastolic Pressure (PADP) will be used in its place. When utilizing PADP in place of PCWP for change measures, comparisons will be made to baseline PADP.

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  9. Change in serum sodium

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  10. Change in serum potassium

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  11. Change in serum dissolved carbon dioxide (CO2)

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  12. Change in blood urea nitrogen (BUN)

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  13. Change in serum creatinine

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  14. Percentage of subjects with reduction of serum creatinine (≥ 0.5 mg/dL) and PCWP (≤ 18 mmHg)

    If PCWP cannot be obtained, PADP will be used in its place. When utilizing PADP in place of PCWP for change measures, comparisons will be made to baseline PADP

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

  15. Percentage of subjects receiving a left ventricular assist device with serum creatinine ≥ 0.5 mg/dL below level at study entry

    Measured: 30 days following discontinuation of SCD

  16. Change in right ventricular fractional area change

    Change in right ventricular fractional area change, TAPSE, and right ventricular global longitudinal strain

    Measured: change from onset of intervention to 3 and 6 days after initiation of SCD treatments and from onset of intervention to end of SCD support prior to LVAD implantation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Feb 2019
  2. Study start2 Oct 2025
  3. Primary completionFeb 2027 (estimated)
  4. Study completionAug 2027 (estimated)

Resources

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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03836482
Sponsor's protocol ID
SCD-CRS-01
Other IDs
1R44HL170779-01A1
Acronym
NEUTRALIZE-CRS
Status last verified
Mar 2026
First submitted
7 Feb 2019
Last updated
31 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Selective Cytopheretic Device in people with Acute on Chronic Systolic Congestive Heart Failure and Cardiorenal Syndrome, run by SeaStar Medical at 1 site in United States.

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 22 inclusion and 16 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: looking for participants now, as of the sponsor's last update on 31 Mar 2026. 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 United States. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Need for continuous IV vasopressor support (time frame: measured daily, at or after 4 hours after termination of daily SCD therapy). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 31 Mar 2026.

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