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Acute Aortic DissectionNCT05874700

A Pilot Study of Sivelestat Sodium to Shorten Mechanical Ventilation in Acute Aortic Dissection

A study testing Sivelestat sodium was given intravenously in people with Acute Aortic Dissection, run by Xiaotong Hou at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is A prospective, randomized, placebo-controlled, reestimable adaptive clinical study to evaluate the efficacy and safety of perioperative application of sivelestat sodium to shorten the duration of postoperative invasive mechanical ventilation in acute type A aortic dissection patients with preoperative moderate… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Acute Aortic Dissection
What is being tested?
Sivelestat sodium was given intravenously
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteChina
Study dates
May 2023to Feb 2024
Phase
Interventional
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18-75;
  • Spontaneous acute (≤14 days) type A aortic dissection;
  • In the emergency department, hypothermic circulatory arrest combined with unilateral anterograde cerebral perfusion was expected to be performed on the aortic arch surgery;
  • Preoperative PaO2/FiO2≤200mmHg;

Who cannot join

  • Preoperative cardiogenic shock;
  • preoperative liver insufficiency;
  • Preoperative dissection involves important organs and seriously endangers the patient's life
  • Pregnant women;
  • hereditary connective tissue diseases, such as Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, etc.;
  • Behcet's disease;
Show all 17Show fewer
  • aortitis;
  • There is a history of neurologic disease that has been clearly diagnosed;
  • There is a history of a clearly diagnosed mental illness;
  • There is a definite diagnosis of chronic respiratory disease;
  • There is a clearly diagnosed immune disease;
  • There is a definite diagnosis of hematological diseases;
  • severe renal failure or require dialysis treatment;
  • Taking anti-inflammatory or anti-coagulant drugs within a week before admission;
  • People who are allergic to sivelestat sodium and other ingredients;
  • Has participated in other clinical trials;
  • The clinician judges that it is not suitable for inclusion in the study;

Trial locations and contacts

1 site in 1 country.

Xiaotong Hou, MD contact

8610 64456631

xt.hou@ccmu.edu.cn

Xiaomeng Wang, MD contact

8610 64456631

dxqzwxm@163.com

China1 site
  • Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University

    Beijing, Beijing Municipality, 100029

Other trials in China

About this study

Official title: A Pilot Study of Perioperative Application of Sivelestat Sodium in Acute Type A Aortic Dissection Patients With Preoperative Moderate to Severe Hypoxemia to Shorten the Duration of Postoperative Invasive Mechanical Ventilation

This is A prospective, randomized, placebo-controlled, reestimable adaptive clinical study to evaluate the efficacy and safety of perioperative application of sivelestat sodium to shorten the duration of postoperative invasive mechanical ventilation in acute type A aortic dissection patients with preoperative moderate and severe hypoxemia (PaO2/FiO2≤200mmHg).

Read the detailed description

In recent years, sivelestat sodium therapy has been used to treat and prevent CPB-associated lung injury with good results. Morimoto K et al., randomized control of a small sample size, demonstrated that sivelestat sodium improves respiratory function in patients with severe respiratory failure after hypothermia thoracic aortic surgery. A retrospective study by Morimoto N et al. confirmed that prophylactic application of sivelestat sodium at the beginning of CPB could improve postoperative respiratory function and shorten the duration of mechanical ventilation in patients with hypothermic circulatory arrest. At present, there is a lack of reliable RCTS to confirm that the intraoperative application of sivelestat sodium can effectively treat preoperative acute lung injury, improve CPB-related lung injury, and reduce the incidence of postoperative acute lung injury. Therefore, the objective of this study was to design A randomized controlled study to evaluate the clinical efficacy and safety of intraoperative use of sivelestat sodium to shorten the duration of postoperative invasive mechanical ventilation in acute type A aortic dissection patients with preoperative moderate to severe hypoxemia. The purpose of this preliminary clinical trial is to provide theoretical basis for sample size calculation of randomized controlled trials, and to evaluate the scientific nature and feasibility of randomized controlled trials.

Being tested
Sivelestat sodium was given intravenously, Placebo was given intravenously
Keywords
acute type A aortic dissection, preoperative moderate to severe hypoxemia, sivelestat sodium

What participants receive

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

  • Sivelestat sodium was given intravenouslyDrug

    Also called Sivelestat sodium group

    Anesthesia induction began with a 0.2mg/Kg/h pump test drug until 48 hours after endotracheal intubation was removed or up to 7 days. If the patient was judged to have successfully removed the endotracheal tube, drug administration was discontinued; If the endotracheal intubation was not removed successfully up to 7 days, drug administration was also discontinued. During CPB, 0.1mg/100mL of the experimental drug was injected into the circulating pump immediately after CPB began.

  • Placebo was given intravenouslyDrug

    Also called Placebo control group

    Anesthesia induction began with a 0.2mg/Kg/h pump test drug until 48 hours after endotracheal intubation was removed or up to 7 days. If the patient was judged to have successfully removed the endotracheal tube, drug administration was discontinued; If the endotracheal intubation was not removed successfully up to 7 days, drug administration was also discontinued. During CPB, 0.1mg/100mL of the experimental drug was injected into the circulating pump immediately after CPB began.

Study groups in NCT05874700
Study groupRoleWhat they receive
Sivelestat sodium groupExperimentalsivelestat sodium
Receives: Drug: Sivelestat sodium was given intravenously
Placebo control groupPlacebo comparatorPlacebo control
Receives: Drug: Placebo was given intravenously

What is being measured

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

  1. Invasive mechanical ventilation time

    Duration from the initiation of invasive mechanical ventilation to the first successful removal of the endotracheal tube

    Measured: 28 days after surgery

Secondary outcomes (5)
  1. Total invasive mechanical ventilation

    mode and duration

    Measured: 28 days after surgery

  2. Total non-invasive mechanical ventilation

    mode and duration

    Measured: 28 days after surgery

  3. Total high flow oxygen uptake

    mode and duration

    Measured: 28 days after surgery

  4. Oxygenation index and area under curve

    Oxygenation index

    Measured: 28 days after surgery

  5. PaO2/FiO2≤300mmHg Duration

    Duration of hypoxemia

    Measured: 28 days after surgery

Timeline

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

  1. First posted25 May 2023
  2. Study startMay 2023 (estimated)
  3. Primary completionDec 2023 (estimated)
  4. Study completionFeb 2024 (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
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05874700
Sponsor's protocol ID
2023-4
Status last verified
May 2023
First submitted
6 May 2023
Last updated
25 May 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bossone E, Eagle KA. Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes. Nat Rev Cardiol. 2021 May;18(5):331-348. doi: 10.1038/s41569-020-00472-6. Epub 2020 Dec 22.

    PubMed 33353985
  • Guo Z, Yang Y, Zhao M, Zhang B, Lu J, Jin M, Cheng W. Preoperative hypoxemia in patients with type A acute aortic dissection: a retrospective study on incidence, related factors and clinical significance. J Thorac Dis. 2019 Dec;11(12):5390-5397. doi: 10.21037/jtd.2019.11.68.

    PubMed 32030257
  • Liu N, Zhang W, Ma W, Shang W, Zheng J, Sun L. Risk factors for hypoxemia following surgical repair of acute type A aortic dissection. Interact Cardiovasc Thorac Surg. 2017 Feb 1;24(2):251-256. doi: 10.1093/icvts/ivw272.

    PubMed 27756811
  • Wang Y, Xue S, Zhu H. Risk factors for postoperative hypoxemia in patients undergoing Stanford A aortic dissection surgery. J Cardiothorac Surg. 2013 Apr 30;8:118. doi: 10.1186/1749-8090-8-118.

    PubMed 23631417
  • Thompson BT, Chambers RC, Liu KD. Acute Respiratory Distress Syndrome. N Engl J Med. 2017 Aug 10;377(6):562-572. doi: 10.1056/NEJMra1608077. No abstract available.

    PubMed 28792873
  • Duan XZ, Xu ZY, Lu FL, Han L, Tang YF, Tang H, Liu Y. Inflammation is related to preoperative hypoxemia in patients with acute Stanford type A aortic dissection. J Thorac Dis. 2018 Mar;10(3):1628-1634. doi: 10.21037/jtd.2018.03.48.

    PubMed 29707315
  • Oda S, Aibiki M, Ikeda T, Imaizumi H, Endo S, Ochiai R, Kotani J, Shime N, Nishida O, Noguchi T, Matsuda N, Hirasawa H; Sepsis Registry Committee of The Japanese Society of Intensive Care Medicine. The Japanese guidelines for the management of sepsis. J Intensive Care. 2014 Oct 28;2(1):55. doi: 10.1186/s40560-014-0055-2. eCollection 2014.

    PubMed 25705413
  • Hashimoto S, Okayama Y, Shime N, Kimura A, Funakoshi Y, Kawabata K, Ishizaka A, Amaya F. Neutrophil elastase activity in acute lung injury and respiratory distress syndrome. Respirology. 2008 Jun;13(4):581-4. doi: 10.1111/j.1440-1843.2008.01283.x. Epub 2008 Apr 10.

    PubMed 18410258
  • Polverino E, Rosales-Mayor E, Dale GE, Dembowsky K, Torres A. The Role of Neutrophil Elastase Inhibitors in Lung Diseases. Chest. 2017 Aug;152(2):249-262. doi: 10.1016/j.chest.2017.03.056. Epub 2017 Apr 23.

    PubMed 28442313
  • Kotani M, Kotani T, Ishizaka A, Fujishima S, Koh H, Tasaka S, Sawafuji M, Ikeda E, Moriyama K, Kotake Y, Morisaki H, Aikawa N, Ohashi A, Matsushima K, Huang YC, Takeda J. Neutrophil depletion attenuates interleukin-8 production in mild-overstretch ventilated normal rabbit lung. Crit Care Med. 2004 Feb;32(2):514-9. doi: 10.1097/01.CCM.0000110677.16968.E4.

    PubMed 14758172
  • Miyoshi S, Hamada H, Ito R, Katayama H, Irifune K, Suwaki T, Nakanishi N, Kanematsu T, Dote K, Aibiki M, Okura T, Higaki J. Usefulness of a selective neutrophil elastase inhibitor, sivelestat, in acute lung injury patients with sepsis. Drug Des Devel Ther. 2013 Apr 10;7:305-16. doi: 10.2147/DDDT.S42004. Print 2013.

    PubMed 23596346
  • Morimoto K, Nishimura K, Miyasaka S, Maeta H, Taniguchi I. The effect of sivelestat sodium hydrate on severe respiratory failure after thoracic aortic surgery with deep hypothermia. Ann Thorac Cardiovasc Surg. 2011;17(4):369-75. doi: 10.5761/atcs.oa.10.01555.

    PubMed 21881324
  • Morimoto N, Morimoto K, Morimoto Y, Takahashi H, Asano M, Matsumori M, Okada K, Okita Y. Sivelestat attenuates postoperative pulmonary dysfunction after total arch replacement under deep hypothermia. Eur J Cardiothorac Surg. 2008 Oct;34(4):798-804. doi: 10.1016/j.ejcts.2008.07.010. Epub 2008 Aug 22.

    PubMed 18722781
  • Ryugo M, Sawa Y, Takano H, Matsumiya G, Iwai S, Ono M, Hata H, Yamauchi T, Nishimura M, Fujino Y, Matsuda H. Effect of a polymorphonuclear elastase inhibitor (sivelestat sodium) on acute lung injury after cardiopulmonary bypass: findings of a double-blind randomized study. Surg Today. 2006;36(4):321-6. doi: 10.1007/s00595-005-3160-y.

    PubMed 16554988
  • Niino T, Hata M, Sezai A, Yoshitake I, Unosawa S, Fujita K, Shimura K, Osaka S, Minami K. Efficacy of neutrophil elastase inhibitor on type A acute aortic dissection. Thorac Cardiovasc Surg. 2010 Apr;58(3):164-8. doi: 10.1055/s-0029-1240846. Epub 2010 Apr 7.

    PubMed 20376727

Questions about this trial

What is this clinical trial studying?

A study testing Sivelestat sodium was given intravenously in people with Acute Aortic Dissection, run by Xiaotong Hou at 1 site in China.

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 4 inclusion and 17 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: status not confirmed, as of the sponsor's last update on 25 May 2023. 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 China. 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. Some participants in this study may receive a placebo. 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?

Results are not available in the source record.

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

Contact Xiaotong Hou, MD (8610 64456631, xt.hou@ccmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Invasive mechanical ventilation time (time frame: 28 days after surgery). 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 NCT05874700, which also lists 24 linked publications.

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 25 May 2023.

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