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SepsisNCT06157320

Clinical Research on Shenfu Injection in Septic Patients

A study testing Shen-Fu and Norepinephrine (NE),antibiotics,fluid resuscitation in people with Sepsis, run by Ruijin Hospital 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 The sponsor has not verified this record for over two years, so it may be out of date.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

Sepsis, characterized by organ dysfunction caused by infection, exhibits increasing incidence and mortality rates, posing a significant challenge to intensive care units. Early-stage sepsis involves hemodynamic disturbances, and severe and complex microcirculatory impairments can result in tissue hypoxia and… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sepsis
What is being tested?
Shen-Fu and Norepinephrine (NE),antibiotics,fluid resuscitation
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteChina
Study dates
1 Dec 2023to 1 Jan 2026
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years;
  • Signed informed consent form;
  • Meets sepsis 3.0 diagnostic criteria;

Who cannot join

  • Age < 18 years;
  • Known pregnancy;
  • Inability to accept and complete signed informed consent within 24 hours of diagnosis of sepsis;
  • Status of tracheal intubation;
  • oral mucosal inflammation or damage;
  • Patients with contraindications to transcutaneous oxygen partial pressure testing such as severe edema and burns;
  • Concurrent participation in other treatment studies.

Trial locations and contacts

1 site in 1 country.

Hongping Qu, phD,MD contact

+86 13641801889

hongpingqu0412@hotmail.com

China1 site, 1 recruiting
  • Ruijin Hospital

    Shanghai, Shanghai Municipality, 200025

    Jieming Qu, MD, +86 02164370045

    Recruiting

Other trials in China

About this study

Official title: Improving Microcirculation and Microvascular Leakage in Sepsis Patients: A Comprehensive Clinical Study of Shenfu Injection

Sepsis, characterized by organ dysfunction caused by infection, exhibits increasing incidence and mortality rates, posing a significant challenge to intensive care units. Early-stage sepsis involves hemodynamic disturbances, and severe and complex microcirculatory impairments can result in tissue hypoxia and accelerate organ dysfunction. Modern medical research has indicated that the effective and rapid restoration of microcirculatory function, along with the correction of microcirculatory disorders, is a crucial aspect in the treatment of sepsis. Current guidelines recommend the use of vasoactive drugs to address hemodynamic disturbances, but their administration may further damage the microcirculation. Additionally, in patients with severe sepsis, there often exists a disparity between macrocirculatory and microcirculatory hemodynamics, and conventional clinical indicators fail to directly reflect the level of microcirculatory perfusion.

Chinese guidelines have incorporated the use of traditional Chinese medicine (TCM) in the diagnosis and treatment of sepsis, offering a new therapeutic approach to ameliorate microcirculatory impairments. This study aims to include patients with sepsis and administer Shenfu Injection via intravenous therapy. Tongue microcirculation assessment will be employed to evaluate changes in microvascular health scores, while transcutaneous oxygen and carbon dioxide pressure alterations, as well as serum lactate level variations, will be monitored to ascertain the effects of Shenfu Injection on improving early-stage microcirculatory impairments and microvascular leakage in sepsis patients. This research will clarify the clinical efficacy of Shenfu Injection in sepsis patients with microcirculatory impairments, provide evidence-based medicine and clinical evidence for TCM treatment of sepsis, and offer a solid foundation for refining sepsis treatment strategies with distinct Chinese characteristics.

Conditions
Sepsis
Being tested
Shen-Fu, Norepinephrine (NE),antibiotics,fluid resuscitation
Keywords
sepsis, microcirculation, Shenfu Injection
Medical subject headings
Sepsis

What participants receive

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

  • Shen-FuDrug

    Also called Traditional Chinese medicine

    Within 24 hours of sepsis diagnosis, patients received a daily intravenous infusion of 100 ml of Shenfu Injection for a continuous duration of 7 days.

  • Norepinephrine (NE),antibiotics,fluid resuscitationDrug

    Also called Strandard treatment

    empirical antimicrobial treatment (which is promptly administered after microbial tests), fluid (crystalloids) replacement (to be established according to fluid tolerance and fluid responsiveness), and vasoactive agents (e.g., norepinephrine (NE)), which are employed to maintain mean arterial pressure above 65 mmHg and reduce the risk of fluid overload

Study groups in NCT06157320
Study groupRoleWhat they receive
Shenfu Injection groupExperimentalwithin 24 hours after the diagnosis of sepsis, Shenfu injection 100 ml/day, intravenous use, continuous application for 7 days.
Receives: Drug: Shen-Fu
Control groupPlacebo comparatorsepsis was treated with standardized western medicine methods
Receives: Drug: Norepinephrine (NE),antibiotics,fluid resuscitation

What is being measured

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

  1. HR:heart rate

    heart rate

    Measured: Day0,Day1,Day 3,Day 7

  2. BP:Blood pressure

    Blood pressure

    Measured: Day0,Day1,Day 3,Day 7

  3. Proportion of perfused vessels

    Grid-based score (3 horizontal and vertical equidistant lines). Percentage of perfused vessels per total number of vessel crossings

    Measured: Day0,Day1,Day 3,Day 7

  4. Microvascular fow index

    fow, 1 = intermittent fow, 2 = sluggish fow, 3 = normal fow Semi-quantitative assessment of the average red blood cell velocity per quadrant

    Measured: Day0,Day1,Day 3,Day 7

  5. Heterogeneity index

    Determinant of heterogeneity of blood fow, characteristic of distributive abnormalities

    Measured: Day0,Day1,Day 3,Day 7

  6. Hemodynamic parameters1

    CI: Cardio index

    Measured: Day0,Day1,Day 3,Day 7

  7. Hemodynamic parameters2

    SVRI:systemic vascular resistance index

    Measured: Day0,Day1,Day 3,Day 7

  8. Hemodynamic parameters3

    GEDVI:global end-diastolic volume index

    Measured: Day0,Day1,Day 3,Day 7

Secondary outcomes (26)
  1. Ang2:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  2. VCAM1:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  3. Sydecan-1:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  4. 6-Keto-PGF-1:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  5. TXB2:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  6. NO:Endothelial cell function indicators

    Endothelial cell function indicators got from the blood of patients

    Measured: Day0,Day1,Day 3,Day 7

  7. Lab test1

    PH

    Measured: Day0,Day1,Day 3,Day 7

  8. Lab test2

    PaO2 mmHg,

    Measured: Day0,Day1,Day 3,Day 7

  9. Lab test3

    PaCO2 mmHg

    Measured: Day0,Day1,Day 3,Day 7

  10. Lab test4

    Serum lactate mmol/L

    Measured: Day0,Day1,Day 3,Day 7

  11. Lab test5

    IL-10 ng/ml

    Measured: Day0,Day1,Day 3,Day 7

  12. Lab test6

    WBC ×109/L

    Measured: Day0,Day1,Day 3,Day 7

  13. Lab test7

    Neu ×109/L

    Measured: Day0,Day1,Day 3,Day 7

  14. Lab test8

    Lym×109/L,

    Measured: Day0,Day1,Day 3,Day 7

  15. Lab test9

    Hb g/L,

    Measured: Day0,Day1,Day 3,Day 7

  16. Lab test10

    PLT×109/L

    Measured: Day0,Day1,Day 3,Day 7

  17. Lab test11

    Total bilirubin IU/L

    Measured: Day0,Day1,Day 3,Day 7

  18. Lab test12

    Cr μmol/L

    Measured: Day0,Day1,Day 3,Day 7

  19. Lab test13

    IL-1βng/ml

    Measured: Day0,Day1,Day 3,Day 7

  20. Lab test14

    APTT s

    Measured: Day0,Day1,Day 3,Day 7

  21. Lab test15

    D-Dimermg/L

    Measured: Day0,Day1,Day 3,Day 7

  22. Lab test16

    CRP mg/L

    Measured: Day0,Day1,Day 3,Day 7

  23. Lab test17

    ProBNP pg/ml

    Measured: Day0,Day1,Day 3,Day 7

  24. Lab test18

    PCT ng/ml

    Measured: Day0,Day1,Day 3,Day 7

  25. Lab test19

    TNFαng/ml

    Measured: Day0,Day1,Day 3,Day 7

  26. Lab test20

    IL-6 ng/ml

    Measured: Day0,Day1,Day 3,Day 7

Timeline

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

  1. First posted5 Dec 2023
  2. Study start1 Dec 2023 (estimated)
  3. Primary completion1 Sep 2025 (estimated)
  4. Study completion1 Jan 2026 (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
Single blind
Who is masked
Investigator
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06157320
Sponsor's protocol ID
320.6750.2022-2-35
Status last verified
Jan 2023
First submitted
19 Jul 2023
Last updated
5 Dec 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.

    PubMed 26903338
  • Gutterman DD, Chabowski DS, Kadlec AO, Durand MJ, Freed JK, Ait-Aissa K, Beyer AM. The Human Microcirculation: Regulation of Flow and Beyond. Circ Res. 2016 Jan 8;118(1):157-72. doi: 10.1161/CIRCRESAHA.115.305364.

    PubMed 26837746
  • Tian R, Wang X, Pan T, Li R, Wang J, Liu Z, Chen E, Mao E, Tan R, Chen Y, Liu J, Qu H. Plasma PTX3, MCP1 and Ang2 are early biomarkers to evaluate the severity of sepsis and septic shock. Scand J Immunol. 2019 Dec;90(6):e12823. doi: 10.1111/sji.12823. Epub 2019 Oct 7.

    PubMed 31489646
  • Tian R, Li R, Liu Y, Liu J, Pan T, Zhang R, Liu B, Chen E, Tang Y, Qu H. Metformin ameliorates endotoxemia-induced endothelial pro-inflammatory responses via AMPK-dependent mediation of HDAC5 and KLF2. Biochim Biophys Acta Mol Basis Dis. 2019 Jun 1;1865(6):1701-1712. doi: 10.1016/j.bbadis.2019.04.009. Epub 2019 Apr 16.

    PubMed 31002870
  • Yao B, Liu DW, Chai WZ, Wang XT, Zhang HM. Microcirculation dysfunction in endotoxic shock rabbits is associated with impaired S-nitrosohemoglobin-mediated nitric oxide release from red blood cells: a preliminary study. Intensive Care Med Exp. 2019 Jan 7;7(1):1. doi: 10.1186/s40635-018-0215-0.

    PubMed 30617929
  • Otero RM, Nguyen HB, Huang DT, Gaieski DF, Goyal M, Gunnerson KJ, Trzeciak S, Sherwin R, Holthaus CV, Osborn T, Rivers EP. Early goal-directed therapy in severe sepsis and septic shock revisited: concepts, controversies, and contemporary findings. Chest. 2006 Nov;130(5):1579-95. doi: 10.1378/chest.130.5.1579.

    PubMed 17099041
  • Fan KL, Wang JH, Kong L, Zhang FH, Hao H, Zhao H, Tian ZY, Yin MX, Fang H, Yang HH, Liu Y. Effect of Shen-Fu Injection () on Hemodynamics in Early Volume Resuscitation Treated Septic Shock Patients. Chin J Integr Med. 2019 Jan;25(1):59-63. doi: 10.1007/s11655-017-2965-z. Epub 2017 Oct 6.

    PubMed 28986814
  • Zhang XJ, Song L, Zhou ZG, Wang XM. Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury. World J Gastroenterol. 2006 Jul 21;12(27):4389-91. doi: 10.3748/wjg.v12.i27.4389.

    PubMed 16865783
  • Zhang X, Guo T, Zhang K, Guo W, An X, Gao P. Effect of shenfu injection on microcirculation in shock patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020 Oct 23;99(43):e22872. doi: 10.1097/MD.0000000000022872.

    PubMed 33120828
  • Ince C. Hemodynamic coherence and the rationale for monitoring the microcirculation. Crit Care. 2015;19 Suppl 3(Suppl 3):S8. doi: 10.1186/cc14726. Epub 2015 Dec 18.

    PubMed 26729241

Questions about this trial

What is this clinical trial studying?

A study testing Shen-Fu and Norepinephrine (NE),antibiotics,fluid resuscitation in people with Sepsis, run by Ruijin Hospital 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 3 inclusion and 7 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 5 Dec 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 Hongping Qu, phD,MD (+86 13641801889, hongpingqu0412@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

HR:heart rate (time frame: Day0,Day1,Day 3,Day 7). The study lists 8 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 NCT06157320, which also lists 10 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 5 Dec 2023.

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