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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05090930
Other study ID # version01
Secondary ID BR10965200
Status Recruiting
Phase N/A
First received
Last updated
Start date January 1, 2021
Est. completion date December 1, 2023

Study information

Verified date October 2021
Source National Research Center for Cardiac Surgery, Kazakhstan
Contact Yuri Pya, PhD, MD
Phone +77172272090
Email rp.nrcsc@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of the program. Formulation of new treatments for heart and pulmonary failure through using organ-replacing technologies. Formulation of a clinical protocol and implementation of treatment methods into clinical practice heart and pulmonary failure using organ-replacing technologies. New methods were created for rehabilitating the function of affected organs after implantation of the LVAD, a total artificial heart, an extracorporeal life-sustaining system will be of great importance, both for Kazakhstan and for states with similar problems of donor organ deficiency, will also improve the effectiveness of surgical treatment and reduce the level of complications and mortality of patients on the extracorporeal life-sustaining system and septic patients.


Description:

Objectives of the program. Task 1. Assessment of the results of the use of extracorporeal life support systems in the treatment of pulmonary and/or heart failure. Subtask 1.1. Assessment of the restoration of organ function during extracorporeal life support systems using extracorporeal hemocorrection. Subtask 1.2. Assessment of the normalization of the body's immune response and restoration of organ function during extracorporeal life support systems using an extracorporeal cytokine adsorber. Task 2. Studying the restoration of organ function during implantation of the left ventricular assist device as an organ-replacing aid in heart failure. Subtask 2.1. Assessment of the restoration of organ function during implantation of the left ventricular assist device with the use of extracorporeal hemocorrection. Subtask 2.2. Assessment of the normalization of the body's immune response and restoration of organ function upon implantation of the left ventricular assist device using an extracorporeal cytokine adsorber. Task 3. Studying the restoration of organ function during the implantation of the total artificial heart as an organ-replacing aid in case of heart failure. Task 3.1. Assessment of normalization of organ function restoration during implantation of the total artificial heart with the use of extracorporeal hemocorrection. Task 4. Studying the restoration of organ function during operations in conditions of the long-term cardiopulmonary bypass. Task 4.1. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest, with the use of extra corporeal hemocorrection. Task 4.2. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest using an extracorporeal cytokine adsorber. Task 5. Improvement of the method of implantation of organ-replacing technologies to reduce complications in the treatment of heart and pulmonary failure. Study design. Study type: interventional (clinical study) Set of participants: 100 participants Distribution: randomized Interventional model: parallel Masking: no Primary Goal: Treatment


Recruitment information / eligibility

Status Recruiting
Enrollment 100
Est. completion date December 1, 2023
Est. primary completion date July 1, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria: Patients on an extracorporeal life support system with heart failure: - Implantation of intravenous ECMO - Hemodynamic support with vasopressors and/or tonics; - Procalcitonin level = 1 ng/ml; - Invasive hemodynamic monitoring; - Written informed consent. Patients on an extracorporeal life support system with pulmonary failure: - IV ECMO implantation - High levels of venous and arterial CO2 (CO2> 50 mmHg), - Low paO2, SvO2, SpO2. - Invasive hemodynamic monitoring; - Written informed consent. -Patients with left ventricular assistive device implantation: - LVAD implantation - Biventricular heart failure IV - INTERMACS I-III - Hemodynamic support with vasopressors and/or tonics; - Procalcitonin level = 0.1 ng/ml; - Invasive hemodynamic monitoring; - Written informed consent. -Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest: - Hemodynamic support with vasopressors and/or tonics; - Bypass duration> 120 minutes - Hypothermia = 25 0? - Circulatory arrest - Procalcitonin level = 1 ng/ml; - Invasive hemodynamic monitoring; - Written informed consent. Exclusion Criteria: - Patients on an extracorporeal life support system with heart failure: - Age less than 18 years old - Terminal hepatic or renal failure just before the procedure - Patient's written refusal to participate in the study - Patients on an extracorporeal life support system with pulmonary failure: - Age less than 18 years old - Terminal hepatic or renal failure just before the procedure - Patient's written refusal to participate in the study - Patients with left ventricular assistive device implantation: - Age less than 18 years old - Acute hepatic or renal failure just before the procedure - Patient's written refusal to participate in the study - Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest: - Age less than 18 years old - Terminal hepatic or renal failure just before the procedure - Patient's written refusal to participate in the study

Study Design


Intervention

Device:
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Locations

Country Name City State
Kazakhstan National Research Center For Cardiac Surgery Astana

Sponsors (2)

Lead Sponsor Collaborator
National Research Center for Cardiac Surgery, Kazakhstan Ministry of Education and Science, Republic of Kazakhstan

Country where clinical trial is conducted

Kazakhstan, 

References & Publications (41)

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Lietz K, Long JW, Kfoury AG, Slaughter MS, Silver MA, Milano CA, Rogers JG, Naka Y, Mancini D, Miller LW. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection. Circulati — View Citation

Lund LH, Edwards LB, Kucheryavaya AY, Benden C, Christie JD, Dipchand AI, Dobbels F, Goldfarb SB, Levvey BJ, Meiser B, Yusen RD, Stehlik J; International Society of Heart and Lung Transplantation. The registry of the International Society for Heart and Lu — View Citation

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Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, Takala J, Sprung C, Antonelli M, Bruining H, Willatts S. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. W — View Citation

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Nemeth E, Kovacs E, Racz K, Soltesz A, Szigeti S, Kiss N, Csikos G, Koritsanszky KB, Berzsenyi V, Trembickij G, Fabry S, Prohaszka Z, Merkely B, Gal J. Impact of intraoperative cytokine adsorption on outcome of patients undergoing orthotopic heart transpl — View Citation

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* Note: There are 41 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Other Length of stay Length of stay in the intensive care unit first 48 hours
Other Length of hospital stay Length of hospital stay up to 1 month
Other 30 day survival rate. 30 day survival rate. 30 day
Primary Extracorporeal life support system with pulmonary and / or heart failure: Cytokine response The level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor alpha-factor) before the start, 2 hours after the start of ECMO support, when ECMO is turned off, 24 hours after ECMO is turned off. 24-48 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure: SOFA-Score Sequential Organ Failure Assessment Score at 24, 48, 72 h (values from 6 to 24, where the higher values explain higher disease severity) 24, 48, 72 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure Doses of vasopressors and / or inotropes (µg / h / kg bodyweight) Time: first 72 hours
Primary Patients with left ventricular assist device implantation: Difference of Cytokine response Level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor necrosis factor-alfa, procalcitonin) 24-48 hours
Primary Patients with left ventricular assist device implantation:vasopressors and / or inotropes Doses of vasopressors and / or inotropes (µg / h / kg bodyweight) first 72 hours
Primary Patients with left ventricular assist device implantation:Renal function creatinine level first 72 hours
Primary Patients with left ventricular assist device implantation:Lactate level Lactate level first 72 hours
Primary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of Cytokine response Level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor necrosis factor-alfa, procalcitonin, C-reactive protein) 24-48 hours
Primary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: SOFA-Score Sequential Organ Failure Assessment Score at 24, 48, 72 h (values from 6 to 24, where the higher values explain higher disease severity) 24, 48, 72 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure:Difference of mean arterial pressure Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron) 24, 48, 72 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure: Difference of CVP Comparison of CVP at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron) 24, 48, 72 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure: Serum lactate Level of serum lactate at 24, 48, 72 h 24, 48, 72 hours
Primary Extracorporeal life support system with pulmonary and / or heart failure:Days on ventilator, vasopressor and renal replacement therapy Total days on ventilator, vasopressor and renal replacement therapy within 30 days post-surgery will be assessed until day 30 post-surgery
Primary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of mean arterial pressure Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron) 24, 48, 72 hours
Primary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of CVP Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron) 24, 48, 72 hours
Primary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Level of Serum lactate Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron) 24, 48, 72 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure:The level of C-reactive protein (CRP) The level of C-reactive protein (CRP) before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation. 24-48 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure: Level of leukocyte Level of leukocyte cells in the bloodstream at 24, 48 hours 24-48 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure:Application and dosage of vasopressors Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery first 48 hours
Secondary Patients with left ventricular assist device implantation: The level of C-reactive protein (CRP) The level of C-reactive protein (CRP) before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation 24-48 hours
Secondary Patients with left ventricular assist device implantation: Application and dosage of vasopressors Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery first 48 hours
Secondary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: The level of C-reactive protein (CRP) The level of C-reactive protein (CRP) before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass. 24-48 hours
Secondary For operations with prolonged artificial circulation, hypothermia and circulatory arrest:Leukocyte function Leukocyte function: heterogeneity of the population of leukocyte cells in the bloodstream first 48 hours
Secondary For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Application and dosage of vasopressors Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery first 48 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure:The level of leukocytes The level of leukocytes before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation 24-48 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure:The level of procalcitonin The level of procalcitonin before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation. 24-48 hours
Secondary Extracorporeal life support system with pulmonary and / or heart failure:Application and dosage of inotropes Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery first 48 hours
Secondary Patients with left ventricular assist device implantation: The level of leukocytes The level of leukocytes before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation 24-48 hours
Secondary Patients with left ventricular assist device implantation: The level of procalcitonin The level of procalcitonin before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation 24-48 hours
Secondary Patients with left ventricular assist device implantation: Application and dosage of inotropes Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery first 48 hours
Secondary For operations with prolonged cardio pulmonary bypass, hypothermia and circulatory arrest: The level of leukocytes The level of leukocytes before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass. 24-48 hours
Secondary For operations with prolonged cardiopulmonary bypass, hypothermia, and circulatory arrest: The level of procalcitonin The level of procalcitonin before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass. 24-48 hours
Secondary For operations with prolonged cardiopulmonary bypass, hypothermia, and circulatory arrest: Application and dosage of inotropes Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery first 48 hours
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