COVID-19 Clinical Trial
Official title:
Almitrine and Severe COVID-19 Patients in ICU [Almitrine et Patients COVID-19 en Reanimation (French)]
NCT number | NCT04380727 |
Other study ID # | 2020PI080_2 |
Secondary ID | |
Status | Completed |
Phase | |
First received | |
Last updated | |
Start date | March 20, 2020 |
Est. completion date | April 25, 2020 |
Verified date | July 2020 |
Source | Central Hospital, Nancy, France |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational [Patient Registry] |
In severe COVID-19 pulmonary failure, the profound hypoxemia is mainly related to pulmonary
vasodilation with altered hypoxic pulmonary vasoconstriction (HPV). Besides prone
positioning, other non-ventilatory strategies may reduce the intrapulmonary shunt. This study
has investigated almitrine, a pharmacological option used in standard care to improve
oxygenation.
A case control series of mechanically ventilated confirmed COVID-19 patients was recorded.
At stable ventilatory settings, consecutive patients received two doses of almitrine (4 and
12 mcg/kg/min) at 30-45 min interval each, and were compared to 7 "control" COVID-matched
patients conventionally treated.
The end-point was the reduction of intra-pulmonary shunt, with an increase in partial
pressure of arterial oxygen (PaO2) and central venous oxygen saturation (ScvO2).
Status | Completed |
Enrollment | 17 |
Est. completion date | April 25, 2020 |
Est. primary completion date | April 14, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria : - a positive RT- PCR, - a highly suggestive thoracic CTScan, and - a severe hypoxemia leading to intubation for less than 3 days - mechanically ventilated at FiO2 1 with a severe intrapulmonary shunt during their early phase Group : patient who has been treated with almitrine (4 mcg/kg/min iv almitrine bismesylate (Vectarion®, Servier Laboratory, France) then 12 mcg/kg/min infusion rate) during their hospital treatment. Control group : Matched COVID-19 patients, on gender, age, BMI and duration of mechanical ventilation, with serial measurements corresponding to the duration of almitrine testing (8 hours), with same inclusion and exclusion criteria. Exclusion Criteria: - the presence of an acute cor-pulmonale on the trans-thoracic 2D Echo-Doppler - abnormal liver function tests - hyperlactatemia |
Country | Name | City | State |
---|---|---|---|
France | Centre Hospitalier Universitaire NANCY | Vandoeuvre-les-Nancy |
Lead Sponsor | Collaborator |
---|---|
Central Hospital, Nancy, France |
France,
B'chir A, Mebazaa A, Losser MR, Romieu M, Payen D. Intravenous almitrine bismesylate reversibly induces lactic acidosis and hepatic dysfunction in patients with acute lung injury. Anesthesiology. 1998 Oct;89(4):823-30. — View Citation
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. — View Citation
Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. COVID-19 Does Not Lead to a "Typical" Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2020 May 15;201(10):1299-1300. doi: 10.1164/rccm.202003-0817LE. — View Citation
Payen DM, Gatecel C, Plaisance P. Almitrine effect on nitric oxide inhalation in adult respiratory distress syndrome. Lancet. 1993 Jun 26;341(8861):1664. — View Citation
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. Lancet. 2020 Mar 28;395(10229):1038. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Changes from baseline PaO2 (mmHg) | Partial pressure of oxygen in arterial blood | 45 minutes after almitrine infusion | |
Primary | Changes from baseline ScvO2 (%) | central venous oxygen saturation | baseline and 45 minutes after almitrine infusion | |
Secondary | Changes from baseline PaO2 (mmHg) | partial pressure of oxygen in arterial blood | 8 hours | |
Secondary | Changes from baseline ScvO2 (%) | central venous oxygen saturation | 8 hours |
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