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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05568160
Other study ID # GUINOT PHRCI 2019
Secondary ID
Status Recruiting
Phase Phase 3
First received
Last updated
Start date January 2, 2023
Est. completion date March 2026

Study information

Verified date September 2023
Source Centre Hospitalier Universitaire Dijon
Contact Pierre-Grégoire GUINOT
Phone 0380281309
Email pierre-gregoire.guinot@chu-dijon.fr
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a randomized, double blind, multicenter study following surgery with extracorporeal circulation to compare blood pressure optimization with vasopressin versus noradrenaline. It is planned to include 840 patients in order to have 420 patients with vasoplegic syndrome. The primary objective of this study is to determine whether the use of vasopressin to maintain blood pressure following cardiac surgery decreases the number of patients with acute renal failure and/or death compared with the usual use of norepinephrine. Participation in the study involves daily follow-up at D1, D2, and D7 of the onset of the syndrome and then follow-up at D30 and D90.


Recruitment information / eligibility

Status Recruiting
Enrollment 840
Est. completion date March 2026
Est. primary completion date March 2026
Accepts healthy volunteers No
Gender All
Age group 70 Years and older
Eligibility Inclusion Criteria: - Patient who has given free, written and informed consent - Patient of legal age. - Negative pregnancy test for women of childbearing age - Patient requiring cardiac surgery: - Scheduled (> 24h) - With extracorporeal circulation (ECC) - Myocardial revascularization (coronary bypass), and/or surgical correction of valvulopathy (aortic, mitral, pulmonary, tricupsidian), and/or of the ascending aorta and/or removal of an intracardiac tumor, and/or closure of a PFO/ASD - Patient with at least 3 risk factors for acute kidney failure including: - age > 70 years, combined surgery (more than two procedures), common trunk lesion, preoperative anemia, chronic respiratory failure, obliterative arterial disease of the lower extremities, diabetes, glomerular filtration < 60 ml min-1 mĀ², LVEF <40%, redux, intra-aortic counterpulsation balloon, expected duration of bypass surgery > 100 min, albuminuria Exclusion Criteria: - Patient not affiliated to national health insurance or not beneficiary of a social security system, - Patient subject to a measure of legal protection (curatorship, guardianship), - Pregnant, parturient or breastfeeding women, - Patients of legal age who are incapable or unable to express their consent, - Patients who have already been included in this study - Patients requiring emergency surgery (less than 24 hours) - Patient with chronic kidney failure on dialysis, - Patient with a cardiac transplant, - Patient on left-sided monoventricular assistance, - Patient on ECMO/ECLS, - Patient with acute circulatory failure in the immediate preoperative period (sepsis, hemorrhage), - Patients with known hypersensitivity to the active ingredient (argipressin) or to one of the excipients of REVERPLEGĀ®. Secondary exclusion criteria: - Patient not developing persistent arterial hypotension (vasoplegic syndrome), within 12 hours after completion of surgery, defined as persistent mean arterial pressure (MAP) <65 mmHg despite correction of preload and inotropism, with a cardiac index >2.2 l min-1 m-2, and not responding to 30 mg cumulative of ephedrine in bolus - Patient with hemorrhagic shock perioperatively before receiving vasopressor therapy (treatment under study)

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Vasopressin
The infusion is started at 5 ml hr-1, increased in increments of 1 ml hr-1 every 5 minutes to reach a maximum target rate of 30 ml hr-1
Norepinephrine
The infusion is started at 5 ml h-1, increased in increments of 1 ml h-1 every 5 minutes to a maximum target rate of 30 ml h-1
Other:
Collection of clinical data
At D1, D2, D7, D30 or D60 and D90
Quality of Life Questionnaire EQ-5D
At the anesthesia consultation, discharge from intensive care, D7, D30 and D90

Locations

Country Name City State
France Chu Dijon Bourgogne Dijon

Sponsors (1)

Lead Sponsor Collaborator
Centre Hospitalier Universitaire Dijon

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary Occurrence of a renal complication or death From the onset of the vasoplegic syndrome until 7 days after
See also
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Completed NCT02675374 - Hemodynamic Instability Prevented With Polaramine® Infusion Before Extracorporeal Circulation Phase 3
Completed NCT06160219 - Prophylactic Use of Hydroxycobolamin in Vasoplegic Syndrome in Adult Patients Undergoing Cardiopulmonary Bypass Phase 2/Phase 3
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