Phase II Study To Evaluate The Safety and Efficacy of Hemoglobin Raffimer in Patients Undergoing First Time CABG Surgery

NCT ID: NCT00038454

Last Updated: 2005-06-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Brief Summary

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To evaluate the efficacy of Hemolink™ in combination with Intraoperative Autologous Donation (IAD) versus control (IAD alone) in facilitating avoidance of allogeneic RBC transfusion during and following primary CABG surgery

Detailed Description

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All subjects who consent to take part in the protocol and who meet the inclusion/exclusion criteria will undergo the IAD harvest following a post-induction IAD harvest calculation. IAD blood will be collected into citrate-phosphate-dextrose-adenine 1 (CPDA-1) blood bags. All subjects will receive a volume of Hespan® equal to the volume of their IAD harvest (to a maximum of 1 liter) performed as a result of the harvest calculation (0-1200 mL inclusive). Additional volume replacement required owing to IAD \>1000mL will be performed with crystalloid, as required. Subjects will be randomized into one of two treatment arms (Hemolink™ arm or control arm) upon meeting a transfusion trigger for the first time while on CPB. Randomization will be administered centrally. Subjects will be transfused upon reaching predetermined transfusion triggers, reflecting a decrease in hemoglobin concentration and/or oxygenation:

Conditions

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Cardiovascular Disease

Keywords

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Oxygen Therapeutics CABG Transfusion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Interventions

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Hemolink (hemoglobin raffimer IV solution)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Subjects meeting all of the following criteria are eligible for inclusion in the study:

* Written Informed Consent.
* Age 18 through 80 years, inclusive.
* Scheduled for primary CABG surgery with CPB and are candidates for IAD.
* Post-induction hemoglobin, which will allow collection of 0-1200 mL inclusive of IAD blood to achieve a target hemoglobin of 7.5 g/dL at 15 minutes on-CPB.
* For women of childbearing potential only, able to use and using a highly-effective contraceptive method from the time of study screening through week 4 - 8 post CABG surgery (follow-up visit).

Note: International Conference on Harmonization (ICH) guidelines define a highly-effective contraceptive method as one with a failure rate of less than one percent when used consistently and correctly

Exclusion Criteria

Subjects meeting any of the following criteria will be excluded from the study:

* Previous treatment with Hemolink(tm) or any other hemoglobin-based oxygen carrier.
* Participation in any clinical trial of an investigational drug, device, or medical procedure within the two months prior to enrollment, or concurrent with participation in this study.
* History of stroke with residual paralysis or of transient ischemic attacks within 6 months prior to surgery.
* Congenital coagulation disorder or treatment with Coumadin within seven days prior to surgery.
* Alcohol or drug use within the 12 months prior to enrollment, which the investigator considers abusive.
* Planned simultaneous surgery (e.g., valve repair or carotid endarterectomy).
* Emergency CABG.
* Previous surgery using sternotomy.
* Current pregnancy or nursing.
* Chronic pancreatitis with or without pancreatic insufficiency.

Any subject who is medically cleared for both the surgical procedure and the intraoperative autologous donation will be eligible for enrollment in the study.

Medical clearance requires the following:

* No current congestive heart failure, New York Heart Association class IV.
* Most recent (within 1 year of surgery) ejection fraction must not be less than or equal to 25 percent, or left ventricular function of grade 4.
* No current uncontrolled hypertension.
* No current severe pulmonary disease which will render the subject at high risk of requiring prolonged post-operative ventilation.
* No serum creatinine \> 2.0 mg/dL (177 umol/L).
* No known AST and ALT and bilirubin \> 3 times the upper limit of normal.
* No uncontrolled angina within 24 hours prior to surgery despite maximal medical treatment, and/or presence of an intraaortic balloon pump preoperatively.
* No history of transmural myocardial infarction within the five days prior to the scheduled CABG surgery.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hemosol

INDUSTRY

Sponsor Role lead

Locations

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Kaiser Permanente Medical Center - San Francisco-Division of Cardiovascular Anesthesia

San Francisco, California, United States

Site Status

Stanford University Medical Center: Department of Anesthesiology

Stanford, California, United States

Site Status

Clinical Research Center

Sarasota, Florida, United States

Site Status

Heart and Vascular Care

Des Moines, Iowa, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

Englewood Hospital

Englewood, New Jersey, United States

Site Status

Robert Wood Johnson Hospital

New Brunswick, New Jersey, United States

Site Status

Mount Sinai Medical Center

New York, New York, United States

Site Status

University of North Carolina: Department of Anesthesiology

Chapel Hill, North Carolina, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

The Ohio State University Department of Anesthesiology

Columbus, Ohio, United States

Site Status

Veterans Affairs Medical Center

Portland, Oregon, United States

Site Status

Legacy Research

Portland, Oregon, United States

Site Status

UPMC Health System

Pittsburgh, Pennsylvania, United States

Site Status

Cardiovascular Anesthesia Research:Texas Heart Institute

Houston, Texas, United States

Site Status

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status

McGuire VA Medical Center

Richmond, Virginia, United States

Site Status

Medical College of Virginia: Department of Anesthesiology

Richmond, Virginia, United States

Site Status

Foothills Medical Centre

Calgary, Alberta, Canada

Site Status

St. Paul's Hospital/ Vancouver General Hospital

Vancouver, British Columbia, Canada

Site Status

Kingston General Hospital

Kingston, Ontario, Canada

Site Status

St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

The Toronto Hospital - General Division

Toronto, Ontario, Canada

Site Status

Institut de Cardiologie de Montreal

Montreal, Quebec, Canada

Site Status

Hopital Laval

Ste Foy, Quebec, Canada

Site Status

St. Thomas Hospital: Department of Anesthesia

London, England, United Kingdom

Site Status

Southampton General Hospital

Southampton, England, United Kingdom

Site Status

Countries

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United States Canada United Kingdom

References

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Jahr JS, Lurie F, Driessen B, Davis JA, Gosselin R, Gunther RA. The HemoCue, a point of care B-hemoglobin photometer, measures hemoglobin concentrations accurately when mixed in vitro with canine plasma and three hemoglobin-based oxygen carriers (HBOC). Can J Anaesth. 2002 Mar;49(3):243-8. doi: 10.1007/BF03020522.

Reference Type BACKGROUND
PMID: 11861341 (View on PubMed)

Kingma JG Jr, Sandhu R, Hamelin ND, Gendron D, Trudel Y, Bosa M, Stewart R, Fargey MB, Biro GP. The effects of hemodilution with Hemolink upon hemodynamics and blood flow distribution in anesthetized dogs. Artif Cells Blood Substit Immobil Biotechnol. 2001 Nov;29(6):465-81. doi: 10.1081/bio-100108551.

Reference Type BACKGROUND
PMID: 11795632 (View on PubMed)

Topfer LA, Hailey D. Oxygen carriers ("blood substitutes"). Issues Emerg Health Technol. 2001 Jul;(21):1-6.

Reference Type BACKGROUND
PMID: 11776287 (View on PubMed)

Scatena R, Giardina B. O-raffinose-polymerised haemoglobin. A biochemical and pharmacological profile of an oxygen carrier. Expert Opin Biol Ther. 2001 Jan;1(1):121-7. doi: 10.1517/14712598.1.1.121.

Reference Type BACKGROUND
PMID: 11727541 (View on PubMed)

Cheng DC. Safety and efficacy of o-raffinose cross-linked human hemoglobin (Hemolink) in cardiac surgery. Can J Anaesth. 2001 Apr;48(4 Suppl):S41-8.

Reference Type BACKGROUND
PMID: 11336436 (View on PubMed)

Caron A, Malfatti E, Aguejouf O, Faivre-Fiorina B, Menu P. Vasoconstrictive response of rat mesenteric arterioles following infusion of cross-linked, polymerized, and conjugated hemoglobin solutions. Artif Cells Blood Substit Immobil Biotechnol. 2001 Jan;29(1):19-30. doi: 10.1081/bio-100001253.

Reference Type BACKGROUND
PMID: 11280681 (View on PubMed)

Toussaint M, Latger-Cannard V, Caron A, Lecompte T, Stoltz JF, Vigneron C, Menu P. Effects of three Hb-based oxygen-carrying solutions on neutrophil activation in vitro: quantitative measurement of the expression of adherence receptors. Transfusion. 2001 Feb;41(2):226-31. doi: 10.1046/j.1537-2995.2001.41020226.x.

Reference Type BACKGROUND
PMID: 11239227 (View on PubMed)

Carmichael FJ, Ali AC, Campbell JA, Langlois SF, Biro GP, Willan AR, Pierce CH, Greenburg AG. A phase I study of oxidized raffinose cross-linked human hemoglobin. Crit Care Med. 2000 Jul;28(7):2283-92. doi: 10.1097/00003246-200007000-00017.

Reference Type BACKGROUND
PMID: 10921554 (View on PubMed)

Cohn SM. Blood substitutes in surgery. Surgery. 2000 Jun;127(6):599-602. doi: 10.1067/msy.2000.106462. No abstract available.

Reference Type BACKGROUND
PMID: 10840352 (View on PubMed)

Ning J, Wong LT, Christoff B, Carmichael FJ, Biro GP. Haemodynamic response following a 10% topload infusion of HemolinkTM in conscious, anaesthetized and treated spontaneously hypertensive rats. Transfus Med. 2000 Mar;10(1):13-22. doi: 10.1046/j.1365-3148.2000.00225.x.

Reference Type BACKGROUND
PMID: 10760199 (View on PubMed)

Lieberthal W, Fuhro R, Andry C, Valeri CR. Effects of hemoglobin-based oxygen-carrying solutions in anesthetized rats with acute ischemic renal failure. J Lab Clin Med. 2000 Jan;135(1):73-81. doi: 10.1016/s0022-2143(00)70023-0.

Reference Type BACKGROUND
PMID: 10638697 (View on PubMed)

Xue S, Paterson W, Valdez D, Miller D, Christoff B, Wong LT, Diamant NE. Effect of an o-raffinose cross-linked haemoglobin product on oesophageal and lower oesophageal sphincter motor function. Neurogastroenterol Motil. 1999 Dec;11(6):421-30. doi: 10.1046/j.1365-2982.1999.00171.x.

Reference Type BACKGROUND
PMID: 10583849 (View on PubMed)

Freilich D, Branda R, Hacker M, Leach L, Barry B, Ferris S, Hebert J. Decreased lactic acidosis and anemia after transfusion of o-raffinose cross-linked and polymerized hemoglobin in severe murine malaria. Am J Trop Med Hyg. 1999 Feb;60(2):322-8. doi: 10.4269/ajtmh.1999.60.322.

Reference Type BACKGROUND
PMID: 10072160 (View on PubMed)

Lieberthal W, Fuhro R, Freedman JE, Toolan G, Loscalzo J, Valeri CR. O-raffinose cross-linking markedly reduces systemic and renal vasoconstrictor effects of unmodified human hemoglobin. J Pharmacol Exp Ther. 1999 Mar;288(3):1278-87.

Reference Type BACKGROUND
PMID: 10027869 (View on PubMed)

Glaser V. Fake blood market gets hemoglobin transfusion from reticulocytes. Nat Biotechnol. 1998 Aug;16(8):709. doi: 10.1038/nbt0898-709. No abstract available.

Reference Type BACKGROUND
PMID: 9702757 (View on PubMed)

Macdonald RL, Zhang J, Weir B, Marton LS, Wollman R. Adenosine triphosphate causes vasospasm of the rat femoral artery. Neurosurgery. 1998 Apr;42(4):825-32; discussion 832-3. doi: 10.1097/00006123-199804000-00082.

Reference Type BACKGROUND
PMID: 9574647 (View on PubMed)

Balion CM, Champagne PA, Ali AC. Evaluation of HemogloBind for removal of o-raffinose cross-linked hemoglobin (Hemolink) from serum. Clin Chem. 1997 Sep;43(9):1796-7. No abstract available.

Reference Type BACKGROUND
PMID: 9299985 (View on PubMed)

Ali AC, Mihas CC, Campbell JA. Interferences of o-raffinose cross-linked hemoglobin in three methods for serum creatinine. Clin Chem. 1997 Sep;43(9):1738-43.

Reference Type BACKGROUND
PMID: 9299969 (View on PubMed)

Kerger H, Tsai AG, Saltzman DJ, Winslow RM, Intaglietta M. Fluid resuscitation with O2 vs. non-O2 carriers after 2 h of hemorrhagic shock in conscious hamsters. Am J Physiol. 1997 Jan;272(1 Pt 2):H525-37. doi: 10.1152/ajpheart.1997.272.1.H525.

Reference Type BACKGROUND
PMID: 9038975 (View on PubMed)

Baines AD, Christoff B, Wicks D, Wiffen D, Pliura D. Cross-linked hemoglobin increases fractional reabsorption and GFR in hypoxic isolated perfused rat kidneys. Am J Physiol. 1995 Nov;269(5 Pt 2):F628-36. doi: 10.1152/ajprenal.1995.269.5.F628.

Reference Type BACKGROUND
PMID: 7503228 (View on PubMed)

Wong LT, Er SS, Ning J, Christoff B, Carmichael FJ. Hemolink-induced effects on intestinal motor function and attenuation of these effects by selected agents. Artif Cells Blood Substit Immobil Biotechnol. 1998 Nov;26(5-6):529-48. doi: 10.3109/10731199809117473.

Reference Type BACKGROUND
PMID: 9844719 (View on PubMed)

Ali AC, Campbell JA. Interference of o-raffinose cross-linked hemoglobin with routine Hitachi 717 assays. Clin Chem. 1997 Sep;43(9):1794-6. No abstract available.

Reference Type BACKGROUND
PMID: 9299984 (View on PubMed)

Arnoldo BD, Minei JP. Potential of hemoglobin-based oxygen carriers in trauma patients. Curr Opin Crit Care. 2001 Dec;7(6):431-6. doi: 10.1097/00075198-200112000-00010.

Reference Type BACKGROUND
PMID: 11805546 (View on PubMed)

Caron A, Menu P, Faivre-Fiorina B, Labrude P, Alayash AI, Vigneron C. Cardiovascular and hemorheological effects of three modified human hemoglobin solutions in hemodiluted rabbits. J Appl Physiol (1985). 1999 Feb;86(2):541-8. doi: 10.1152/jappl.1999.86.2.541.

Reference Type BACKGROUND
PMID: 9931189 (View on PubMed)

Other Identifiers

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HLK-213

Identifier Type: -

Identifier Source: org_study_id