L-citrulline Supplementation During Sepsis

NCT ID: NCT00628381

Last Updated: 2010-09-03

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2013-01-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to study the stimulating effects of prolonged (8h) enteral L-citrulline supplementation on the normalisation of the plasma citrulline concentrations and the Arginine-NO metabolism, the microcirculation, the systemic hemodynamics, vascular permeability, and organ function and disease severity scores.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

NO synthesis is compromised during sepsis through lack of arginine de novo synthesis and may thereby contribute to impaired microcirculation and organ dysfunction. Supplementation of L-citrulline in septic patients will increase NO production without increased arginase activity and these effects will be studied on arginine-NO metabolism,improved organ function, vascular permeability and microcirculation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Sepsis Multiple Organ Failure

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

AA

24 ICU patients with severe sepsis will get a L-citrulline 8 h enteral supplementation.

Group Type EXPERIMENTAL

L-citrulline supplementation

Intervention Type DIETARY_SUPPLEMENT

L-citrulline, 1.8micromol/kg/min, during 8 hours continuously supplemented

AB

24 ICU patients with severe sepsis will get an alternative isocaloric amino acid supplementation (L-alanine) during 8 hours

Group Type ACTIVE_COMPARATOR

L-alanine

Intervention Type DIETARY_SUPPLEMENT

L-alanine enteral infusion, isocaloric dosage (3.6 micromol/kg/min), during 8 hours, continuously supplemented

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

L-citrulline supplementation

L-citrulline, 1.8micromol/kg/min, during 8 hours continuously supplemented

Intervention Type DIETARY_SUPPLEMENT

L-alanine

L-alanine enteral infusion, isocaloric dosage (3.6 micromol/kg/min), during 8 hours, continuously supplemented

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Written informed consent from close relative
* Age \> 18 years
* Patient meets the general criteria for severe sepsis or septic shock, diagnosed less than 48 h prior to study inclusion.
* Patient must be relatively hemodynamically stable, defined as stable blood pressure (variation in mean arterial pressure \<15 mm Hg) during 2h without necessity of increasing the vasopressor dose, inotropic support or rate of fluid administration.
* Systemic arterial catheter in place with continuous pressure monitoring.
* Patients in whom the clinician is prepared to provide full life support during the duration of the study

Exclusion Criteria

* Shock due to any cause other than sepsis (e.g. drug reaction or drug overdose, pulmonary embolus, burn injury etc.)
* Prolonged or high dose corticosteroid use
* Liver cirrhosis
* Chronic pancreatitis
* Insulin-dependent diabetes mellitus
* Metastases, haematological malignancies or chemotherapy
* Patients on dialysis (CVVH or other)
* Pre-existent renal failure (on dialysis)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

ZonMw: The Netherlands Organisation for Health Research and Development

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Department of surgery, University hospital Maastricht

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Martijn Poeze, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Surgery

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University Hospital Maastricht

Maastricht, Limburg, Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Nina Wijnands, MD, PhD-student

Role: CONTACT

+31-43-3884502

Martijn Poeze, MD, PhD

Role: CONTACT

+31-43-3874425

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Martijn Poeze, MD, PhD

Role: primary

+31-43 3876543

Nina Wijnands, MD, PhD-student

Role: backup

+31-43-3884502

References

Explore related publications, articles, or registry entries linked to this study.

Rouge C, Des Robert C, Robins A, Le Bacquer O, Volteau C, De La Cochetiere MF, Darmaun D. Manipulation of citrulline availability in humans. Am J Physiol Gastrointest Liver Physiol. 2007 Nov;293(5):G1061-7. doi: 10.1152/ajpgi.00289.2007. Epub 2007 Sep 27.

Reference Type BACKGROUND
PMID: 17901164 (View on PubMed)

Barr FE, Tirona RG, Taylor MB, Rice G, Arnold J, Cunningham G, Smith HA, Campbell A, Canter JA, Christian KG, Drinkwater DC, Scholl F, Kavanaugh-McHugh A, Summar ML. Pharmacokinetics and safety of intravenously administered citrulline in children undergoing congenital heart surgery: potential therapy for postoperative pulmonary hypertension. J Thorac Cardiovasc Surg. 2007 Aug;134(2):319-26. doi: 10.1016/j.jtcvs.2007.02.043.

Reference Type BACKGROUND
PMID: 17662768 (View on PubMed)

Lehr HA, Bittinger F, Kirkpatrick CJ. Microcirculatory dysfunction in sepsis: a pathogenetic basis for therapy? J Pathol. 2000 Feb;190(3):373-86. doi: 10.1002/(SICI)1096-9896(200002)190:33.0.CO;2-3.

Reference Type BACKGROUND
PMID: 10685071 (View on PubMed)

Wu G, Morris SM Jr. Arginine metabolism: nitric oxide and beyond. Biochem J. 1998 Nov 15;336 ( Pt 1)(Pt 1):1-17. doi: 10.1042/bj3360001.

Reference Type BACKGROUND
PMID: 9806879 (View on PubMed)

Hallemeesch MM, Lamers WH, Deutz NE. Reduced arginine availability and nitric oxide production. Clin Nutr. 2002 Aug;21(4):273-9. doi: 10.1054/clnu.2002.0571.

Reference Type BACKGROUND
PMID: 12135586 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

ZON/NW 40-00806-98-114

Identifier Type: -

Identifier Source: secondary_id

MEC-08

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.