Fish OIL Optimal dosE Determination Study

NCT ID: NCT01146821

Last Updated: 2017-04-19

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

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

7 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-10-31

Study Completion Date

2017-04-30

Brief Summary

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The primary objective of this trial is to determine the safety and efficacy of IV fish oil doses of 0.20 g/kg and 0.50 g/kg, compared to a control group, in critically ill patients with severe sepsis by examining organ function, blood safety and biochemical parameters, markers of systemic inflammation and innate immunological parameters

Detailed Description

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Objectives: The overall objective is to determine the effect of IV fish oil on 28-day mortality of critically ill patients with severe sepsis. However, prior to such a large trial, we need to determine the optimal dose of IV fish oils in this population. Therefore, the primary objective of this proposal (FOILED) is to determine the safety and efficacy of IV fish oil doses of 0.20 g/kg and 0.50 g/kg, compared to a control group, in critically ill patients with severe sepsis by examining organ function, blood safety and biochemical parameters, markers of systemic inflammation and innate immunological parameters.

Study Design: This is a multi-centre, open-label, phase I dose ranging clinical trial with prospective controls.

Setting: 2 tertiary care ICUs in Germany (Universitätsklinikum Carl Gustav Carus, Dresden and University Hospital Giessen and Marburg, Giessen).

Patients: Mechanically ventilated adult patients (\>18 years old) admitted to ICU with clinical evidence of sepsis, sepsis associated organ dysfunction, and high expression of inflammatory cytokines.

Conditions

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Sepsis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard care

Standard care

Group Type NO_INTERVENTION

No interventions assigned to this group

standard care + 0.20gm/kg fish oil

standard care + 0.20gm/kg fish oil

Group Type ACTIVE_COMPARATOR

0.20 gm/kg fish oil

Intervention Type DIETARY_SUPPLEMENT

Group 2: 7 patients will receive 0.20gm/kg of ideal body weight \[IBW\] fish oil in addition to standard care

standard care + 0.50 gm/kg fish oil

standard care + 0.50 gm/kg fish oil

Group Type ACTIVE_COMPARATOR

0.50 gm/kg fish oil

Intervention Type DIETARY_SUPPLEMENT

Group 3: 7 patients will receive 0.50 gm/kg of ideal body weight \[IBW\] fish oil in addition to standard care.

Interventions

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0.20 gm/kg fish oil

Group 2: 7 patients will receive 0.20gm/kg of ideal body weight \[IBW\] fish oil in addition to standard care

Intervention Type DIETARY_SUPPLEMENT

0.50 gm/kg fish oil

Group 3: 7 patients will receive 0.50 gm/kg of ideal body weight \[IBW\] fish oil in addition to standard care.

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Omegaven Omegaven

Eligibility Criteria

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Inclusion Criteria

* Adult ICU patients
* Requiring invasive or non-invasive ventilation
* Clinical evidence of sepsis
* Presence of one or more organ failures

Exclusion Criteria

* \>24 hours from admission to ICU to time of consent
* Low level of inflammatory cytokine (IL-6(qualitative assay \<100 pg/ml)
* lack of commitment to full aggressive care (anticipated withholding or withdrawing treatments in the first week)
* Immunocompromised (post-organ transplantation, HIV, neutropenic \[\<1000 PMN\], steroids \>20 mgs/day for 6 months).
* Chronic non-invasive ventilation (except if they become mechanically ventilated)
* Platelet count of \< 30 GPt/L
* Pregnant patients. Urine/blood tests for pregnancy will be done on all women of childbearing age by each site as part of standard of ICU practice.
* Previous enrollment in this study
* Enrollment in other ICU intervention study
* Allergy to fish or fish oil (shellfish allergy not an exclusion criterion)
* Has already received enteral or IV omega-3 fatty acids during this hospitalization and current ICU admission.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Giessen

OTHER

Sponsor Role collaborator

Clinical Evaluation Research Unit at Kingston General Hospital

OTHER

Sponsor Role collaborator

GWT-TUD GmbH

OTHER

Sponsor Role collaborator

University Hospital Carl Gustav Carus

OTHER

Sponsor Role lead

Responsible Party

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Axel R. Heller

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Axel R. Heller, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital Dresden, Germany

Daren Heyland, MD, PhD

Role: STUDY_CHAIR

Kingston General Hospital, Canada

Rupinder Dhaliwal, RD

Role: STUDY_DIRECTOR

Kingston General Hospital, Canada

Locations

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University Hospital Dresden

Dresden, , Germany

Site Status

University Hospital Giessen and Marburg

Giessen, , Germany

Site Status

Countries

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Germany

References

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Pradelli L, Mayer K, Muscaritoli M, Heller AR. n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis. Crit Care. 2012 Oct 4;16(5):R184. doi: 10.1186/cc11668.

Reference Type BACKGROUND
PMID: 23036226 (View on PubMed)

Heller AR, Rossler S, Litz RJ, Stehr SN, Heller SC, Koch R, Koch T. Omega-3 fatty acids improve the diagnosis-related clinical outcome. Crit Care Med. 2006 Apr;34(4):972-9. doi: 10.1097/01.CCM.0000206309.83570.45.

Reference Type BACKGROUND
PMID: 16484909 (View on PubMed)

Heller AR, Rossel T, Gottschlich B, Tiebel O, Menschikowski M, Litz RJ, Zimmermann T, Koch T. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Int J Cancer. 2004 Sep 10;111(4):611-6. doi: 10.1002/ijc.20291.

Reference Type BACKGROUND
PMID: 15239141 (View on PubMed)

Heller AR, Fischer S, Rossel T, Geiger S, Siegert G, Ragaller M, Zimmermann T, Koch T. Impact of n-3 fatty acid supplemented parenteral nutrition on haemostasis patterns after major abdominal surgery. Br J Nutr. 2002 Jan;87 Suppl 1:S95-101. doi: 10.1079/bjn2001462.

Reference Type BACKGROUND
PMID: 11895160 (View on PubMed)

Mayer K, Fegbeutel C, Hattar K, Sibelius U, Kramer HJ, Heuer KU, Temmesfeld-Wollbruck B, Gokorsch S, Grimminger F, Seeger W. Omega-3 vs. omega-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation. Intensive Care Med. 2003 Sep;29(9):1472-81. doi: 10.1007/s00134-003-1900-2. Epub 2003 Jul 25.

Reference Type BACKGROUND
PMID: 12897994 (View on PubMed)

Manzanares W, Dhaliwal R, Jurewitsch B, Stapleton RD, Jeejeebhoy KN, Heyland DK. Parenteral fish oil lipid emulsions in the critically ill: a systematic review and meta-analysis. JPEN J Parenter Enteral Nutr. 2014 Jan;38(1):20-8. doi: 10.1177/0148607113486006. Epub 2013 Apr 22.

Reference Type BACKGROUND
PMID: 23609773 (View on PubMed)

Pradelli L, Eandi M, Povero M, Mayer K, Muscaritoli M, Heller AR, Fries-Schaffner E. Cost-effectiveness of omega-3 fatty acid supplements in parenteral nutrition therapy in hospitals: a discrete event simulation model. Clin Nutr. 2014 Oct;33(5):785-92. doi: 10.1016/j.clnu.2013.11.016. Epub 2013 Dec 4.

Reference Type BACKGROUND
PMID: 24345520 (View on PubMed)

Other Identifiers

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2010-021018-49

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

FK-FOILED

Identifier Type: -

Identifier Source: org_study_id

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