Effect of Antioxidant Vitamins on Coagulopathy and Nosocomial Pneumonia After Severe Trauma

NCT ID: NCT01897792

Last Updated: 2017-03-29

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

11 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Study Completion Date

2015-02-28

Brief Summary

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The purpose of this study is to determine the effect of antioxidant vitamins (vitamins C and E) on the development of coagulation derangements and nosocomial pneumonia after severe trauma in patients.

Detailed Description

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Conditions

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Coagulopathy Nosocomial Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Vitamins C and E

Vitamin C (1,000 mg i.v.) and Vitamin E (1,000 IU p.o. via the naso-gastric tube) administered every 8 hours starting within one hour after admission to the Emergency department for up to 5 days or until discharge from the ICU, whichever comes first.

Group Type EXPERIMENTAL

Vitamin C

Intervention Type DIETARY_SUPPLEMENT

Vitamin E

Intervention Type DIETARY_SUPPLEMENT

0.9% saline and sugar pill

100 ml of 0.9% saline (for i.v. Vitamin C) and a p.o. placebo (sugar pill for the p.o. Vitamin E) administered every 8 hours starting within one hour after admission to the Emergency department for up to 5 days or until discharge from the ICU, whichever comes first.

Group Type PLACEBO_COMPARATOR

Saline (for Vitamin C)

Intervention Type DIETARY_SUPPLEMENT

0.9% saline administered to mimic Vitamin C

Placebo (for Vitamin E)

Intervention Type DRUG

Sugar pill administered to mimic Vitamin E

Interventions

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Vitamin C

Intervention Type DIETARY_SUPPLEMENT

Vitamin E

Intervention Type DIETARY_SUPPLEMENT

Saline (for Vitamin C)

0.9% saline administered to mimic Vitamin C

Intervention Type DIETARY_SUPPLEMENT

Placebo (for Vitamin E)

Sugar pill administered to mimic Vitamin E

Intervention Type DRUG

Other Intervention Names

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ascorbic acid alpha-tocopherol

Eligibility Criteria

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Inclusion Criteria

* Adult trauma patients admitted to the emergency department at the University of Alabama at Birmingham (UAB) Hospital
* Blunt or penetrating injury
* UAB highest trauma activation

Exclusion Criteria

* Age \< 19 years of age
* Patients with known bleeding diathesis or who are concurrently taking anticoagulant medication
* Patients with known liver disease
* Minor patients
* Pregnant patients (known or suspected pregnancy)
* Patients who are incarcerated
* Patients who lack a surrogate
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Jean-Francois Pittet

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jean-Francois Pittet, M.D.

Role: PRINCIPAL_INVESTIGATOR

The University of Alabama at Birmingham

Jeffrey Kerby, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The University of Alabama at Birmingham

Locations

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The University of Alabama at Birmingham Hospital

Birmingham, Alabama, United States

Site Status

Countries

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United States

References

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Brohi K, Cohen MJ, Ganter MT, Matthay MA, Mackersie RC, Pittet JF. Acute traumatic coagulopathy: initiated by hypoperfusion: modulated through the protein C pathway? Ann Surg. 2007 May;245(5):812-8. doi: 10.1097/01.sla.0000256862.79374.31.

Reference Type BACKGROUND
PMID: 17457176 (View on PubMed)

Brohi K, Cohen MJ, Ganter MT, Schultz MJ, Levi M, Mackersie RC, Pittet JF. Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma. 2008 May;64(5):1211-7; discussion 1217. doi: 10.1097/TA.0b013e318169cd3c.

Reference Type BACKGROUND
PMID: 18469643 (View on PubMed)

Chesebro BB, Rahn P, Carles M, Esmon CT, Xu J, Brohi K, Frith D, Pittet JF, Cohen MJ. Increase in activated protein C mediates acute traumatic coagulopathy in mice. Shock. 2009 Dec;32(6):659-65. doi: 10.1097/SHK.0b013e3181a5a632.

Reference Type BACKGROUND
PMID: 19333141 (View on PubMed)

Cohen MJ, Bir N, Rahn P, Dotson R, Brohi K, Chesebro BB, Mackersie R, Carles M, Wiener-Kronish J, Pittet JF. Protein C depletion early after trauma increases the risk of ventilator-associated pneumonia. J Trauma. 2009 Dec;67(6):1176-81. doi: 10.1097/TA.0b013e3181c1c1bc.

Reference Type BACKGROUND
PMID: 20009664 (View on PubMed)

Nathens AB, Neff MJ, Jurkovich GJ, Klotz P, Farver K, Ruzinski JT, Radella F, Garcia I, Maier RV. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg. 2002 Dec;236(6):814-22. doi: 10.1097/00000658-200212000-00014.

Reference Type BACKGROUND
PMID: 12454520 (View on PubMed)

Collier BR, Giladi A, Dossett LA, Dyer L, Fleming SB, Cotton BA. Impact of high-dose antioxidants on outcomes in acutely injured patients. JPEN J Parenter Enteral Nutr. 2008 Jul-Aug;32(4):384-8. doi: 10.1177/0148607108319808.

Reference Type BACKGROUND
PMID: 18596309 (View on PubMed)

Secor D, Li F, Ellis CG, Sharpe MD, Gross PL, Wilson JX, Tyml K. Impaired microvascular perfusion in sepsis requires activated coagulation and P-selectin-mediated platelet adhesion in capillaries. Intensive Care Med. 2010 Nov;36(11):1928-34. doi: 10.1007/s00134-010-1969-3. Epub 2010 Aug 6.

Reference Type BACKGROUND
PMID: 20689935 (View on PubMed)

Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. J Trauma. 2003 Jun;54(6):1127-30. doi: 10.1097/01.TA.0000069184.82147.06.

Reference Type BACKGROUND
PMID: 12813333 (View on PubMed)

MacLeod JB, Lynn M, McKenney MG, Cohn SM, Murtha M. Early coagulopathy predicts mortality in trauma. J Trauma. 2003 Jul;55(1):39-44. doi: 10.1097/01.TA.0000075338.21177.EF.

Reference Type BACKGROUND
PMID: 12855879 (View on PubMed)

Esmon CT. The protein C pathway. Chest. 2003 Sep;124(3 Suppl):26S-32S. doi: 10.1378/chest.124.3_suppl.26s.

Reference Type BACKGROUND
PMID: 12970121 (View on PubMed)

Giladi AM, Dossett LA, Fleming SB, Abumrad NN, Cotton BA. High-dose antioxidant administration is associated with a reduction in post-injury complications in critically ill trauma patients. Injury. 2011 Jan;42(1):78-82. doi: 10.1016/j.injury.2010.01.104. Epub 2010 Feb 10.

Reference Type BACKGROUND
PMID: 20149369 (View on PubMed)

Other Identifiers

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F101108001

Identifier Type: -

Identifier Source: org_study_id

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