Methylene Blue and Microcirculation in Septic Shock

NCT ID: NCT04295993

Last Updated: 2020-03-05

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

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-10

Study Completion Date

2020-09-20

Brief Summary

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

This trial aims to identify the effects of methylene blue infusion on the the micro-circulation in patients with septic shock. The investigators will evaluate various indices of micro-circulation such as: microvascular flow index, the flow heterogeneity index, the total vessel density, the perfused vessel density, and the proportion of perfused vessels.

Detailed Description

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

The mortality rate of patients with septic shock remains very high. Arterial hypotension, related to arteriolar vasodilation and myocardial depression are the mainstays of septic shock pathology.

At the level of the micro-circulation, there is insufficient delivery of oxygen to organs and tissues which results in organ dysfunction and potential organ necrosis.One key factor leading to vascular dysfunction is the inappropriately increased production of nitric oxide within the blood vessel endothelium. Elevated levels of nitric oxide results in the blood vessel endothelium receiving direct vasodilator input, as well as the inability to respond to norepinephrine-mediated vasoconstriction. Nitric oxide activates the soluble isoform of the enzyme guanylatecyclase, which in turn increases production of cyclic guanosine monophosphate. Nitric oxide has other beneficial effects which are mediated via other pathways than guanylatecyclase; therefore, administration of a guanylate cyclase inhibitor such as methylene blue could be a safer therapeutic option than the inhibition of nitric oxide production.

These effects of methylene blue could be related to vasoconstriction and positive inotropic effects as well to an increase in blood volume, itself related to a decrease in vascular permeability. The use of methylene blue has been recently advocated as a potential adjunct in the treatment of shock states. However, the effect of MB at the level of the capillary bed, where vital exchange of oxygen and nutrients occurs, is unknown. Thus in this study, the investigators will investigate the effect of methylene blue in combination with NE at the microvascular level in septic shock.

Conditions

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

Septic Shock

Study Design

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

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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

methylene blue group

The patients in this group will receive methylene blue bolus in addition to the norepinephrine infusion.

Group Type EXPERIMENTAL

Methylene Blue

Intervention Type DRUG

The patient will receive Methylene Blue bolus with a dose of 2 mg/kg over 10 minutes.

Norepinephrine infusion

Intervention Type DRUG

The patient will receive norepinephrine infusion to maintain mean arterial pressure above 65 mmHg

Norepinephrine group

The patients in this group will receive norepinephrine infusion.

Group Type ACTIVE_COMPARATOR

Norepinephrine infusion

Intervention Type DRUG

The patient will receive norepinephrine infusion to maintain mean arterial pressure above 65 mmHg

Interventions

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

Methylene Blue

The patient will receive Methylene Blue bolus with a dose of 2 mg/kg over 10 minutes.

Intervention Type DRUG

Norepinephrine infusion

The patient will receive norepinephrine infusion to maintain mean arterial pressure above 65 mmHg

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Levophed

Eligibility Criteria

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

Inclusion Criteria

* Septic shock
* The patient is on norepinephrine infusion

Exclusion Criteria

* Elevated serum creatinine (above 1.4 mg/dL)
* Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

Cairo University

OTHER

Sponsor Role lead

Responsible Party

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

Kareman Mohammad Saad Eldin Abd El Ghafar

Assistant lecturer of anesthesia and critical care medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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

Ahmed Mukhtar, Professor

Role: PRINCIPAL_INVESTIGATOR

Professor of anesthesia

Locations

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

Cairo University

Cairo, , Egypt

Site Status

Countries

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

Egypt

Central Contacts

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

kareman abdelghaffar, Demonstrator

Role: CONTACT

+201223931469

Ahmed Hasanin, Professor

Role: CONTACT

+201095076954

Facility Contacts

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

Ashraf Rady, Professor

Role: primary

Other Identifiers

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

N-13-2019

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

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

Adjunctive Methylene Blue in Septic Shock
NCT06900140 RECRUITING PHASE3