Innovative Technologies for the Treatment of Pulmonary and Heart Failure

NCT ID: NCT05090930

Last Updated: 2021-10-25

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2023-12-01

Brief Summary

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The purpose of the program. Formulation of new treatments for heart and pulmonary failure through using organ-replacing technologies.

Formulation of a clinical protocol and implementation of treatment methods into clinical practice heart and pulmonary failure using organ-replacing technologies.

New methods were created for rehabilitating the function of affected organs after implantation of the LVAD, a total artificial heart, an extracorporeal life-sustaining system will be of great importance, both for Kazakhstan and for states with similar problems of donor organ deficiency, will also improve the effectiveness of surgical treatment and reduce the level of complications and mortality of patients on the extracorporeal life-sustaining system and septic patients.

Detailed Description

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Objectives of the program. Task 1. Assessment of the results of the use of extracorporeal life support systems in the treatment of pulmonary and/or heart failure.

Subtask 1.1. Assessment of the restoration of organ function during extracorporeal life support systems using extracorporeal hemocorrection.

Subtask 1.2. Assessment of the normalization of the body's immune response and restoration of organ function during extracorporeal life support systems using an extracorporeal cytokine adsorber.

Task 2. Studying the restoration of organ function during implantation of the left ventricular assist device as an organ-replacing aid in heart failure.

Subtask 2.1. Assessment of the restoration of organ function during implantation of the left ventricular assist device with the use of extracorporeal hemocorrection.

Subtask 2.2. Assessment of the normalization of the body's immune response and restoration of organ function upon implantation of the left ventricular assist device using an extracorporeal cytokine adsorber.

Task 3. Studying the restoration of organ function during the implantation of the total artificial heart as an organ-replacing aid in case of heart failure.

Task 3.1. Assessment of normalization of organ function restoration during implantation of the total artificial heart with the use of extracorporeal hemocorrection.

Task 4. Studying the restoration of organ function during operations in conditions of the long-term cardiopulmonary bypass.

Task 4.1. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest, with the use of extra corporeal hemocorrection.

Task 4.2. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest using an extracorporeal cytokine adsorber.

Task 5. Improvement of the method of implantation of organ-replacing technologies to reduce complications in the treatment of heart and pulmonary failure.

Study design. Study type: interventional (clinical study) Set of participants: 100 participants Distribution: randomized Interventional model: parallel Masking: no Primary Goal: Treatment

Conditions

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Cardiogenic Shock Ventricular Arrythmia Cardiac Arrest With Successful Resuscitation Sepsis Multiple Organ Failure Pulmonary Failure Decompensated Heart Failure Acute Heart Failure

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Intervention team # 1 using an extracorporeal hemoperfusion device Jafron (Zhuhai Jafron Biomedical, China) (50 patients) in subgroups: A (n = 10) - patients on extracorporeal life support systems with heart failure; B (n = 10) - patients on extracorporeal life support systems with pulmonary failure; C (n = 5) - patients with implantation of a left ventricular accessory device; D (n = 25) - during operations with prolonged artificial circulation, hypothermia and circulatory arrest.

Intervention team # 2 using extracorporeal cytokine, CytoSorb (CytoSorbents Corporation, Monmouth Junction, NJ, USA) (50 patients) in subgroups: A (n = 10) - patients on extracorporeal life support systems in heart failure; B (n = 10) - patients on extracorporeal life support systems with pulmonary failure; C (n = 5) - patients with implantation of a left ventricular accessory device; D (n = 25) - during operations with prolonged artificial circulation, hypothermia and circulatory arrest.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention team (1/1 group)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for heart failure...

(10 patients)

Group Type ACTIVE_COMPARATOR

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection

Intervention Type DEVICE

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (1/2 group)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for pulmonary failure (10 patients).

Group Type ACTIVE_COMPARATOR

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection

Intervention Type DEVICE

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (1/3 group)

An extracorporeal hemoperfusion device will be installed in patients before/during the implantation of a left ventricular accessory (5 patients).

Group Type ACTIVE_COMPARATOR

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection

Intervention Type DEVICE

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (1/4 group)

An extracorporeal hemoperfusion device will be installed in patients during operations with prolonged artificial circulation, hypothermia, and circulatory arrest. (25 patients).

Group Type ACTIVE_COMPARATOR

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection

Intervention Type DEVICE

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (2/1 groups)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for heart failure.

(10 patients)

Group Type ACTIVE_COMPARATOR

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber

Intervention Type DEVICE

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (2/2 groups)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for pulmonary failure.

(10 patients)

Group Type ACTIVE_COMPARATOR

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber

Intervention Type DEVICE

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (2/3 groups)

An extracorporeal hemoperfusion device will be installed in patients before/during the implantation of a left ventricular accessory (5 patients)

Group Type ACTIVE_COMPARATOR

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber

Intervention Type DEVICE

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Intervention team (2/4 groups)

An extracorporeal hemoperfusion device will be installed in patients during operations with prolonged artificial circulation, hypothermia, and circulatory arrest. (25 patients)

Group Type ACTIVE_COMPARATOR

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber

Intervention Type DEVICE

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Interventions

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HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection

HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Intervention Type DEVICE

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber

CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

Patients on an extracorporeal life support system with heart failure:

* Implantation of intravenous ECMO
* Hemodynamic support with vasopressors and/or tonics;
* Procalcitonin level ≥ 1 ng/ml;
* Invasive hemodynamic monitoring;
* Written informed consent.

Patients on an extracorporeal life support system with pulmonary failure:

* IV ECMO implantation
* High levels of venous and arterial CO2 (CO2\> 50 mmHg),
* Low paO2, SvO2, SpO2.
* Invasive hemodynamic monitoring;
* Written informed consent.

-Patients with left ventricular assistive device implantation:
* LVAD implantation
* Biventricular heart failure IV
* INTERMACS I-III
* Hemodynamic support with vasopressors and/or tonics;
* Procalcitonin level ≥ 0.1 ng/ml;
* Invasive hemodynamic monitoring;
* Written informed consent.

-Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest:
* Hemodynamic support with vasopressors and/or tonics;
* Bypass duration\> 120 minutes
* Hypothermia ≤ 25 0С
* Circulatory arrest
* Procalcitonin level ≥ 1 ng/ml;
* Invasive hemodynamic monitoring;
* Written informed consent.

Exclusion Criteria

* Patients on an extracorporeal life support system with heart failure:

* Age less than 18 years old
* Terminal hepatic or renal failure just before the procedure
* Patient's written refusal to participate in the study
* Patients on an extracorporeal life support system with pulmonary failure:

* Age less than 18 years old
* Terminal hepatic or renal failure just before the procedure
* Patient's written refusal to participate in the study
* Patients with left ventricular assistive device implantation:

* Age less than 18 years old
* Acute hepatic or renal failure just before the procedure
* Patient's written refusal to participate in the study
* Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest:

* Age less than 18 years old
* Terminal hepatic or renal failure just before the procedure
* Patient's written refusal to participate in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Education and Science, Republic of Kazakhstan

OTHER_GOV

Sponsor Role collaborator

National Research Center for Cardiac Surgery, Kazakhstan

OTHER

Sponsor Role lead

Responsible Party

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Yuriy Pya

Director for Surgery and Science

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yuri Pya, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

National research Center for Cardiac Surgery JSC

Locations

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National Research Center For Cardiac Surgery

Astana, , Kazakhstan

Site Status RECRUITING

Countries

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Kazakhstan

Central Contacts

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Yuri Pya, PhD, MD

Role: CONTACT

+77172272090

Timur Lesbekov, MD

Role: CONTACT

+77172703100

Facility Contacts

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Yuriy Pya, PhD, MD

Role: primary

+77172703100

Zhuldyz Nurmykhametova, MD

Role: backup

+77781115377

References

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Lietz K, Long JW, Kfoury AG, Slaughter MS, Silver MA, Milano CA, Rogers JG, Naka Y, Mancini D, Miller LW. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection. Circulation. 2007 Jul 31;116(5):497-505. doi: 10.1161/CIRCULATIONAHA.107.691972. Epub 2007 Jul 16.

Reference Type RESULT
PMID: 17638928 (View on PubMed)

Feldman D, Pamboukian SV, Teuteberg JJ, Birks E, Lietz K, Moore SA, Morgan JA, Arabia F, Bauman ME, Buchholz HW, Deng M, Dickstein ML, El-Banayosy A, Elliot T, Goldstein DJ, Grady KL, Jones K, Hryniewicz K, John R, Kaan A, Kusne S, Loebe M, Massicotte MP, Moazami N, Mohacsi P, Mooney M, Nelson T, Pagani F, Perry W, Potapov EV, Eduardo Rame J, Russell SD, Sorensen EN, Sun B, Strueber M, Mangi AA, Petty MG, Rogers J; International Society for Heart and Lung Transplantation. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary. J Heart Lung Transplant. 2013 Feb;32(2):157-87. doi: 10.1016/j.healun.2012.09.013. No abstract available.

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Hetzer R, Delmo Walter EM. Trends and outcomes in heart transplantation: the Berlin experience. HSR Proc Intensive Care Cardiovasc Anesth. 2013;5(2):76-80.

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PMID: 23888228 (View on PubMed)

Chen YF, Tsai WC, Lin CC, Tsai LY, Lee CS, Huang CH, Pan PC, Chen ML. Effect of leukocyte depletion on endothelial cell activation and transendothelial migration of leukocytes during cardiopulmonary bypass. Ann Thorac Surg. 2004 Aug;78(2):634-42; discussion 642-3. doi: 10.1016/j.athoracsur.2004.02.091.

Reference Type RESULT
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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

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Document Type: Informed Consent Form

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Other Identifiers

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BR10965200

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

version01

Identifier Type: -

Identifier Source: org_study_id