Strong Albumin Solutions in Patients With Septic Shock

NCT ID: NCT05208242

Last Updated: 2023-12-13

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

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-10

Study Completion Date

2026-02-28

Brief Summary

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Sepsis is an increasingly recognised burden to healthcare systems worldwide. Intravenous fluid therapy is a common first-line intervention recommended by international guidelines. Hyperoncotic preparations of human albumin solution are widely available, but their efficacy has yet to be proven.

This randomised feasibility trial will test whether it is feasible to administer hyperoncotic albumin solutions as both fluid resuscitation and as a regular supplement in patients with early septic shock.

Detailed Description

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Background to this research

Sepsis is the most severe type of infection. It happens when a patient's own immune system is trying to fight an infection, but causes damage or even failure to vital organs such as the heart, lungs or kidneys. It is a life-threatening condition and even with prompt treatment as many as 1 in 4 patients with sepsis don't survive. Septic shock is a term used to describe the worst form of sepsis, where patients need life-supporting treatments in intensive care.

Guidelines recommend doctors give fluid to patients with sepsis. This aims to improve blood flow to vital organs and reduce the risk of further damage. However, there maybe risks if patients are given too much fluid, such as developing kidney failure or even death.

Human albumin solution is a type of fluid, made from blood donated by healthy volunteers. Albumin has been used safely for many years but is more expensive compared to other fluids. Alternative fluids include solutions of salts and water that closely match the contents of human blood. Some research suggests patients with sepsis might benefit from being given albumin, particularly those with septic shock, but doctors remain unsure on whether they should give it to patients with sepsis, or whether the additional expense is worthwhile.

The overall aims of this research

The aim of this research is to test whether it is possible to give patients with early septic shock strong solutions of albumin when they arrive in intensive care. The investigators will also begin to explore the financial costs of using albumin and whether they can be justified for patients treated in the NHS.

What will happen in this research?

The investigators will conduct a study of 50 patients who are admitted to intensive care with septic shock. Patients will be randomly divided into two groups. One group will receive albumin and the other standard salt solutions. Participating patients will provide blood and urine samples shortly after their arrival in intensive care and also 2 and 5 days later. All other aspects of care and treatment will remain the same. Patients will be observed and followed up to see how they are 6 months after entering the study.

What will happen with the results?

The findings of this research will be published in a medical journal and presented at meetings where other healthcare providers can hear of our work. Every participating patient will receive a written summary of the study results. Most importantly, the results of this study will help us move forward with further research into how albumin maybe used cost-effectively in patients with sepsis in the NHS.

Conditions

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Sepsis Septic Shock Shock, Toxic

Keywords

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sepsis septic shock fluid therapy hyperoncotic albumin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A multi-centre, randomised, open-label, feasibility study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Hyperoncotic albumin

Hyperoncotic albumin for all fluid resuscitation and also as a daily supplement, guided by daily serum albumin values, for up to 7 days.

Group Type EXPERIMENTAL

hyperoncotic human albumin solution

Intervention Type DRUG

20% human albumin solution (presented in 100ml glass bottles)

Buffered crystalloids

Buffered crystalloid solutions for all fluid resuscitation and maintenance purposes. Participants in this arms will NOT receive any albumin during their participation.

Group Type ACTIVE_COMPARATOR

Buffered crystalloid solutions

Intervention Type DRUG

Buffered crystalloids solutions for all intravenous fluid therapy

Interventions

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hyperoncotic human albumin solution

20% human albumin solution (presented in 100ml glass bottles)

Intervention Type DRUG

Buffered crystalloid solutions

Buffered crystalloids solutions for all intravenous fluid therapy

Intervention Type DRUG

Other Intervention Names

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Hartmann's solution Compound Sodium Lactate

Eligibility Criteria

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Inclusion Criteria

1. Suspected or documented infection
2. Organ dysfunction defined as SOFA score ≥2
3. Need for vasopressor infusion for ≥2 hours
4. Serum lactate ≥2 mmol/L
5. Eligible for critical care admission without any restrictions

2. \<18 years of age
3. Pregnancy
4. Patients with a known allergy to albumin
5. Jehova's witnesses or other patients expressing a known objection to the use of blood products
6. Previous receipt of human albumin solution for the episode of sepsis in question
7. Previous enrolment in this study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Manchester

OTHER

Sponsor Role collaborator

Manchester University NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Manchester Royal Infirmary

Manchester, Lancashire, United Kingdom

Site Status RECRUITING

Wythenshawe Hospital

Manchester, Lancashire, United Kingdom

Site Status NOT_YET_RECRUITING

Countries

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United Kingdom

Facility Contacts

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Jonathan Bannard-Smith, MB ChB

Role: primary

Tim Felton

Role: primary

Other Identifiers

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287590

Identifier Type: OTHER

Identifier Source: secondary_id

B01459

Identifier Type: -

Identifier Source: org_study_id