Optimization of Serum Phosphorus Level and Weaning From Mechanical Ventilation

NCT ID: NCT05682846

Last Updated: 2023-05-19

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

COMPLETED

Clinical Phase

NA

Total Enrollment

124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-01

Study Completion Date

2023-02-28

Brief Summary

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The goal of this clinical trial is to test the impact of serum phosphorus level optimization on weaning from mechanical ventilation in adult ICU patients in Alexandria University Hospitals.

The main questions it aims to answer are:

* Does serum phosphorus level optimization affect the duration of mechanical ventilation?
* Is serum phosphorus level optimization associated with successful weaning from mechanical ventilation?

In critically ill patients, phosphorus supplementation is done using Sodium glycerophosphate pentahydrate solution.

Detailed Description

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Investigators will document patients' data in terms of independent variables and will randomly allocate the participants into one of the two study groups mentioned below.

* Control group, defined by maintaining serum phosphorus level at ≥ 2.5 and \< 3.5 mg/dL.
* Intervention group, defined by optimization of serum phosphorus P to ≥ 3.5 and ≤ 4.5 mg/dL (Average 4mg/dL).

Regression and comparative statistics will be used to determine whether the optimum serum phosphorus level offers a benefit in terms of the duration of mechanical ventilation and the success of weaning from mechanical ventilation.

Conditions

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Mechanical Ventilation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Intervention group

Optimization of serum phosphorus to ≥ 3.5 and ≤ 4.5 mg/dL (Average 4mg/dL) using Sodium glycerophosphate pentahydrate solution.

Sodium glycerophosphate pentahydrate 20ml solution (20 mmol glycerophosphate) dose will be given once daily till the target serum phosphorus level is achieved.

Group Type EXPERIMENTAL

Sodium glycerophosphate pentahydrate solution

Intervention Type DRUG

Glycophos is a 20 ml vial of Sodium glycerophosphate pentahydrate containing 1 mmol glycerophosphate and 2 mmol sodium per ml

Control group

Maintaining serum phosphorus level at ≥ 2.5 and \< 3.5 mg/dL.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Sodium glycerophosphate pentahydrate solution

Glycophos is a 20 ml vial of Sodium glycerophosphate pentahydrate containing 1 mmol glycerophosphate and 2 mmol sodium per ml

Intervention Type DRUG

Other Intervention Names

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Glycophos

Eligibility Criteria

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Inclusion Criteria

* Adult mechanically ventilated ICU patients.
* Age ≥ 18 years.

Exclusion Criteria

* Age \<18 years
* Hypernatremia
* Permanent or prolonged mechanical ventilation
* Hyperphosphatemia which might occur in the following conditions:
* Chronic kidney disease and end stage renal disease
* Parathyroid disorders
* Cancer patients at risk of tumor lysis syndrome
* Immobility
* Body weight \< 50 Kg
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Alexandria University

OTHER

Sponsor Role lead

Responsible Party

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Yasmin Mohamed Mahmoud Abdelghany

Master's student in Clinical Pharmacy and Pharmacy Practice, Alexandria University

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Magda A El-Massik, PhD

Role: PRINCIPAL_INVESTIGATOR

Professor of Pharmaceutics, Alexandria University

Haitham M Tammam, PhD

Role: PRINCIPAL_INVESTIGATOR

Associate professor of Critical Care Medicine, Alexandria University

Noha A Hamdy, PhD

Role: PRINCIPAL_INVESTIGATOR

Assistant Professor of Clinical Pharmacy, Alexandria University

Marawan M ElBourini, PhD

Role: PRINCIPAL_INVESTIGATOR

Lecturer in Critical Care Medicine, Alexandria University

Yasmin M Abd Elghany, PharmD

Role: PRINCIPAL_INVESTIGATOR

Master's student in Clinical Pharmacy and Pharmacy Practice, Alexandria University.

Locations

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Alexandria University

Alexandria, , Egypt

Site Status

Countries

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Egypt

References

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Aubier M, Murciano D, Lecocguic Y, Viires N, Jacquens Y, Squara P, Pariente R. Effect of hypophosphatemia on diaphragmatic contractility in patients with acute respiratory failure. N Engl J Med. 1985 Aug 15;313(7):420-4. doi: 10.1056/NEJM198508153130705.

Reference Type BACKGROUND
PMID: 3860734 (View on PubMed)

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013 Nov 27;310(20):2191-4. doi: 10.1001/jama.2013.281053. No abstract available.

Reference Type BACKGROUND
PMID: 24141714 (View on PubMed)

Liu B, Cheng Y, Shen F, Wang Y, Wu Y, Yao L, Liu Y, Gou X. [Hypophosphatemia is associated with poor prognosis of critically ill patients: a meta-analysis of 1 555 patients]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Jan;30(1):34-40. doi: 10.3760/cma.j.issn.2095-4352.2018.01.007. Chinese.

Reference Type BACKGROUND
PMID: 29308755 (View on PubMed)

Sin JCK, King L, Ballard E, Llewellyn S, Laupland KB, Tabah A. Hypophosphatemia and Outcomes in ICU: A Systematic Review and Meta-Analysis. J Intensive Care Med. 2021 Sep;36(9):1025-1035. doi: 10.1177/0885066620940274. Epub 2020 Aug 12.

Reference Type BACKGROUND
PMID: 32783487 (View on PubMed)

Padelli M, Leven C, Sakka M, Plee-Gautier E, Carre JL. [Causes, consequences and treatment of hypophosphatemia: A systematic review]. Presse Med. 2017 Nov;46(11):987-999. doi: 10.1016/j.lpm.2017.09.002. Epub 2017 Oct 28. French.

Reference Type BACKGROUND
PMID: 29089216 (View on PubMed)

Sahetya S, Allgood S, Gay PC, Lechtzin N. Long-Term Mechanical Ventilation. Clin Chest Med. 2016 Dec;37(4):753-763. doi: 10.1016/j.ccm.2016.07.014. Epub 2016 Oct 14.

Reference Type BACKGROUND
PMID: 27842754 (View on PubMed)

Santibanez-Velazquez M, Medina-Garcia G, Ocharan-Hernandez ME. Association of independent risk factors with post-extubation failure in patients undergoing mechanical ventilation weaning. Gac Med Mex. 2020;156(6):539-545. doi: 10.24875/GMM.M21000493.

Reference Type BACKGROUND
PMID: 33877109 (View on PubMed)

Wang L, Xiao C, Chen L, Zhang X, Kou Q. Impact of hypophosphatemia on outcome of patients in intensive care unit: a retrospective cohort study. BMC Anesthesiol. 2019 May 24;19(1):86. doi: 10.1186/s12871-019-0746-2.

Reference Type BACKGROUND
PMID: 31122196 (View on PubMed)

Wozniak H, Dos Santos Rocha A, Beckmann TS, Larpin C, Buetti N, Quintard H, Pugin J, Heidegger CP. Hypophosphatemia on ICU Admission Is Associated with an Increased Length of Stay in the ICU and Time under Mechanical Ventilation. J Clin Med. 2022 Jan 24;11(3):581. doi: 10.3390/jcm11030581.

Reference Type BACKGROUND
PMID: 35160032 (View on PubMed)

Other Identifiers

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0107114

Identifier Type: -

Identifier Source: org_study_id

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