Remote Ischemic Preconditioning in Septic Patients

NCT ID: NCT05830669

Last Updated: 2024-12-12

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

NA

Total Enrollment

64 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-11

Study Completion Date

2026-01-31

Brief Summary

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Acute kidney injury is a well-recognized complication in critically ill patients. Up to date there is no clinically established method to reduce the incidence or the severity of acute kidney injury.

Remote ischemic preconditioning (RIPC) will be induced by three cycles of upper limb ischemia.

The aim of the study is to reduce the incidence of AKI by implementing remote ischemic preconditioning (identified by the urinary biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7(IGFBP7)

Detailed Description

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Acute kidney injury (AKI) is a common complication in critically ill patients with sepsis. To date, there is no pharmacological option to treat or prevent AKI.

Ischemic conditioning is an innate tissue adaptation elicited by ischemia that mediates local and remote organ protection against subsequent exposure to the same or other injury.

The aim of this trial is to evaluate the effects of remote ischemic conditioning in critically ill patients on acute kidney injury.

Conditions

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Critically Ill Acute Kidney Injury Sepsis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Intervention Group

Remote ischemic preconditioning (RIPC) Three Cycles of 5-min upper limb ischemia. If there is no response this will be followed by 2 cycles of 10-min upper-limb ischemia.

Group Type EXPERIMENTAL

Remote ischemic preconditioning (RIPC)

Intervention Type PROCEDURE

3 cycles of 5 min inflation of a blood-pressure cuff to 200 millimetres of mercury (mmHG) (or at least to a pressure 50 mmHG higher than the systolic arterial pressure) to one upper arm followed by 5 min reperfusion with the cuff deflated. In Non-Responder two additional cycles of 10 min cuff inflation will be performed.

Control Group

Three cycles of 5- min upper limb sham ischemia.

Group Type SHAM_COMPARATOR

Sham RIPC

Intervention Type PROCEDURE

3 cycles of 5 min inflation of a blood-pressure cuff to 20 mmHG to one upper arm followed by 5 min reperfusion with the cuff deflated. In Non-Responder two additional cycles of 10 min cuff inflation will be performed

Interventions

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Remote ischemic preconditioning (RIPC)

3 cycles of 5 min inflation of a blood-pressure cuff to 200 millimetres of mercury (mmHG) (or at least to a pressure 50 mmHG higher than the systolic arterial pressure) to one upper arm followed by 5 min reperfusion with the cuff deflated. In Non-Responder two additional cycles of 10 min cuff inflation will be performed.

Intervention Type PROCEDURE

Sham RIPC

3 cycles of 5 min inflation of a blood-pressure cuff to 20 mmHG to one upper arm followed by 5 min reperfusion with the cuff deflated. In Non-Responder two additional cycles of 10 min cuff inflation will be performed

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adult patients (age ≥18 years)
* Critically ill patients with sepsis \< 12 hours
* Invasive ventilation for at least 24 hours (propofol-free-sedation) and/or vasopressor therapy
* Unrestricted intensive care for at least 72 hours
* Written informed consent

Exclusion Criteria

* Pre-existing AKI
* (Glomerulo-)nephritis, interstitial nephritis, vasculitis
* Chronic kidney disease with estimated glomerular filtration rate (eGFR) \< 30 ml/min/1.73m²
* Chronic dialysis dependency
* Kidney transplant in the last 12 months
* Oral antidiabetics, sulfonamides or nicorandil
* Pregnancy or breastfeeding
* Do-not-reanimate order
* Participation in another interventional trial involving kidney outcomes within the last 3 months
* Dependency on the investigator or center
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universität Münster

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Melanie Meersch-Dini, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital Muenster, Dept. of Anesthesiology, Intensive Care Therapy and Pain Medicine

Locations

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University Hospital Münster; Department of Anesthesiology, Intensive Care Medicine and Pain Medicine

Münster, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Melanie Meersch-Dini, MD

Role: CONTACT

Phone: +49-251-8347255

Email: [email protected]

Facility Contacts

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Meersch, MD

Role: primary

Other Identifiers

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AnIt22-06

Identifier Type: -

Identifier Source: org_study_id