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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05697770
Registration number
NCT05697770
Ethics application status
Date submitted
15/01/2023
Date registered
26/01/2023
Titles & IDs
Public title
SODium BICarbonate for Metabolic Acidosis in the ICU
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Scientific title
SODium BICarbonate for Metabolic Acidosis in the Intensive Care Unit (SODa-BIC): A Multicentre, Randomised, Double-blind Clinical Trial
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Secondary ID [1]
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ANZIC-RC/ASN001
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Universal Trial Number (UTN)
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Trial acronym
SODa-BIC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Metabolic Acidosis
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Shock
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Condition category
Condition code
Metabolic and Endocrine
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Other metabolic disorders
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Respiratory
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Other respiratory disorders / diseases
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Renal and Urogenital
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Sodium bicarbonate
Treatment: Drugs - 5% Dextrose
Experimental: Sodium bicarbonate - Sodium bicarbonate 8.4% (1000 mEq/L) will be diluted in a D5W solution (500 mL bag). For preparation, 300 mL of D5W will be removed and 300 mL of sodium bicarbonate 8.4% added to prepare the bicarbonate solution in a total volume of 500 mL (final concentration: 600 mEq/L).
Active comparator: 5% dextrose - Standard 500 mL bag of D5W.
Treatment: Drugs: Sodium bicarbonate
Sodium bicarbonate 8.4% will be continuously infused for a maximum of 5 hours. The infusion will start at 100 mL/hr and be kept at this rate until both pH and BE targets are achieved, following which, the infusion rate will be decreased to 25 mL/hr and kept constant at this rate until 5 hours has elapsed since the start of the infusion. At this point, the infusion will be stopped, independently, of the results of arterial blood gas analysis.
Treatment: Drugs: 5% Dextrose
5% dextrose will be continuously infused for a maximum of 5 hours. The infusion will start at 100 mL/hr and be kept at this rate until both pH and BE targets are achieved, following which, the infusion rate will be decreased to 25 mL/hr and kept constant at this rate until 5 hours has elapsed since the start of the infusion. At this point, the infusion will be stopped, independently, of the results of arterial blood gas analysis.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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MAKE30 score
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Assessment method [1]
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The primary outcome is MAKE30 from the date of randomisation. MAKE30 is defined as a composite of death from any cause, receipt of RRT, or persistent renal dysfunction (defined as an elevation of the creatinine level to =200% of baseline), all censored at hospital discharge or 30 days, whichever occurs first.
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Timepoint [1]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [1]
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30-day in-hospital mortality
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Assessment method [1]
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All-cause in-hospital mortality at day 30
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Timepoint [1]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [2]
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Receipt of renal replacement therapy in the first 30 days
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Assessment method [2]
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Receipt of renal replacement therapy in the first 30 days
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Timepoint [2]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [3]
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Persistent renal dysfunction
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Assessment method [3]
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Defined as an elevation of the creatinine level to = 200% of baseline
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Timepoint [3]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [4]
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Renal replacement therapy dependence at day 30
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Assessment method [4]
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Defined by the receipt of any form of renal replacement therapy within ± 10 days of the 30-day time point following randomisation
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Timepoint [4]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [5]
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ICU mortality
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Assessment method [5]
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All-cause ICU mortality at day 30
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Timepoint [5]
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30 days or at hospital discharge (whichever occurs first)
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Secondary outcome [6]
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Hospital mortality
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Assessment method [6]
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All-cause hospital mortality at day 90
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Timepoint [6]
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90 days or at hospital discharge (whichever occurs first)
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Secondary outcome [7]
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90-day in-hospital mortality
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Assessment method [7]
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All-cause mortality at day 90
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Timepoint [7]
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90 days or at hospital discharge (whichever occurs first)
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Eligibility
Key inclusion criteria
All the diagnostic criteria of metabolic acidosis below have to be fulfilled within the last 2 hours before randomisation (pH, PaCO2 and BE from the same blood gas), and a vasopressor is being infused continuously at the time of randomization.
1. Adults (= 18 years);
2. Receiving a continuous infusion of a vasopressor to maintain mean arterial pressure > 65 mmHg (or a mean arterial pressure target set by the treating clinician);
3. A dedicated intravenous line (central or peripheral) is available (or insertion of such a line is planned within the next hour); and
4. Metabolic acidosis, defined as:
1. pH < 7.30; and
2. BE = -4 mEq/L; and
3. PaCO2 = 45 mmHg for non-intubated patients or PaCO2 = 50 mmHg for intubated patients.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Fulfilled all eligibility criteria greater than 48 hours ago; or
2. Suspected clinically significant digestive or urinary tract loss of sodium bicarbonate (e.g., diarrhoea, ileostomy losses, renal tubular acidosis, or drainage of pancreatic or bile duct); or
3. DKA; or
4. Estimated glomerular filtration rate (eGFR) < 30 mL/min due to chronic kidney disease; or
5. Currently receiving sodium bicarbonate at the moment of randomisation (doses of sodium bicarbonate prior to randomisation are allowed); or
6. Currently receiving RRT (acute or chronic) or planned to start RRT in the next 3 hours (according to the treating clinical team); or
7. Severe dysnatraemia (serum Na = 155 mEq/L or < 120 mEq/L); or
8. Hypokalaemia (serum K < 2.5 mEq/L); or
9. Pulmonary oedema with PaO2 / FiO2 < 100; or
10. Hypocalcaemia (iCa < 0.8mmol/L); or
11. Patients admitted to the ICU after a drug overdose or intoxication (including alcohol intoxication); or
12. Pregnancy or breastfeeding; or
13. Death is deemed to be inevitable as a result of the current acute illness and either the treating clinician, the patient or the substitute decision maker are not committed to full active treatment; or
14. Patients with a life expectancy < 30 days due to a chronic or underlying medical condition; or
15. Considered to be at high risk of cerebral oedema by the treating clinician (e.g. traumatic brain injury or acute brain disease); or
16. Clinician believes that being enrolled in intervention or control arm is not in the best interest of the patient; or
17. Previous enrolment in this study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
26/04/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/06/2027
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Actual
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Sample size
Target
500
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,NT,QLD,SA,VIC
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [2]
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St Vincent's Hospital Sydney - Darlinghurst
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Recruitment hospital [3]
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Gosford Hospital - Gosford
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Recruitment hospital [4]
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [5]
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Royal Darwin Hospital - Tiwi
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Recruitment hospital [6]
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Cairns Hospital - Cairns
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Recruitment hospital [7]
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Queen Elizabeth II Jubilee Hospital - Coopers Plains
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Recruitment hospital [8]
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Royal Brisbane and Women's Hospital - Herston
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Recruitment hospital [9]
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Princess Alexandra Hopsital - Woolloongabba
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Recruitment hospital [10]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [11]
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [12]
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The Queen Elizabeth Hospital - Woodville
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Recruitment hospital [13]
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Grapmians Health - Ballarat
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Recruitment hospital [14]
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Casey Hospital - Berwick
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Recruitment hospital [15]
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Footscray Hospital - Footscray
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Recruitment hospital [16]
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Frankston Hospital - Frankston
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Recruitment hospital [17]
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The Austin Hospital - Heidelberg
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Recruitment hospital [18]
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Peninsula Private Hospital - Langwarrin
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Recruitment hospital [19]
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The Alfred Hospital - Melbourne
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Recruitment hospital [20]
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Epworth - Richmond
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Recruitment hospital [21]
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Sunshine Hospital - St Albans
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2010 - Darlinghurst
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Recruitment postcode(s) [3]
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2250 - Gosford
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Recruitment postcode(s) [4]
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2298 - Waratah
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Recruitment postcode(s) [5]
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0810 - Tiwi
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Recruitment postcode(s) [6]
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4870 - Cairns
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Recruitment postcode(s) [7]
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4108 - Coopers Plains
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Recruitment postcode(s) [8]
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4006 - Herston
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Recruitment postcode(s) [9]
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4102 - Woolloongabba
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Recruitment postcode(s) [10]
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5000 - Adelaide
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Recruitment postcode(s) [11]
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- Bedford Park
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Recruitment postcode(s) [12]
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5011 - Woodville
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Recruitment postcode(s) [13]
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3350 - Ballarat
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Recruitment postcode(s) [14]
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3806 - Berwick
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Recruitment postcode(s) [15]
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3011 - Footscray
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Recruitment postcode(s) [16]
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3199 - Frankston
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Recruitment postcode(s) [17]
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3084 - Heidelberg
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Recruitment postcode(s) [18]
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3910 - Langwarrin
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Recruitment postcode(s) [19]
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3004 - Melbourne
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Recruitment postcode(s) [20]
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3121 - Richmond
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Recruitment postcode(s) [21]
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3021 - St Albans
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Country [2]
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New Zealand
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State/province [2]
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Christchurch
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Country [3]
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New Zealand
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State/province [3]
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Wellington
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Country [4]
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Oman
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State/province [4]
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Seeb
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australian and New Zealand Intensive Care Research Centre
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This trial aims to assess if, among adults in the ICU with metabolic acidosis, an infusion of sodium bicarbonate diluted in 5% dextrose, compared with an infusion of 5% dextrose, reduces Major Adverse Kidney Events within 30 days of randomization.
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Trial website
https://clinicaltrials.gov/study/NCT05697770
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Ary Serpa Neto, PhD
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Address
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ANZIC RC, Monash university
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Mairead McNamara
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Address
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Country
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Phone
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+613 9903 0513
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05697770