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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05752279
Registration number
NCT05752279
Ethics application status
Date submitted
7/02/2023
Date registered
2/03/2023
Titles & IDs
Public title
Balanced Multi-Electrolyte Solution Versus Saline Trial for Diabetic KetoAcidosis
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Scientific title
Balanced Multi-electrolyte Solution Versus 0.9% Sodium Chloride as Fluid Therapy for Patients Presenting With Moderate to Severe Diabetic Ketoacidosis
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Secondary ID [1]
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TGI CCP-2378-352
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Universal Trial Number (UTN)
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Trial acronym
BEST-DKA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetic Ketoacidosis
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Condition category
Condition code
Diet and Nutrition
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Other diet and nutrition disorders
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Metabolic and Endocrine
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0
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Other metabolic disorders
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Respiratory
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0
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Other respiratory disorders / diseases
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Renal and Urogenital
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0
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0
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Kidney disease
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Metabolic and Endocrine
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0
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Diabetes
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Metabolic and Endocrine
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0
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Metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Plasma-Lyte 148
Treatment: Drugs - 0.9% sodium chloride
Active comparator: Plasma-Lyte® 148 - Plasma-Lyte® 148 fluid 1L given intravenously for fluid replacement
Active comparator: 0.9% sodium chloride - Normal saline fluid 1L given intravenously for fluid replacement
Treatment: Drugs: Plasma-Lyte 148
Plasma-Lyte® 148 intravenous fluid for resuscitation in patients with keto-acidosis
Treatment: Drugs: 0.9% sodium chloride
0.9% sodium chloride intravenous fluid for resuscitation in patients with keto-acidosis
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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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Hospital free days (HFD) up to day-28 after study enrolment
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Assessment method [1]
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Number of hospital free days from time of hospital discharge
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Timepoint [1]
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from time of enrolment to 28 days
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Secondary outcome [1]
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ICU free days up to 28 days after study enrolment
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Assessment method [1]
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Number of ICU free days from time of ICU discharge
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Timepoint [1]
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28 days after enrolment
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Secondary outcome [2]
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ICU and hospital readmissions up to 28 days after study enrolment
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Assessment method [2]
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Number of days free from ICU and hospital from time of hospital discharge
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Timepoint [2]
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28 days after enrolment
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Secondary outcome [3]
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Acute kidney injury assessed by comparing serum creatinine using Kidney Disease: Improving Global Outcomes (KDIGO) criteria
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Assessment method [3]
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injury assessed by comparing change in serum creatinine using Kidney Disease: Improving Global Outcomes (KDIGO) criteria
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Timepoint [3]
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28 days after enrolment
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Secondary outcome [4]
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Episodes of post-study enrolment decrease in Glasgow Coma Scale (GCS) by more than 2 in the first 24 hours
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Assessment method [4]
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decrease in Glasgow Coma Score by more than 2 points
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Timepoint [4]
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first 24 hours from enrolment
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Secondary outcome [5]
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Time to resolution of ketosis
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Assessment method [5]
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resolution of acidosis
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Timepoint [5]
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from time of enrolment to day 28
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Secondary outcome [6]
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Cumulative insulin dosage in the first 48 hours
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Assessment method [6]
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Total amount of insulin given to the patient from enrolment to 48 hours
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Timepoint [6]
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first 48 hours from time of enrolment
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Secondary outcome [7]
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Duration of IV insulin infusion
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Assessment method [7]
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Total amount of IV insulin given to the patient from time of enrolment to day 28
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Timepoint [7]
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from time of enrolment to day 28
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Secondary outcome [8]
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Cumulative potassium replacement
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Assessment method [8]
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Total amount of potassium given to the patient from time of enrolment to day 28
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Timepoint [8]
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from time of enrolment to day 28
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Eligibility
Key inclusion criteria
* Patients in the ED with a primary diagnosis of moderate to severe DKA for whom both saline and Plasma-Lyte® 148 are considered appropriate fluids
* Blood glucose level > 14mmol/L
* pH < 7.25
* Serum bicarbonate <15 mmol/L
* Elevated anion gap > 12mEq/L
* Ketones positive on finger prick measurements
* In the judgement of the treating clinician critical care area admission is required
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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
* Age less than 18 years
* Patients who have received more than 2000ml of non study fluid prior to study enrolment
* Serum Na > 155 or <120 mmol/L
* Contraindication to either study fluid e.g. previous allergic reaction to Plasma-Lyte® 148
* Patients with hyperosmotic hyperglycaemic non-ketotic syndrome
* Other clinical conditions that preclude large volumes of fluid resuscitation
* Previous inclusion in BEST-DKA trial
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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 analysing the results/data
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Intervention assignment
Crossover
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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
Not yet 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
1/03/2024
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Actual
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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
1/06/2026
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Actual
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Sample size
Target
680
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD
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Recruitment hospital [1]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [2]
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Redcliffe Hospital - Redcliffe
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Recruitment postcode(s) [1]
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2065 - St Leonards
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Recruitment postcode(s) [2]
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4020 - Redcliffe
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Funding & Sponsors
Primary sponsor type
Other
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Name
The George Institute
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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
The goal of this blinded, cluster cross-over, randomised controlled trial is to determine whether fluid therapy with Plasma-Lyte® 148 increases the number of days alive and days out of hospital to day-28 compared to 0.9% sodium chloride ('0.9% saline') in critically ill patients presenting to the Emergency Department (ED) and deemed to require admission to a critical care area (ICU, HDU) with moderate to severe diabetic ketoacidosis (DKA).
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Trial website
https://clinicaltrials.gov/study/NCT05752279
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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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Address
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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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Address
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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 scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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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/NCT05752279