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Trial registered on ANZCTR
Registration number
ACTRN12610000950066
Ethics application status
Approved
Date submitted
4/11/2010
Date registered
5/11/2010
Date last updated
5/11/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Fibrinolytic treatment of acute respiratory failure due to inflammatory lung injury
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Scientific title
Fibrinolytic treatment of acute respiratory failure due to inflammatory lung injury to assess improvement in alveolar dead space and right ventricular function
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Secondary ID [1]
253027
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Not applicable
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
acute respiratory failure due to inflammatory lung injury
258588
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Condition category
Condition code
Respiratory
258725
258725
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Administration of tissue plasminogen activator (t-PA) on one occasion.
Dose escalation study
The first 4 patients will receive
1. 10 mg bolus and 10 mg over 30 min.
The second 4 patients will receive
2. 10 mg bolus and 20 mg over 30 min.
The final 4 patients will receive
3. 10 mg bolus and 40 mg over 30 min.
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Intervention code [1]
257553
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
259592
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Phase 1 study
Alveolar dead space will be assessed using an expired breath carbon dioxide analyser
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Assessment method [1]
259592
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Timepoint [1]
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baseline and at 1 and 4 hours post t-pa
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Primary outcome [2]
259593
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pulmonary artery pressure and cardiac function will be assessed using echocardiology
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Assessment method [2]
259593
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Timepoint [2]
259593
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baseline and at 1 and 4 hours post t-pa
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Primary outcome [3]
259594
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safety (bleeding) will be assessed by monitoring of the patient in the Intensive Care Unit for fall in Haemoglobin levels or clinical evidence of bleeding
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Assessment method [3]
259594
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Timepoint [3]
259594
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in 24 hours following the t-pa
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Secondary outcome [1]
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urinary albumin creatinine ratio will be assessed by analysing albumin and creatinine levels in the urine
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Assessment method [1]
266224
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Timepoint [1]
266224
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baseline and at 1 and 4 hours post t-pa
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Eligibility
Key inclusion criteria
Patients with acute respiratory failure due to an acute inflammatory insult.
Requiring positive pressure ventilation via an endo-tracheal tube.
Impaired oxygenation - arterial partial pressure of oxygen to inspire fraction of oxygen ratio (P/F) <300 mmHg.
At least one quadrant of pulmonary infiltrate present on CXR.
Enrolled within 24 hrs of developing all of these criteria.
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Minimum age
15
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
Known hypersensitivity to alteplase (t-PA)
Aspirin in the last week
Any therapeutic anti-coagulant therapy
Significant bleeding disorder within the past six months
Any history of brain or spinal injury including trauma, stroke, transient ischaemic attack, neoplasm, surgery, infection, aneurysm or intracranial bleed.
Uncontrolled hypertension, systolic blood pressure (BP) >185 mmHg or diastolic BP >110 mmHg.
Recent (within ten days) prolonged or traumatic cardiopulmonary resuscitation (> 2 minutes), obstetric delivery, organ biopsy, puncture of non-compressible blood vessel (e.g. subclavian vein), major surgery or significant trauma.
Documented ulcerative gastrointestinal disease during the last three months.
Arterial aneurysms, arterial/venous malformations.
Neoplasm with increased bleeding risk.
Bacterial endocarditis, pericarditis.
Acute pancreatitis.
Severe hepatic disease/ dysfunction, including hepatic failure, cirrhosis, portal hypertension (oesophageal varices) or active hepatitis.
Age <18 or > 75
Pulmonary haemorrhage in previous 12 months
Major surgery planned over the next 2 days
Diabetic haemorrhagic retinopathy or other haemorrhagic ophthalmic conditions.
Unlikely to survive 24 hours
Platelet count below 80,000/mm3
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
not applicable
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Phase
Phase 1
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
12/12/2010
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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
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
258004
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Self funded/Unfunded
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Name [1]
258004
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Barry Dixon
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Address [1]
258004
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St Vincent's Hospital Fitzroy, Victoria, 3065
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Country [1]
258004
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital
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Address
Victoria Pde, Fitzroy, Victoria, 3065
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Country
Australia
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Secondary sponsor category [1]
257199
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None
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Name [1]
257199
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Address [1]
257199
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Country [1]
257199
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
259999
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St Vincent's Hospital Fitzroy, Victoria, 3065
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Ethics committee address [1]
259999
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41 Victoria Pde, Fitzroy, Victoria, 3065
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Ethics committee country [1]
259999
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Australia
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Date submitted for ethics approval [1]
259999
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Approval date [1]
259999
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29/10/2010
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Ethics approval number [1]
259999
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1/10/0129
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Summary
Brief summary
Inflammatory insults including pneumonia, sepsis, aspiration, trauma, prolonged hypotension, cardiac surgery and pancreatitis can cause lung damage. One mechanism by which inflammation mediates lung injury is through deposition of fibrin in the pulmonary microcirculation. This study will investigate if limiting fibrin deposition through administration of tissue plasminogen activator reduces lung damage.
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Trial website
none
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Trial related presentations / publications
none
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Public notes
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Contacts
Principal investigator
Name
31873
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Address
31873
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Country
31873
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Phone
31873
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Fax
31873
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Email
31873
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Contact person for public queries
Name
15120
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Barry Dixon
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Address
15120
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ICU St.Vincent's Hospital 41 Victoria Pde, Melbourne, Victoria, 3065
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Country
15120
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Australia
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Phone
15120
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61 0439618815
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Fax
15120
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Email
15120
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[email protected]
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Contact person for scientific queries
Name
6048
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Barry Dixon
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Address
6048
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ICU St.Vincent's Hospital 41 Victoria Pde, Fitzroy, Melbourne, Victoria, 3065
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Country
6048
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Australia
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Phone
6048
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61 0439618815
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Fax
6048
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Email
6048
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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