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Trial registered on ANZCTR
Registration number
ACTRN12611000453987
Ethics application status
Approved
Date submitted
28/04/2011
Date registered
3/05/2011
Date last updated
5/11/2018
Date data sharing statement initially provided
5/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Crystalloid versus Albumin in the Resuscitation of Emergency Department Patients with Septic Shock
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Scientific title
Crystalloid versus Albumin for improving organ dysfunction and microcirculation in Emergency Department Patients with Septic Shock
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Secondary ID [1]
260071
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There are no secondary IDs
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Universal Trial Number (UTN)
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Trial acronym
CARESS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Septic Shock
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Condition category
Condition code
Infection
265890
265890
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Albumin for fluid resuscitation. Albumin will be given via intravenous injection. Dose will be determined by treating clinician in accordance with current best practice. Albumin will be given during the resuscitation phase while in the Emergency Department
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Intervention code [1]
264492
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Treatment: Other
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Comparator / control treatment
Crystalloid for fluid resuscitation
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Control group
Active
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Outcomes
Primary outcome [1]
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Organ Dysfunction will be measured using the sequential organ dysfunction assessment tool. This tool requires clinical and laboratory based data that is obtained routinely as part of standard care.
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Assessment method [1]
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Timepoint [1]
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0, 6, 24 and 72 hours after trial enrolment
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Secondary outcome [1]
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Sublingual microcirculation will be assessed using the microvision microscan sublingual microcirculation video microscope. Four measures of microcirculation will be calculated using this equipment; capillary density, microvascular flow index, percent of perfused capillaries and perfused capillary density.
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Assessment method [1]
276144
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Timepoint [1]
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0, 6, 24 and 72 hours after trial enrolment
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Eligibility
Key inclusion criteria
1. Infection (according to treating emergency physician’s clinical assessment)
2. Shock, as defined by either:
a. Hypotension (Systolic blood pressure <90 or Mean arterial pressure <65 despite 20ml/kg fluid bolus), or
b. Elevated lactate (arterial or venous, >4.0 mmol/l)
3. At least 2 systemic inflammatory response syndrome (SIRS) criteria present, defined as
a. Core temperature < 36.0 degrees C or > 38 degrees C
b. Heart rate > 90 beats/minute
c. Respiratory rate > 20 breaths/minute or PaC02 < 32 mmHg
d. White cell count > 12 or < 4 * 109/L
4. Antimicrobials commenced
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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. Inter-hospital transfer
2. >8 hours in ED
3. Death is expected and imminent.
4. Underlying disease process with a life expectancy of <90 days.
5. Jehovah’s Witness
6. Age<18
7. A “limitation of therapy” order has been documented restricting implementation of the study protocol or treating team clinician deems aggressive care unsuitable.
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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)
Patients eligible for inclusion will be consented and enrolled while in the Emergency Department. This is an unblinded study. Random allocation concealment will be implemented through the use of serially numbered, tamper-evident envelopes. The envelopes contain group assignment, study instructions and data sheets
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A randomisation sequence will generated with the aid of random allocation software . Permuted block randomisation with variable block sizes will be used.
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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
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Withdrawn
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
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Date of first participant enrolment
Anticipated
1/06/2011
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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
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Hospital
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Name
Royal Brisbane and Women's Hospital
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Address
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston QLD 4029
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
264058
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Country [1]
264058
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Brisbane and Women's Hospital Human Research Ethics Committee
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Ethics committee address [1]
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Butterfield Street, Herston, QLD, 4029
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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29/03/2011
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Ethics approval number [1]
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HREC/11/QRBW/33
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Summary
Brief summary
Individuals who present to the Emergency Department with severe infections are treated with fluids in the vein to maintain optimal blood volume, keep the heart working properly, and keep tissues well oxygenated. There are a number of fluids that Emergency Physicians can provide to patients including saline and 4% albumin. Further work is required to determine which of these fluids is most effective in improving the outcome of patients with severe infection. This project aims to determine whether 4% albumin solution is superior to crystalloid solutions for fluid resuscitation of patients presenting to the Emergency Department (ED) with septic shock. A randomised controlled trial is proposed, in which 100 patients will be enrolled over 2 years, each assigned to receive either 4% albumin or crystalloid fluids for the first six hours of resuscitation in the ED. All other aspects of care will be common to both groups and according to evidence-based guidelines. A variety of outcomes will be measured, including organ dysfunction scores, inflammatory markers and measures of circulation.
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Trial website
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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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Dr Julian Williams
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Address
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Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD, 4029
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Country
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Australia
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Phone
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+61 36468111
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Julian Williams
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Address
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Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4029
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Country
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Australia
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Phone
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+61 7 3636 7901
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Fax
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61 7 3636 1643
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Julian Williams
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Address
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Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, QLD 4029
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Country
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Australia
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Phone
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+61 7 3636 7901
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Fax
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+61 7 3636 1643
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Email
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[email protected]
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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
This trial was ended before data collection commenced
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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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