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Trial registered on ANZCTR
Registration number
ACTRN12608000090314
Ethics application status
Approved
Date submitted
15/02/2008
Date registered
15/02/2008
Date last updated
3/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effects of methylene blue infusion on gastrointestinal perfusion and gut mucosal damage in septic shock patients
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Scientific title
The effects of methylene blue infusion on gastrointestinal perfusion and gut mucosal damage in septic shock patients
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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:
septic shock
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Condition category
Condition code
Cardiovascular
2974
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Methylene blue infusion 1 mg/kg/hr during 4 hours
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Intervention code [1]
2571
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Treatment: Drugs
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Comparator / control treatment
No control group, measurements compared to baseline
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Tonometry: decrease in difference between gastric and arterial CO2 (Carbon Dioxide) partial pressure (Pg-aCO2 gradient) of more than 5 mmHg
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Assessment method [1]
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Timepoint [1]
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Measured at baseline and every 30 minutes for 6 hours
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Secondary outcome [1]
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Urinary level of intestinal fatty acid binding protein (iFABP)
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Assessment method [1]
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Timepoint [1]
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Measured at baseline, after 6 and after 24 hours
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Eligibility
Key inclusion criteria
Patients with refractory septic shock defined as having a mean arterial pressure < 70 mmHg despite norepinephrine infusion > 0.2 mcg/kg/min
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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
myocardial infarction < 6 months prior to study, pregnancy
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/11/2004
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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
10
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Netherlands
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State/province [1]
797
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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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Netherlands
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Primary sponsor type
Individual
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Name
Dr Frank van Haren
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Address
Department of Intensive Care Waikato Hospital Private Bag 3200 Hamilton
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Peter Pickkers
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Address [1]
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Intensive Care Department
Radboud University Nijmegen Medical Centre
Nijmegen
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Country [1]
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Netherlands
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Committee on Research Involving Humans in the Netherlands (CCMO)
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Ethics committee address [1]
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Postbus 16302 2500 BH Den Haag The Netherlands www.ccmo.nl
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Ethics committee country [1]
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Netherlands
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Date submitted for ethics approval [1]
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Approval date [1]
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17/08/2004
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Ethics approval number [1]
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P04.0589C
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Summary
Brief summary
Patients with severe sepsis (infection) frequently die. Sepsis interferes with the clotting and inflammatory systems and affects the heart, blood pressure as well as tissue oxygenation of the body. The pathogenesis of vasodilation and organ dysfunction in septic shock involves the excessive production of nitric oxide (NO) by activated inducible NO synthase (iNOS). NO stimulates the soluble intracellular enzyme guanylate cyclase (sGC), increasing the generation of cyclic guanosine monophosphate (cGMP). Ultimately, this pathway leads to vasodilation, myocardial depression, increased vascular permeability, loss of gut barrier function, and organ dysfunction. Methylene blue (MB) is a chemical dye that has been shown to scavenge NO, inhibit iNOS, and to inhibit sGC. In septic patients, small trials of MB have consistently demonstrated an increase in blood pressure. MB has been shown to be safe in humans, and has been used for treatment of cyanide poisoning, methemoglobimemia, and malaria. In this study we administered MB to 10 Intensive Care patients with septic shock. A variety of invasive and non-invasive measurements and blood tests were taken over a 24 hour period. Demographic data and illness severity scores were recorded as well as usual haemodynamic measures and recordings for seriously ill patients. Statistical analysis using standard techniques, was done on SPSS version 14.0.
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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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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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Dr Frank van Haren
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Address
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Department of Intensive Care Waikato Hospital Private Bag 3200 Hamilton
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Country
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New Zealand
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Phone
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+64 78398899
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Fax
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+64 78398912
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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 Frank van Haren
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Address
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Department of Intensive Care Waikato Hospital Private Bag 3200 Hamilton
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Country
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New Zealand
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Phone
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+64 78398899
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Fax
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+64 78398912
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Email
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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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