REmote Ischemic COnditioning in Septic Shock (RECO-Sepsis)
REmote Ischemic COnditioning in Septic Shock: The RECO-Sepsis Study
Septic shock remains a major public health problem in industrialized countries, with a mortality rate as high as 50%, largely related to multiple organ dysfunction. In addition to dysregulated inflammatory response, the pathophysiology of organ failures in septic shock involves ischemia-reperfusion processes. Remote ischemic conditioning is a therapeutic strategy for protecting organs against the detrimental effects of ischemia-reperfusion injury.
The objective of the present study is to determine whether remote ischemic conditioning can limit the severity of organ failure in patients with septic shock.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Clermont-Ferrand, France
- CHU de Clermont-Ferrand
-
Grenoble, France
- CHU de Grenoble
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Lyon, France
- Hopital Edouard Herriot
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Montpellier, France
- CHU de Montpellier
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Roanne, France
- CH de ROANNE
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Saint-Etienne, France
- CHU de Saint-Etienne
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years
- Hospitalization in an intensive care unit for less than 24 hours
- Septic shock evolving for less than 12 hours defined as:
- Documented or suspected infection
- Norepinephrine administration to maintain a mean arterial pressure ≥ 65 mmHg after volemia correction
- Lactatemia > 2 mmol/L at least once in the past 12 hours before inclusion
- Written informed consent signed by the patient or by a next of kin or oral consent given by the patient and as soon as permitted by the clinical state written informed consent signed by the patient.
Exclusion Criteria:
- Patient who has expressed the wish not to be resuscitated
- Contraindication of the use of brachial cuff on both arms
- Intercurrent pathology with an expected life expectancy of less than 24 hours
- Cardiac arrest
- Female patients currently pregnant or women of childbearing age who are not using contraception
- Previous inclusion in RECO-Sepsis study
- Previous inclusion in another clinical study
- Patients without health coverage
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Remote ischemic conditioning
A brachial cuff is positioned around the arm of the patient.
The remote ischemic conditioning consists in alternative inflations and deflations of the brachial cuff.
|
A brachial cuff is positioned around the arm of the patient.
Four cycles of [5 min brachial cuff inflation at 200 mmHg followed by 5 min of cuff deflation] started as soon as possible after randomization.
The intervention is repeated at 12 and 24 hours after inclusion.
|
|
Other: Control group
A brachial cuff is positioned around the arm of the patient.
No inflation or deflation is made.
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A brachial cuff is positioned around the arm of the patient and no inflation or deflation is made.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Average SOFA score (Sequential Organ Failure Assessment)
Time Frame: 96 hours.
|
The SOFA score ranges from 0 to 24 (higher scores indicate more severe organ failure), with 0 to 4 points assigned for each of 6 organ dysfunctions (ie, central nervous system, cardiovascular, respiratory, renal, coagulation, and liver).
|
96 hours.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Average SOFA score without the neurologic sub-score.
Time Frame: 96 hours.
|
The SOFA score without the neurologic subscore ranges from 0 to 20 (higher scores indicate more severe organ failure), with 0 to 4 points assigned for each of 5 organ dysfunctions (ie, cardiovascular, respiratory, renal, coagulation, and liver).
|
96 hours.
|
|
SOFA score.
Time Frame: 24 hours
|
24 hours
|
|
|
SOFA score.
Time Frame: 48 hours
|
48 hours
|
|
|
SOFA score.
Time Frame: 72 hours
|
72 hours
|
|
|
SOFA score.
Time Frame: 96 hours
|
96 hours
|
|
|
Variations of SOFA score (delta-SOFA)
Time Frame: 24 hours
|
24 hours
|
|
|
SOFA sub-scores for each organs
Time Frame: 48 hours
|
48 hours
|
|
|
SOFA sub-scores for each organs
Time Frame: 72 hours
|
72 hours
|
|
|
SOFA sub-scores for each organs
Time Frame: 96 hours
|
96 hours
|
|
|
Survival without organ support
Time Frame: Day 28
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Day 28
|
|
|
Intensive care unit (ICU) length of stay.
Time Frame: Day 90
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Day 90
|
|
|
Hospital length of stay
Time Frame: Day 90
|
Day 90
|
|
|
All-cause mortality
Time Frame: Day 90
|
Day 90
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Martin COUR, Hospices Civils de Lyon
Publications and helpful links
General Publications
- Cour M, Buisson M, Klouche K, Bouzgarrou R, Schwebel C, Quenot JP, Zeni F, Beuret P, Ovize M, Argaud L. Remote ischemic conditioning in septic shock (RECO-Sepsis): study protocol for a randomized controlled trial. Trials. 2019 May 22;20(1):281. doi: 10.1186/s13063-019-3406-4.
- Cour M, Klouche K, Souweine B, Quenot JP, Schwebel C, Perinel S, Amaz C, Buisson M, Ovize M, Mewton N, Argaud L; RECO-Sepsis Trial Investigators. Remote ischemic conditioning in septic shock: the RECO-Sepsis randomized clinical trial. Intensive Care Med. 2022 Nov;48(11):1563-1572. doi: 10.1007/s00134-022-06872-1. Epub 2022 Sep 14.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 69HCL17_0290
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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