The Effects of Enoximone in Acute Exacerbation COPD
Introduction:
The pharmacodynamic properties of enoximone could be beneficial for patients with an Acute Exacerbation COPD (AE-COPD). This research will focus on patients suffering of a severe AE-COPD and the bronchodilatory and inotropic effects of lower doses of enoximone. The main objective of the pilot study is to investigate if there is a bronchodilatory effect of enoximone in patients with AE-COPD. Secondary objective is to investigate a dose responsiveness in a range between 0.5 and 1.5 mg/kg enoximone.
Methods:
The study design is a prospective interventional non-randomized clinical series study involving patients admitted and intubated at the Intensive Care Unit (ICU) with an AE-COPD. Patients will receive three times a dose of 0.5 mg/kg enoximone with a one-hour-interval. The primary objective is a reduction in auto-positive end-expiratory pressure (PEEP) after enoximone compared to baseline. A dose-titration will test for dose dependency. Secondary objectives are a reduction in ventilator pressures, a reduction in pulmonary artery pressures and an increase in cardiac output.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Ventilator will be set during the study period at Volume Controle, 6 ml/kg, 5 PEEP and a respiratory rate of 15 bpm with an I:E-ratio of 1:2.
Salbutamol/ipratropium bromide and magnesium sulphate will be administered at baseline (t=0h) and measurements will be made for an hour.
At T=1h the first dose of 0.5 mg/kg enoximone will be administered and will be repeated at T=2h and T=3h. Ventilator derived variables will be obtained every fifteen minutes and echocardiography, arterial and central venous bloodgas analyses every hour until t=6h.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
M
-
Arnhem, M, Netherlands
- M.V. Koning
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with an AE-COPD for which intubation occurred within 24 hours before enrolment.
Exclusion Criteria:
- Patients with known asthma or interstitial lung disease (ILD)
- Known neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), Guillain-Barre and Dementia
- Hypertrophic obstructive cardiomyopathy (HOCM)
- Severe aortic stenosis with aortic valve area < 1cm2
- Known ventricular arrhythmias
- Severe kidney disorders with Glomerular Filtration Rate (GFR) < 30
- Severe liver insufficiency with spontaneous PT/INR > 1.5
- Pregnancy
- Lactation
- High dose-diuretics use (daily dose of >480 mg furosemide)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Enoximone
Patients will receive three times a dose of 0.5 mg/kg enoximone with a one-hour-interval.
|
Patients will receive three times a dose of 0.5 mg/kg enoximone with a one-hour-interval.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
PEEP
Time Frame: within 6 hoursmeasured every 15 minutes
|
Reduction in intrinsic PEEP, in cmH2O
|
within 6 hoursmeasured every 15 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Lung compliance
Time Frame: within 6 hours, measured every hour
|
ml/H2O
|
within 6 hours, measured every hour
|
|
Airway resistence
Time Frame: within 6 hours, measured every hour
|
cmH2O/L/sec
|
within 6 hours, measured every hour
|
|
VEI
Time Frame: within 6 hours, measured every hour
|
ml
|
within 6 hours, measured every hour
|
|
VCO2
Time Frame: within 6 hours, measured every hour
|
ml/min
|
within 6 hours, measured every hour
|
|
etCO2
Time Frame: within 6 hours, measured every hour
|
kPa
|
within 6 hours, measured every hour
|
|
Vd/Vt
Time Frame: within 6 hours, measured every hour
|
Measured by Bohr-equation, in percentage
|
within 6 hours, measured every hour
|
|
FiO2
Time Frame: within 6 hours, measured every hour
|
percentage
|
within 6 hours, measured every hour
|
|
Shunt fraction
Time Frame: within 6 hours, measured every hour
|
measured by Fick-equation, using the SvO2, in percentage
|
within 6 hours, measured every hour
|
|
Cardiac Output
Time Frame: within 6 hours, measured every hour
|
Measured by echocardiography (LVOT VTI), ml/hr
|
within 6 hours, measured every hour
|
|
RVSP
Time Frame: within 6 hours, measured every hour
|
Measured by echocardiography, in mmHg
|
within 6 hours, measured every hour
|
|
TAPSE
Time Frame: within 6 hours, measured every hour
|
Measured by echocardiography, in mm
|
within 6 hours, measured every hour
|
|
MAPSE
Time Frame: within 6 hours, measured every hour
|
Measured by echocardiography, in mm
|
within 6 hours, measured every hour
|
|
LV Ejection Fraction
Time Frame: within 6 hours, measured every hour
|
Measured by echocardiography, in percentage
|
within 6 hours, measured every hour
|
|
Bloodgas analysis
Time Frame: within 6 hours, measured every hour
|
Arterial bloodgas analysis and central venous gas analysis (through catheter placed in superior vena cava)
|
within 6 hours, measured every hour
|
Collaborators and Investigators
Sponsor
Sponsor
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 (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2019-1432
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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