- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00207844
Selenium, as Sodium Selenite, in the Treatment of Septic Shock
Prospective, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study Evaluating Efficacy and Safety of a Therapeutic Administration of Selenium, as Selenite, in Septic Shock Patients.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Septic shock - an uncontrolled systemic host response to invasive infection -, leading to multiple organ failure, is a public health issue because of its frequency (> 1/1000 inhabitants per year), its cost and its 45% mortality rate, remaining high despite all the improvements made in ICU for the past 20 years. His physiopathology is better understood with increasing data supporting the key role of free radicals, and a more than 40% plasma selenium concentration decrease that maybe associated with increased morbidity and mortality. Meanwhile, for the past 30 years, researches have been conducted on the essential trace element selenium for its requirement for key antioxidant enzymes, through the 21st aa selenocystein, and also for its potentially toxic, pro-oxidant properties. In septic shock, both properties may be useful, antioxidant enzymatic to increase cell defense especially endothelial cells, and direct pro-oxidant action to decrease the genomic response, especially on phagocytic cells.
The objective of this study is to evaluate the effects of a high dose of selenium administration, such as selenite, at pro-oxydant initial dose followed by anti-oxidant dose in severe septic shock patients with documented infection. The initial dose was chosen as the highest dose of selenium, as sodium selenite, estimated without severe adverse effects in healthy people for a one-day ingestion. The patients are randomized to receive either the placebo or the selenite at this high initial dose followed by lower doses on a 9-day period. The efficacy will be evaluated by the weaning time of catecholamines, with a special attention to the 6-month mortality rate as first secondary end point.
Study Type
Enrollment
Phase
- Phase 2
Contacts and Locations
Study Locations
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Argenteuil, France, 95107
- Service de Réanimation - Centre Hospitalier Victor Dupouy
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Châlons-en-Champagne, France, 51000
- Service de Réanimation Polyvalente - CH de Châlons
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Garches, France, 92380
- Service de Réanimation Médicale - Hôpital Raymond Poincaré
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Lyon, France, 69275
- Service de Réanimation - HIA Desgenettes
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Meaux, France, 77104
- Service de Réanimation Polyvalente - Hôpital Saint Faron
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Toulon, France, 83800
- Service Réanimation - HIA Saint Anne
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Tourcoing, France, 59208
- Service de Réanimation - Centre Hospitalier G. Dron
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Hospitalization in ICU
- Severe documented infection
- Ventilation
- Circulatory failure requiring high dose of catecholamine
- IGS II score >25 at inclusion
- Informed written consent
Exclusion Criteria:
- Pregnancy
- End phase chronic disease
- Limitation of care
- Shock due to an urinary infection without bacteriemia
- Peritonitis related to peritoneal dialysis or trauma
- Preliminary circulatory failure
- Participating to another clinical trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
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Weaning time of catecholamines
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Secondary Outcome Measures
Outcome Measure |
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- 6 month mortality rate
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- 6 month quality of life
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- 28 days mortality
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- ICU mortality
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- Hospital mortality
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- ICU length of stay
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- Hospital length of stay
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- Number of nosocomial infections in ICU
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- Duration of ventilation
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- SOFA score in ICU at days 4, 7, 10 and 14
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- Oxidative stress evaluation at days 4, 7, 10 and 14
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- Inflammation evaluation at days 4, 7, 10 and 14
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- Selenium status
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- Costs and work load
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- Onset of clinical events
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Xavier Forceville, MD, CH Meaux
Publications and helpful links
General Publications
- Brun-Buisson C, Doyon F, Carlet J, Dellamonica P, Gouin F, Lepoutre A, Mercier JC, Offenstadt G, Regnier B. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA. 1995 Sep 27;274(12):968-74.
- Forceville X, Vitoux D, Gauzit R, Combes A, Lahilaire P, Chappuis P. Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med. 1998 Sep;26(9):1536-44. doi: 10.1097/00003246-199809000-00021.
- Goode HF, Webster NR. Free radicals and antioxidants in sepsis. Crit Care Med. 1993 Nov;21(11):1770-6. doi: 10.1097/00003246-199311000-00029.
- Novelli GP. Role of free radicals in septic shock. J Physiol Pharmacol. 1997 Dec;48(4):517-27.
- Forceville X, Laviolle B, Annane D, Vitoux D, Bleichner G, Korach JM, Cantais E, Georges H, Soubirou JL, Combes A, Bellissant E. Effects of high doses of selenium, as sodium selenite, in septic shock: a placebo-controlled, randomized, double-blind, phase II study. Crit Care. 2007;11(4):R73. doi: 10.1186/cc5960.
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- AFSSAPS 10602
- CIC0203/003
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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