- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01193777
L-Carnitine Administration in Early Sepsis
Sepsis is a severe and overwhelming response to an infection in the body. Over 750,000 patients in the United States develop sepsis every year. As sepsis becomes progressively more severe, a patient's blood pressure drops to dangerous levels and the body cannot pump oxygen to the rest of the body, which is necessary for normal cell function. This is called septic shock. When someone develops septic shock, it is very common for the smallest blood vessels in the body called the microcirculation to clog, like a highway during rush hour. Even with the best medical care, more than one in three patients with septic shock will die.
The major goal of this study is to test if intravenous replacement of a naturally occurring nutrient that is lost by the body during sepsis called L-carnitine can reduce how sick a patient with sepsis becomes. In our study, some patients will receive L-carnitine and others will receive saline. We will measure markers determining severity of illness in both groups and compare them to see if L-carnitine helps patients get better faster. Based on research already conducted, we believe L-carnitine will improve blood flow in the microcirculation, delivering more oxygen to cells, and help the body get better. To test if this is true, we will directly look at the microcirculation under the tongue with a special magnifying camera that looks at red blood cells, and compare both groups.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Mississippi
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Jackson, Mississippi, United States, 39216
- University of Mississippi Medical Center
-
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North Carolina
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Charlotte, North Carolina, United States, 28203
- Carolinas Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Suspected or confirmed infection
- Any two of four criteria of systemic inflammatory response
- Requirement for vasopressors to treat shock
- Enrollment within 12 hours of vasopressor initiation
- SOFA score of greater than or equal to 5 at the time of enrollment
Exclusion Criteria:
- Age <18 years
- Pregnancy or breastfeeding
- Any primary diagnosis other than sepsis
- Established Do Not Resuscitate status or advanced directives restricting aggressive care or treating physician deems aggressive care unsuitable
- Any history of seizures or a known seizure disorder
- Any known inborn error of metabolism
- Anticipated requirement for surgery that would interfere with the 12 hour infusion time
- Active participation in another interventional study
- Inability to obtain informed consent
- Cardiopulmonary resuscitation (chest compression or defibrillation) prior to enrollment
- Known systemic allergy to carnitine
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Saline
|
Bolus followed by 1 L NS infusion over 12 hours.
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Experimental: L-Carnitine
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4 gram bolus followed by 8 gram in 1 L NS infused over 12 hours.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Reduction in organ failure
Time Frame: 24 hours
|
SOFA score will be measured at 0 and 24 hours
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
All-cause mortality
Time Frame: 3 months
|
3 months
|
|
All-cause mortality
Time Frame: 6 months
|
6 months
|
|
All-cause mortality
Time Frame: 12 months
|
12 months
|
|
Microcirculation
Time Frame: 12 hours
|
Test if carnitine improves blood flow in the sublingual microvasculature during septic shock by performing sidestream dark-field (SDF) video-microscopy of the sublingual microcirculation, prior to and after 12 hours of carnitine infusion.
|
12 hours
|
ICU and hospital length of stay
Time Frame: Duration of stay
|
Duration of stay
|
|
All-cause mortality
Time Frame: 28 day
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28 day
|
|
Change in inflammatory markers
Time Frame: 12 hours
|
Assess change in various inflammatory markers over predefined time points.
|
12 hours
|
Change in inflammatory markers
Time Frame: 24 hours
|
Assess change in various inflammatory markers over predefined time points.
|
24 hours
|
Change in inflammatory markers
Time Frame: 48 hours
|
Assess change in various inflammatory markers over predefined time points.
|
48 hours
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Alan E Jones, MD, University of Mississippi and Carolinas Medical Center, Department of Emergency Medicine
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 04-10-06A
- 10POST3560001 (Other Grant/Funding Number: American Heart Association)
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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