- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02966080
Fixed Low-dose Heparin Versus Standard Adjusted-dose Heparin Infusion in Adults Receiving Venovenous ECMO With a Heparin Bonded Circuit.
August 16, 2017 updated by: Robert Raschke, University of Arizona
Fixed Low-dose Heparin Versus Standard Adjusted-dose Heparin Infusion in Adults Receiving Venovenous Extracorporeal Membrane Oxygenation (ECMO) With a Heparin Bonded Circuit.
Heparin is a blood thinner used to prevent blood clots in patients on a form of life-support called ECMO.
Heparin can cause bleeding - the most common complication of ECMO.
New materials used in ECMO machines may help prevent clots - this could allow the use of lower doses of heparin which might reduce the risk of bleeding.
Our study will compare low dose to high dose heparin in patients on ECMO.
We think low dose heparin may be adequate to prevent clotting, but may cause less bleeding and be safer for patients.
Study Overview
Status
Withdrawn
Intervention / Treatment
Detailed Description
Intravenous heparin is considered standard therapy to prevent clotting complications in patients on ECMO, however the optimal method of heparin dosing has not yet been determined.
International surveys have shown that most ECMO centers use adjusted dose heparin to achieve an activated clotting time of at least 180 seconds.
However, heparin may contribute to the most common complication of ECMO - bleeding.
Advances in material technology have potentially reduced the thrombogenicity of modern ECMO circuits.
Our observational data suggest that fixed low dose heparin infusion may reduce the rate of bleeding complications from 75% to 50% compared to standard adjusted-dose heparin, without increasing clotting complications.
We intend to perform a randomized controlled trial in adults receiving venovenous ECMO comparing these two heparin regimens.
The main outcome measures are bleeding complications and oxygenator failure due to clotting.
A safety committee will monitor the results of the study.
Power calculations indicate a sample size of 110 patients is required, which we estimate will take us five years to achieve.
Study Type
Interventional
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Arizona
-
Phoenix, Arizona, United States, 85006
- Banner - University Medical Center Phoenix
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- on ECMO for acute respiratory failure, achieving ECMO blood flow rate >3L/min,
- patient or surrogate able to speak/understand English or Spanish
Exclusion Criteria:
- History of heparin-induced thrombocytopenia, decision by clinicians to run ECMO off heparin due to high bleeding risk,
- pregnancy
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Adjusted-dose heparin
Patients in this arm of the study will receive intravenous unfractionated heparin at a dose adjusted to achieve an activated clotting time of 180-200 seconds.
|
Other Names:
|
Other: Fixed low-dose heparin
Patients in this arm of the study will receive intravenous unfractionated heparin at 500 units/hour without activated clotting time monitoring.
|
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
significant bleeding complications
Time Frame: intraoperative
|
requires surgery, >1 unit packed blood cell transfusion or is intracranial, pulmonary or retroperitoneal
|
intraoperative
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oxygenator failure
Time Frame: intraoperative
|
Requirement to replace oxygenator due to clotting
|
intraoperative
|
cerebral vascular event (stroke)
Time Frame: intraoperative
|
intraoperative
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Robert Raschke, MD, Banner University Medical Center
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Esper SA, Levy JH, Waters JH, Welsby IJ. Extracorporeal membrane oxygenation in the adult: a review of anticoagulation monitoring and transfusion. Anesth Analg. 2014 Apr;118(4):731-43. doi: 10.1213/ANE.0000000000000115.
- Poulos EM, Raschke R, Amabile O et al. A Nonrandomized comparison of three different heparin infusion strategies for patients receiving venovenous extracorporeal membrane oxygenation. Am J Respir Crit Care Med 2014;189: A4499.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
December 1, 2016
Primary Completion (Anticipated)
December 1, 2020
Study Completion (Anticipated)
February 1, 2021
Study Registration Dates
First Submitted
November 15, 2016
First Submitted That Met QC Criteria
November 16, 2016
First Posted (Estimate)
November 17, 2016
Study Record Updates
Last Update Posted (Actual)
August 21, 2017
Last Update Submitted That Met QC Criteria
August 16, 2017
Last Verified
August 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1609884386
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
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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