- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04109144
Fresh Frozen Plasma as a Substitute for Albumin in Patients Receiving a Large Volume Paracentesis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
There will be three periods of this study, one for each of three consecutive routine large volume paracenteses. The length of the study will be 6 days post paracentesis for each period, for a total of 3 periods. The interval between successive LVP's will be determined by patients' need. In order to ensure follow up on Day 6, Day 1 will be restricted to a Tuesday, Wednesday, Thursday, or Friday.
All participants will be monitored for 3 consecutive routine large volume paracenteses. The 3 periods (LVP's) of this study will differ in administration of volume replacement solution. First LVP will be with intravenous albumin (12.5gm 25% Human Albumin for every 2 liters removed), 2nd LVP with administration 1 unit of FFP for every 2 liters removed for the first 4 liters followed by 12.5gm 25% albumin for every subsequent 2 liters removed, and 3rd LVP again with administration of intravenous albumin. The first LVP serves as the study entry time period and also as a control period for the same patient. The second LVP is to test the new intervention with FFP. The third LVP is included so that we can monitor the patient's status.
Albumin or FFP administration:
Albumin administration:
50ml of 25% albumin for every 2L removed
FFP administration:
2 units of FFP for the first 4L removed followed by 50ml of 25% albumin for every additional 2L removed FFP will be supplied by the Blood Bank and albumin from the pharmacy at Montefiore Medical Center.
Details for each study period:
- st Period: Day 1: Enrollment, baseline pre-LVP laboratory testing and measurements, and large volume paracentesis with administration of albumin Day 6: Laboratory testing and measurements
- nd Period: Day 1: pre-LVP baseline labs and measurements, LVP with FFP administration Day 6: Laboratory testing and measurements
- rd Period: Day 1: pre-LVP baseline labs and measurements, LVP with albumin administration Day 6: Laboratory testing and measurements
Study Type
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18 years or older
- Cirrhosis of the liver based on biopsy or clinical and radiographic criteria
- Ability to provide informed consent (Grade 0 to 1 HE)
- Grade 3 ascites or refractory ascites
- Ascites requiring frequent large volume paracentesis of at least 5 liters at least once a month
- No diuretic use
- INR > 1.7, <2.5
Exclusion Criteria:
- Inability to obtain informed consent
- Age less than 18
- Hepatic Encephalopathy Grade > 1 as defined by the presence of an impaired mental status or the presence of asterixis
- Septic shock
- Active infection
- Respiratory failure
- Heart failure with reduced ejection fraction of ≤ 50%
- Moderate or severe pulmonary hypertension
- History of stroke
- Unstable coronary artery disease
- Chronic kidney disease (GFR <60)
- GI bleed within 2 weeks
- Any licorice within 2 weeks of starting the study
- Any Beta Blocker use within the last 2 weeks
- Any diuretic use within 2 weeks
- Absence of paracentesis within 2 weeks
- Absence of volume expanders within 2 weeks
- INR > 1.7
- Pregnancy - pregnancy test will be administered for all female patients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Large Volume Paracentesis (LVP) with Fresh Frozen Plasma (FFP)
All participants who are scheduled for a LVP and meet the eligibility criteria will be monitored for 3 consecutive periods.
At the second drainage participants will receive 2 units, or about 500 ccs, of fresh frozen plasma intravenously, plus 1 bottle, or 50 ccs, of 25% albumin if more than 4 liters of fluid are removed
|
FFP will be used as a substitute for albumin during the 2nd of 3 total paracentesis being monitored
All participants who have this procedure, meet eligibility criteria and who consent
|
Active Comparator: Large Volume Paracentesis (LVP) with Albumin
All participants who are scheduled for a LVP and meet the eligibility criteria will be monitored for 3 consecutive periods.
At the first and third drainage participants will receive 1 bottle, or 50 ccs, of 25% albumin intravenously for every two liters of fluid removed
|
All participants who have this procedure, meet eligibility criteria and who consent
Albumin will be used during the 1st and 3rd paracentesis
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in plasma renin activity (PRA) post paracentesis
Time Frame: 6 Days
|
Efficacy of LVP with FFP will be measured as the change of plasma renin activity (PRA) from Day 1 to Day 6 during the 2nd LVP with FFP.
We hypothesize that FFP will reduce the PRA by 25% from Day 1 to Day 6.
|
6 Days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Occurrence of post-paracentesis circulatory dysfunction (PPCD)
Time Frame: 6 days
|
We hypothesize that the PPCD incidence will reduce in the 2nd LVP with FFP in comparison to the 1st LVP with albumin.
|
6 days
|
Safety: Adverse Events (AE)
Time Frame: 6 days
|
We hypothesize that the overall adverse events (including PPCD incidence) will be reduced in the 2nd LVP with FFP in comparison to the 1st LVP with albumin.
AE's will be summarized by presenting the number and percentages of patients having any AE.
|
6 days
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2019-10354
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
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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