- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04774705
Effectiveness of Non-invasive Vagus Nerve Stimulation as an Adjuvant Treatment in Patients With Sepsis in Intensive Care. (SNV-Sepsis)
June 23, 2021 updated by: Assistance Publique - Hôpitaux de Paris
Randomized Pilot Study Evaluating the Effectiveness of Non-invasive Vagus Nerve Stimulation as an Adjuvant Treatment in Patients With Sepsis in Intensive Care.
Sepsis is one of the leading causes of death in intensive care.
About 50% of patients with septic shock die after 1 year; and 50% of survivors suffer from cognitive decline.
The pathophysiological mechanisms of serious complications of sepsis are now well known.
In fact, the systemic inflammation related to sepsis amplifies the release of pro-inflammatory cytokines and neurotoxic mediators, hence an increase in deleterious phenomena such as oxidative stress, mitochondrial dysfunction, endothelial activation, disruption of the blood-brain barrier, neuroinflammation (astrocytic and microglial activation) leading to multi-organ failure which compromises the patient's vital and functional prognosis.
Although there has been progress in the understanding of its pathophysiology, the management of sepsis and septic shock in intensive care relies mainly on anti-infective treatments and the restoration of cardiovascular and respiratory functions.
There is virtually no adjuvant therapy for the management of sepsis, apart from a few hormonal therapies such as insulin to maintain blood glucose levels below 180 mg / dL and low doses of corticosteroids and vasopressin.
There is therefore a pressing need to develop innovative treatments targeting inflammatory and immunological processes in order to reduce the complications of sepsis and improve patient prognosis.
Some recent work has shown that electrical vagus nerve stimulation (SNV), a technique used for the treatment of drug-resistant epilepsy, can modulate inflammatory and immune responses and control inflammation syndrome in animal models of sepsis, arthritis and rheumatism in humans.
In this pilot study the investigators plan to evaluate the efficacy of transcutaneous (non-invasive) SNV as an adjuvant treatment in patients with sepsis in intensive care.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
30
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 Contact
- Name: Eric AZABOU
- Phone Number: +331 47 10 79 40
- Email: eric.azabou@aphp.fr
Study Locations
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-
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Garches, France
- Recruiting
- Raymond Poincaré Hospital
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Contact:
- Eric AZABOU
- Phone Number: +331 47 10 79 40
-
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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:
- Age> 18 years old
- Adult man or woman, hospitalized in intensive care, presenting with sepsis for at least 24 hours according to the diagnostic criteria (Singer et al., 2016).
Exclusion Criteria:
- Patient under guardianship,
- Patient in a severe state of agitation.
- Patient in a state of brain death or active limitation of treatment.
- Multiple trauma patient, with multiple fractures of the skull.
- Refusal to participate in the study or to sign the informed consent by the patient or his loved one,
- Pregnant or breastfeeding woman,
- No affiliation to a social security scheme.
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: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SNV activ group (Non-invasive transcutaneous stimulation of the vagus nerve )
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A transcutaneous stimulator of the atrial branch of the vagus nerve of the TENS eco Plus type (Schwa-medico) will be used.
SNV stimulation will be applied in the concha of the left ear to the subcutaneous area of the atrial branch of the vagus nerve in the left ear (cymba conchae) for each patient, at an intensity of 2 mA, 30 minutes per day for 5 consecutive days, from the day of inclusion / randomization.
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Placebo Comparator: Control group
For the SNV placebo group, the stimulation electrode will be inverted so as to deliver the stimulation to the ear lobule.
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For the control group, the stimulation electrode will be inverted so as to deliver the stimulation to the ear lobule.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality
Time Frame: at day 90
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Overall death
|
at day 90
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cumulative incidence of delirium and its duration
Time Frame: up to day 90
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up to day 90
|
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Cumulative incidence of mechanical ventilation and its duration
Time Frame: up to day 90
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up to day 90
|
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Proportion of patients having been the subject of a decision to limit or withdraw care
Time Frame: at day 90
|
at day 90
|
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Duration of use of vasopressors
Time Frame: at day 90
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at day 90
|
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Number of days alive with a SOFA score <6
Time Frame: at day 90
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at day 90
|
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Length of stay in intensive care and hospitalization in all patients and in survivors
Time Frame: at day 90
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at day 90
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at inclusion
|
at inclusion
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at day 7
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at day 7
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at day 14
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at day 14
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at day 21
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at day 21
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at day 28
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at day 28
|
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Measurements of changes in C-reactive protein (CRP)
Time Frame: at day 90
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at day 90
|
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Measurements of changes in fibrinogen level
Time Frame: at inclusion
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at inclusion
|
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Measurements of changes in fibrinogen level
Time Frame: at day 7
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at day 7
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Measurements of changes in fibrinogen level
Time Frame: at day 14
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at day 14
|
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Measurements of changes in fibrinogen level
Time Frame: at day 21
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at day 21
|
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Measurements of changes in fibrinogen level
Time Frame: at day 28
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at day 28
|
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Measurements of changes in fibrinogen level
Time Frame: at day 90
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at day 90
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at inclusion
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at inclusion
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at day 7
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at day 7
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at day 14
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at day 14
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at day 21
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at day 21
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at day 28
|
at day 28
|
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Measurements of changes in interleukin-6 (IL-6)
Time Frame: at day 90
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at day 90
|
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Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at inclusion
|
at inclusion
|
|
Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at day 7
|
at day 7
|
|
Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at day 14
|
at day 14
|
|
Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at day 21
|
at day 21
|
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Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at day 28
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at day 28
|
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Measurements of changes in interleukin-1β (IL-1β)
Time Frame: at day 90
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at day 90
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at inclusion
|
at inclusion
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at day 7
|
at day 7
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at day 14
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at day 14
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at day 21
|
at day 21
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at day 28
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at day 28
|
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Measurements of changes in tumor necrosis factor α (TNF-α)
Time Frame: at day 90
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at day 90
|
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Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at inclusion
|
at inclusion
|
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Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at day 7
|
at day 7
|
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Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at day 14
|
at day 14
|
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Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at day 21
|
at day 21
|
|
Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at day 28
|
at day 28
|
|
Measurements of changes in the calcium binding protein B S100B (S100B)
Time Frame: at day 90
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at day 90
|
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Measurements of changes in the arterial lactate level
Time Frame: at inclusion
|
at inclusion
|
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Measurements of changes in the arterial lactate level
Time Frame: at day 7
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at day 7
|
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Measurements of changes in the arterial lactate level
Time Frame: at day 14
|
at day 14
|
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Measurements of changes in the arterial lactate level
Time Frame: at day 21
|
at day 21
|
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Measurements of changes in the arterial lactate level
Time Frame: at day 28
|
at day 28
|
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Measurements of changes in the arterial lactate level
Time Frame: at day 90
|
at day 90
|
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Characteristics of the EEG
Time Frame: at inclusion
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at inclusion
|
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Characteristics of the EEG
Time Frame: at day 7
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at day 7
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Mortality rate
Time Frame: at day 28
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Overall death
|
at day 28
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Neurological fate of patients
Time Frame: at day 90
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Neurological fate of patients will evaluated using Glasgow Outcome Scale - GOS
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at day 90
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
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 (Actual)
March 29, 2021
Primary Completion (Anticipated)
March 29, 2023
Study Completion (Anticipated)
March 29, 2023
Study Registration Dates
First Submitted
February 24, 2021
First Submitted That Met QC Criteria
February 24, 2021
First Posted (Actual)
March 1, 2021
Study Record Updates
Last Update Posted (Actual)
June 24, 2021
Last Update Submitted That Met QC Criteria
June 23, 2021
Last Verified
June 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- D20170804
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Undecided
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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