- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05081375
Pre-operative Enoxaparin in the Surgical Management of Multi-trauma Patients Undergoing Orthopedic Surgical Procedures
A Blinded, Controlled, Randomized Study of the Safety of Pre-operative Enoxaparin in the Surgical Management of Multi-trauma Patients Undergoing Orthopedic Surgical Procedures
Study Overview
Status
Intervention / Treatment
Detailed Description
This study will be conducted in an Intensive Care Unit (ICU) and Operating Room (OR) of Valleywise Health Medical Center. The study population will include adult subjects age ≥ 18 years of age, that require surgery for management of their traumatic long bone and/or pelvic fractures.
A total of 60 evaluable subjects will be enrolled in this pilot safety study, with a 1:1 randomization into each group. It is anticipated that approximately 70 patients will need to be consented to reach 60 evaluable subjects.
Subjects recruited for study participation must meet all study enrollment criteria prior to being enrolled in the study. Patients who meet inclusion / exclusion criteria will be invited to participate in the study. As feasible, the patient or his/her representative will be approached for enrollment in the study and asked to provide informed consent for participation.
Written informed consent will be obtained for all subjects by an investigator or delegate prior to enrollment in the study. All subjects meeting inclusion/exclusion criteria will be randomized to either enoxaparin or placebo.
Patients will be monitored for bleeding complications from the time of test article administration to 24 hours post-surgery. Subjects will be monitored for the development of DVT and/or PE through-out their hospitalization.
Subjects will be randomized to either 30 mg enoxaparin Sub Cutaneous (SQ) of 0.9% Sodium Chloride (NaCl) placebo SQ. Randomization will be 1:1, using a masked randomization list. Study personnel and the treatment team will be blinded to the randomization assignment. The Clinical Research Manager and pharmacy staff will be un-blinded and will not participate in study assessments.
The two groups will be treated as follows:
Treatment Group:
Enoxaparin 30mg/0.3ml SQ will be given within 12 hours prior to surgery. If surgery should be delayed longer than 12 hours following the initial dose a second dose will be given to ensure uninterrupted dosing.
If the patient is already on Lovenox 12 hours prior to surgery, no doses will be skipped.
Placebo Group Normal Saline (0.9%) 0.3 ml SQ will be given within 12 hours prior to surgery If surgery should be delayed longer than 12 hours following the initial dose a second dose of normal saline will be given to ensure the appearance of uninterrupted dosing in order to maintain the blind.
If the patient is already being given Enoxaparin 12 hours prior to surgery, the dose 12 hours prior to surgery will be substituted with normal saline.
Both groups
Will receive routine administration of Enoxaparin 12 hours following surgery
Will be monitored at 12 hours and 24 hours post procedure for any evidence of deep vein thrombosis (DVT) or pulmonary embolism (PE) formation.
Will be monitored during surgery, at 12 hrs and 24 hrs post-operatively for any bleeding events. A bleeding event is present if one or more of the following are present:
A drop of 3mg/dl or more in hemoglobin, Transfusion of blood product, Intervention/surgery for bleeding (hematoma, hemorrhage)
The following information will be collected and recorded:
Demographics: name, age, race, ethnicity, height, weight, physical exam
- Medical history
- Acute trauma history
- Surgical data: procedure, length of surgery, estimated blood loss
- Lab results
- Imaging results
- Bleeding complications
- DVT and PE events
- Outcome data (length of stay, ICU days, vent days, complications, disposition, etc.)
- Unanticipated problems
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Arizona
-
Phoenix, Arizona, United States, 85008
- Valleywise Health
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age > 18 years
- Traumatic injury of long bones or pelvis requiring surgical intervention
- Admission to the ICU
Exclusion Criteria:
- Age < 18 years
- Intracranial hemorrhage
- Direct admit to OR without prior ICU admission
- Pregnancy
- Prisoner
- Chronic Kidney Disease requiring dialysis or a glomerular filtration rate (GFR) or creatinine clearance requiring a decrease in Enoxaparin dosage
- Presence of DVT prior to study drug dose
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Enoxaparin
Enoxaparin dose will not be held for surgical procedure.
|
Not holding prophylaxis dose prior to surgical procedure
Other Names:
|
Placebo Comparator: Placebo dose given and Enoxaparin dose held
Enoxaparin dose will be held and replaced by placebo and not given prior to surgical procedure.
|
Holding prophylaxis dose of Enoxaparin replacing with placebo
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluate Bleeding Complications Related to DVT chemoprophylaxis
Time Frame: From the time of study drug administration to 24 hours post-operation
|
Evaluate the rate of bleeding complications related to DVT chemoprophylaxis after administering DVT chemoprophylaxis vs holding doses within 12 hours of surgery in patients with long bones and/or pelvic fractures requiring surgical intervention.
|
From the time of study drug administration to 24 hours post-operation
|
Evaluate Other Complications (besides bleeding) Related to DVT chemoprophylaxis
Time Frame: From the time of study drug administration to 24 hours post-operation
|
Evaluate the rate of other complications (besides bleeding) Related to DVT chemoprophylaxis after administering DVT chemoprophylaxis vs holding doses within 12 hours of surgery in patients with long bones and/or pelvic fractures requiring surgical intervention.
|
From the time of study drug administration to 24 hours post-operation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of DVT and PE
Time Frame: From the time of study drug administration to hospital discharge up to 3 months
|
Recording any incidence of deep vein thrombosis or pulmonary embolism
|
From the time of study drug administration to hospital discharge up to 3 months
|
study duration
Time Frame: From Institutional Review Board approval to date of last subject completion up to 2 years
|
Record the time required to complete study enrollment goals
|
From Institutional Review Board approval to date of last subject completion up to 2 years
|
Assess feasibility of a larger trial with respect to study design
Time Frame: Duration of the study up to 2 years
|
Assess a superiority study design using the rates of development of DVT/PE.
|
Duration of the study up to 2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Thomas Wertin, MD, FACS, Valleywise Health
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- 2019-071
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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