- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05613218
Oxygen Targets in Acute Heart Failure With Pulmonary Congestion (REDOX-AHF)
Restrictive Versus Liberal Oxygenation Targets in Patients With Acute Heart Failure and Pulmonary Congestion - a Randomized Clinical Pilot-trial
This investigator-initiated, prospective, randomized, blinded, multi-center, controlled trial will investigate the effect of a restrictive vs. liberal oxygenation-strategy in patients hospitalized with acute heart failure with pulmonary congestion.
Patients will be randomized 1:1 in the emergency department to either liberal or restrictive oxygenation after providing informed written consent.
- Liberal oxygenation group = SpO2 target of 96%.
- Restrictive oxygenation group = SpO2 target of 90%.
The allocation will be concealed through the use of an oxygen-delivery robot, termed O2MATIC. The study will include 122 patients.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
One million hospitalizations occur each year with a primary diagnosis of acute heart failure in the USA, with comparable numbers in Europe. Most patients with acute heart failure are treated with supplemental oxygen during hospitalization and guidelines recommend initiation of oxygen therapy if SpO2 <90% (class I, level C). However, no clinical trials of oxygen targets in humans with acute heart failure investigating clinically relevant endpoints have been performed.
Primary objective:
To investigate the effect of a restrictive vs. liberal oxygenation-strategy in patients hospitalized with acute heart failure.
Hypothesis:
Restrictive oxygenation is associated with improved clinical outcome compared to liberal oxygenation.
Design: Investigator-initiated, prospective, randomized, blinded, multi-center, controlled trial.
Intervention:
Patients will be randomized 1:1 in the emergency department to either liberal or restrictive oxygenation after providing informed written consent.
- Liberal oxygenation group = SpO2 target of 96%.
- Restrictive oxygenation group = SpO2 target of 90%.
Patients will have nasal cannula or oxygen mask placed as the usual care, and oxygen is titrated to the prespecified target range.
Consented patients will be randomly allocated to study groups via the automated web-based system within REDCap. The allocation will be concealed. Time at randomization will be considered as study time zero (T0). All patients will receive usual standard of care except for their oxygen-administration.
The intervention-phase will be 24 h, and hereafter oxygen therapy will be at the discretion of the treating physician.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
- Name: Johannes Grand, MD, Phd
- Phone Number: +4535453545
- Email: johannes.grand@regionh.dk
Study Contact Backup
- Name: Ida Taraldsen, MD
Study Locations
-
-
-
Copenhagen, Denmark, 2200
- Not yet recruiting
- Bispebjerg Hospital
-
Contact:
- Olav W Nielsen, MD, DMSc
-
Principal Investigator:
- Olav W Nielsen, MD DMSc
-
Copenhagen, Denmark, 2650
- Recruiting
- Amager-Hvidovre Hospital
-
Contact:
- Johannes Grand
- Email: johannes.grand@regionh.dk
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years
- Acute (within minutes to days) onset or worsening of subjective dyspnea
- Oxygen saturation <92% (on arterial blood gas) or need of oxygen
- At least one of the following clinical or radiological signs of congestion:
1. Pulmonary rales 2. Chest X-ray or CT with pulmonary congestion 3. Lung ultrasound with multiple B-lines
Exclusion Criteria:
- More than 4 hours from hospital admission to randomization
- Suspected infection or sepsis
- Known severe pulmonary disease
- Systolic blood pressure <90 mmHg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Liberal oxygenation group
SpO2 target of 96%
|
Patients will have nasal cannula or oxygen mask placed as the usual standard of care. Patients will be screened and randomized in the emergency department to either liberal or restrictive oxygenation after providing informed written consent and oxygen is titrated to the prespecified target range using an automated feedback device (O2MATIC). Consented patients will be randomly allocated to study groups via the web-based system within REDCap. The allocation will be concealed. Time at randomization will be considered as study time zero (T0). All patients will receive usual standard of care except for their O2 management. The intervention will last for 24 h. After 24 h, patients will be switched over to usual care for oxygen therapy. If the treating physician thinks, that the patient need another oxygenation target and it is thought to be harmful to continue with the allocated target, the intervention-phase can be stopped prematurely. |
Active Comparator: Restrictive oxygenation group
SpO2 target of 90%.
|
Patients will have nasal cannula or oxygen mask placed as the usual standard of care. Patients will be screened and randomized in the emergency department to either liberal or restrictive oxygenation after providing informed written consent and oxygen is titrated to the prespecified target range using an automated feedback device (O2MATIC). Consented patients will be randomly allocated to study groups via the web-based system within REDCap. The allocation will be concealed. Time at randomization will be considered as study time zero (T0). All patients will receive usual standard of care except for their O2 management. The intervention will last for 24 h. After 24 h, patients will be switched over to usual care for oxygen therapy. If the treating physician thinks, that the patient need another oxygenation target and it is thought to be harmful to continue with the allocated target, the intervention-phase can be stopped prematurely. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pulmonary parenchymal fluid content after 24 hours
Time Frame: 24 hours
|
Pulmonary parenchymal fluid content after 24 hours preceded by 10 minutes without oxygen-supplementation assessed noninvasively by the remote dielectric sensing (ReDS) device (Sensible Medical, Netanya, Israel)
|
24 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
All-cause mortality
Time Frame: 30 days
|
Death from all causes
|
30 days
|
Days alive out-of-hospital
Time Frame: 30 days
|
30 days
|
|
Time to freedom from oxygen-supplementation
Time Frame: 48 hours
|
48 hours
|
|
4) Change from baseline in log-transformed biomarkers N-Terminal Pro-Brain Natriuretic Peptide to 24 hours from admission.
Time Frame: 24 hours
|
24 hours
|
|
5) Arterial blood gas concentration after 24 hours preceded by 10 minutes without oxygen-supplementation.
Time Frame: 24 hours
|
24 hours
|
|
Tricuspid annular plane systolic excursion
Time Frame: 24 hours
|
24 hours
|
|
Global longitudinal strain of the right ventricle
Time Frame: 24 hours
|
24 hours
|
Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Jens Hove, MD, PhD, Copenhagen University Hospital Amager-Hvidovre Department of Cardiology
- Principal Investigator: Johannes Grand, MD, PhD, Copenhagen University Hospital Amager-Hvidovre Department of Cardiology
- Study Director: Ida Taraldsen, MD, Copenhagen University Hospital Amager-Hvidovre Department of Cardiology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- REDOX
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
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.
Clinical Trials on Hypoxemia
-
University of CincinnatiUnited States Air ForceCompletedHypoxemia | Hypobaric HypoxemiaUnited States
-
Inogen Inc.CompletedNocturnal HypoxemiaUnited States
-
Seoul National University HospitalCompleted
-
Gepner YftachEnrolling by invitationExercise-induced Arterial HypoxemiaIsrael
-
Beth Israel Deaconess Medical CenterWellcomeRecruitingAcute HypoxemiaKenya, Malawi, Rwanda
-
University of CincinnatiNot yet recruiting
-
University Hospital, Clermont-FerrandCompletedPostoperative HypoxemiaFrance
-
Sichuan Provincial People's HospitalCompleted
-
Indiana UniversityTerminatedExercise-induced Arterial HypoxemiaUnited States
-
Bezmialem Vakif UniversitySuspendedHypoxia | Hypoxemia During SurgeryTurkey
Clinical Trials on Oxygen
-
National Baromedical ServicesMayo Clinic; Dartmouth-Hitchcock Medical Center; Eastern Virginia Medical School and other collaboratorsCompletedCarcinoma, Squamous Cell | Cancer of the Head and NeckUnited States
-
Aalborg University HospitalRigshospitalet, Denmark; Copenhagen Trial Unit, Center for Clinical Intervention...Active, not recruitingHypoxemic Respiratory Failure | Oxygen ToxicityNorway, Switzerland, Denmark
-
Aalborg University HospitalUniversity of AarhusUnknownCardiac Surgery | Cardiopulmonary Bypass | Acute Lung Injury | Hyperoxia | Oxygen ToxicityDenmark
-
Chang, Steve S., M.D.Santa Barbara Cottage HospitalCompletedPostoperative AbscessUnited States
-
Princess Margaret Hospital for ChildrenCompleted
-
Royal Brompton & Harefield NHS Foundation TrustLiverpool University Hospitals NHS Foundation Trust; National Institute for...CompletedLung; Disease, Fibroid (Chronic)United Kingdom
-
UMC UtrechtThe Netherlands Cancer InstituteCompletedBreast Cancer | Radiation ToxicityNetherlands
-
Heidelberg UniversityRecruitingPulmonary Arterial Hypertension | Oxygen Deficiency | CTEPHGermany
-
Aalborg University HospitalRigshospitalet, Denmark; Copenhagen Trial Unit, Center for Clinical Intervention...CompletedHypoxemic Respiratory Failure | Oxygen ToxicityUnited Kingdom, Denmark, Finland, Iceland, Netherlands, Norway, Switzerland
-
University Hospital Plymouth NHS TrustCompletedSepsisUnited Kingdom