- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06503289
Myoglobin Removal With CytoSorb in Rhabdomyolysis
Effects of The Removal of Myoglobin With CytoSorb on The Endothelium and Glycocalyx Shedding Biomarkers in Patients With Rhabdomyolysis
The aim of this observational study is to assess whether myoglobin removal with CytoSorb® ameliorates endothelial damage in severe rhabdomyolysis patients who are admitted to the intensive care unit. The primary objective of the study is:
- Does myoglobin removal with CytoSorb® reduces glycocalyx degradation markers?
Patients with severe rhabdomyolysis will receive the intervention and blood samples will be obtained in regular intervals.
Study Overview
Status
Intervention / Treatment
Detailed Description
Rhabdomyolysis is characterized by destruction of muscle by various causes and is diagnosed by increased creatine kinase concentrations in the blood. Myoglobin released into the blood may cause acute kidney injury in up to half of these patients. The mortality caused by severe rhabdomyolysis is also high (32%). Extracorporeal modalities, such as CytoSorb (CS) can effectively eliminate the myoglobin from the bloodstream.
In addition to ischemic and inflammatory damage, myoglobin also causes direct endothelial cell injury. Degradation of the endothelial glycocalyx layer can be assessed by several biomarkers such as Syndecan-1, Heparan sulfate, cadherin
However, it is not fully known whether myoglobin elimination improves the outcomes or it is irrelevant of the outcome.
The investigator hypothesized that myoglobin elimination with CS alleviates the damage inflicted upon the endothelium and may have a role in improving patient outcomes in severe rhabdomyolysis.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Istanbul, Turkey, 34371
- Sisli etfal research and training hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with Creatine Kinase > 5000 IU/L.
- Myoglobin results can be obtained only after 5 working days after sampling in our center, therefore it cannot be used as an inclusion criteria.
- GFR below 40 ml/min.
Exclusion Criteria:
- High dose vasopressor requirement
- Not expected to survive > 24 h
- Lack of consent to participate
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
cytosorb therapy
18 years older patients who need cytsorb therapy due to rhabdomyolysis
|
Extracorporeal treatment with cytosorb filter to patients diagnosed with rhabdomyolysis
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Syndecan-1
Time Frame: 12 hour
|
Reduction in Syndecan-1 with CS therapy
|
12 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
glycocalyx markers
Time Frame: 12 hour
|
Sustained reduction in other glycocalyx markers after CS therapy
|
12 hour
|
|
myoglobin
Time Frame: 12 hours
|
Reduction in myoglobin levels with CS therapy
|
12 hours
|
Collaborators and Investigators
Investigators
- Study Director: mustafa altınay, şişli etfal eğitim araştırma hastanesi
Publications and helpful links
General Publications
- Hahn RG, Patel V, Dull RO. Human glycocalyx shedding: Systematic review and critical appraisal. Acta Anaesthesiol Scand. 2021 May;65(5):590-606. doi: 10.1111/aas.13797. Epub 2021 Mar 7.
- Albrecht F, Schunk S, Fuchs M, Volk T, Geisel J, Fliser D, Meiser A. Rapid and Effective Elimination of Myoglobin with CytoSorb(R) Hemoadsorber in Patients with Severe Rhabdomyolysis. Blood Purif. 2024;53(2):88-95. doi: 10.1159/000534479. Epub 2023 Nov 2.
- D'Agnillo F, Alayash AI. A role for the myoglobin redox cycle in the induction of endothelial cell apoptosis. Free Radic Biol Med. 2002 Oct 15;33(8):1153-64. doi: 10.1016/s0891-5849(02)01007-9.
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
- 2346
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
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