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Hemadsorption for at forbedre eliminering af medikamenter i beruselse (MATRIX)

18. september 2026 opdateret af: Universitair Ziekenhuis Brussel

In this trial the investigators assess the effectiveness of applying a hemadsorber (cytosorb®) in removing benzodiazepines or tricyclic antidepressants in intoxicated patients admitted to ICU with prolonged impaired consciousness. This is a one arm interventional investigation where a hemadsorption filter is applied in patients fulfilling inclusion criteria 8 hours after admission. Plasma titer of the neurodepressing drug will be collected sequentially both before and after start of hemadsorption to evaluate the speed of drug elimination before and after application of a hemadsorption filter. Pre- and post filter titers will be obtained to evaluate adsorbability and to evaluate time to saturation of the filter.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

In this prospective interventional study with medical device, the investigotors would include 18 patients admitted to ICU after an intoxication with a quantifiable neurodepressing drugs (type benzodiazepines or tricyclic antidepressants) and with impaired consciousness defined as need for intubation or need for Flumazenil to prevent intubation. Naloxone is administered per standard of care to identify if opioid intoxications is the main reason of neurodepression. Patients requiring mechanical ventilation for other reasons than impaired consciousness due to this intoxication or indication for prolonged use of sedatives are excluded.

Patients with at least one risk factor for delayed drug elimination (Chronic kidney disease G3b or CHILD-Pugh B or C) and persisting impaired consciousness after eight hours (including patients with persisting need for flumazenil) and having 5 plasma titers of the neurodepressing drug with intervals of 2 hours will be initiated on a hemadsorption filter after contact between the treating team and either dr. Michaël Mekeirele or dr. Tim Balthazar to verify inclusion criteria. Patients fulfilling inclusion criteria but lacking the 5 plasma titers will get additional plasma titers with intervals of 2 hours until 5 plasma titers are obtained. If these patients still fulfill inclusion criteria at that time then a hemadosorption filter will be initiated.

After starting hemadsorption a plasma titer pre- and post filter will be obtained after 15 minutes and every 4 hours after starting hemadsorption for the first 24 hours. After this timepoint additional plasma titers will be obtained every 24 hours until stopping hemadsorption or normalisation of the plasma titer.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

18

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • Brussels Capital
      • Brussels, Brussels Capital, Belgien, 1090
        • Rekruttering
        • Universitair Ziekenhuis Brussel
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Michaël Mekeirele, Medical Doctor

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. older than18 years
  2. Admission to ICU
  3. GCS < 8 or requiring Flumazenil 8 hours after hospital admission
  4. Having an intoxication with a benzodiazepine or tricyclic antidepressant that we can measure/quantify
  5. Having a risk factor for delayed drug elimination defined as either Cirrhosis CHILD B/C or chronic kidney insufficiency KDIGO 3b or worse

Exclusion Criteria:

  1. Pregnant patient
  2. Patients in chronic dialysis before admission
  3. Need for mechanical ventilation for other reasons than intoxications (e.g. pneumonia, neurotrauma)
  4. Concomitant pathology requiring continued intravenous sedation
  5. Known history of seizures
  6. Contra-indication to heparin use
  7. DNR restricting the use of mechanical ventilation or dialysis

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Hemadsorption

Hemadsorption via a dialysis catheter will be performed in patients who are unconscious due to an intoxication with quantifiable benzodiazepines or tricyclic antidepressants 8 hours after admission. Before and after application fo this hemadsorption filter plasma titers of this drug will be obtained. After application of the hemadsorption filter pre- and post-filter titers will be obtained.

Plasma titers neurodepressing drug:

  • At admission to the hospital (standard of care)
  • 2 hours after admission (+/- 15 minutes)
  • 4 hours after admission (+/- 15 minutes)
  • 6 hours after admission (+/- 15 minutes)
  • 8 hours after admission (+/- 15 minutes)
  • Just before start hemadsorption

Hemadsorption via dialysis catheter in patients still fulfilling inclusion criteria 8 hours after admission.

Subsequent plasma titers pre- and post-hemadosorption filter:

  • 15 minutes after start of hemadsorption (+ 15 minutes)
  • 4 hours after start of hemadsorption (+/- 15 minutes)
  • 8 hours after start of hemadsorption (+/- 15 minutes)
  • 12 hours after start of hemadsorption (+/- 15 minutes)
  • 16 hours after start of hemadsorption (+/- 15 minutes)
  • 20 hours after start of hemadsorption (+/- 15 minutes)
  • 24 hours after start of hemadsorption (+/- 15 minutes)
  • Every other 24 hours until cessation of hemadsorption or normalization of the plasma titer (+/- 15 minutes)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Difference in time to upper limit of normal of the dosed drug with versus without hemadsorption
Tidsramme: From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Based on plasma titers before start of hemadsorption the half life of the drug can be calculated. A theoretical intersection with the upper boundary of normal of the intoxicated drug plasma titer can be calculated. This will be statistically compared to the real time of attaining this titer after start of hemadsorption.

From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Adsorbability of the individual neurodepressing drugs
Tidsramme: From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Comparing the pre- and post filter titer of the neurodepressing drug the adsorbability can be observed.

From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days
Time to saturation of hemadsorption filter
Tidsramme: From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Comparing the pre- and post filter titer of the neurodepressing drug the time to saturation can be observed

From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days
Catheter related complications
Tidsramme: From enrollment to the removal of the dialysis catheter +/- 3 days

Catheter related complications (eg bleeding, infection) will be noted

From enrollment to the removal of the dialysis catheter +/- 3 days
Seizures during hemadsorption therapy
Tidsramme: From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Seizures during hemadsorption therapy will be noted

From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days
Bleeding during hemadsorption therapy
Tidsramme: From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days

Bleeding during hemadsorption therapy will be noted

From enrollment to the end of treatment (cesation hemadsorption) +/- 3 days
Cost effectiveness of applying a Cytosorb® hemadsorption filter
Tidsramme: From enrollment to discharge from ICU (+/- 1 week)

Duration of ICU stay, duration of ventilation, cost of a hemadsorption filter and disposables amongst others will be used for an evaluation of cost effectiveness

From enrollment to discharge from ICU (+/- 1 week)
Duration mechanical ventilation
Tidsramme: From enrollment to extubation (+/- 3 days)

Time to extubation and stop of flumazenil will be noted

From enrollment to extubation (+/- 3 days)
Duration ICU stay
Tidsramme: From enrollment to discharge from ICU (+/- 1 week)

Time to discharge will be noted

From enrollment to discharge from ICU (+/- 1 week)
Need and duration vasopressors
Tidsramme: From enrollment to stop of vasopressors (+/- 3 days)

Time untill discontinuation of vasopressors will be noted

From enrollment to stop of vasopressors (+/- 3 days)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Michaël Mekeirele, Medical Doctor, Universitair Ziekenhuis Brussel

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. maj 2025

Primær færdiggørelse (Anslået)

1. december 2028

Studieafslutning (Anslået)

1. januar 2029

Datoer for studieregistrering

Først indsendt

2. april 2025

Først indsendt, der opfyldte QC-kriterier

3. april 2025

Først opslået (Faktiske)

10. april 2025

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

23. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

18. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • CIV-24-12-050174

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Single center study

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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