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CompletedNCT03454867HAISMUpdated Mar 6, 2018

Hemofiltration in Acute Ischemic Stroke

An interventional study of Hemofiltration and Standard acute ischemic stroke treatment in Acute Ischemic Stroke, sponsored by University Medical Center, Kazakhstan. Completed. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2018-03-06.

Sponsored by University Medical Center, Kazakhstan · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
37
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Ischemic stroke is accompanied by a three to four hundred percent increase in the brain's extracellular fluid (ECF) and cerebrospinal fluid (CSF) concentration of glutamate, which diffuses and damages surrounding neurons. In this study we tested our hypothesis that blood glutamate levels can be reduced by hemofiltration, resulting in increased extracellular clearance of glutamate and attenuated neurodegeneration, and that decreased blood glutamate levels can provide significant neuroprotection against stroke-associated neurodegeneration, dysfunction and death. Our primary outcome of interest was to assess safety of hemofiltration in acute ischemic stroke patients.

Read the detailed description

Ethical Conduct of the Study

Investigator Responsibilities

The principle investigator was responsible for monitoring and responding to adverse events, ethical participant use, compliance with the protocols and any protocol amendments, decisions to end the study early and compliance with data and sample management protocols. CO-PI was trained in both local and international requirements and standards and assisted and report to the PI on these tasks.

Participant Selection and Enrollment

Eligible participants were identified by medical staff at the ICU or emergency department. Enrollment will be standardized and directed by Co-PI.

Screening for Eligibility

A screening log was completed for all eligible patients. Data including inclusion criteria met, exclusion criteria not met and date consent obtained was collected on this form. It was kept in a locked cabinet at the center.

Informed Consent

The informed consent form was available in both Russian and Kazakh languages and was approved by the Institutional Research Ethics Committee (IREC) before use.

Monitoring for safety (hemofiltration-related adverse events (HRAE). All adverse events which occurred during the course of HF including the serious adverse events (SAE) were documented and analyzed. The attending physicians as well as the chief of neurocritical care unit and the principal investigator were responsible for screening for HRAE. In case if any of HRAE occurred all research team members as well as the chief of ICU and the medical director of the hospital were informed. All HRAEs were analyzed by the research team members and the medical director of the hospital. The patients were screened for the following adverse events: hypotension, hypertension, cardiac dysrhythmia, hypothermia or hyperthermia, disorders of water-electrolyte and acid-base balance, bleeding disorders, hemorrhagic transformation of acute ischemic stroke.

02

Conditions studied

03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. 18 to 75 year-old; both males and females;
  2. Diagnosis of acute ischemic stroke verified by CT or MRI and moderate to severe disability (NIHSS 5-21 points, GCS > 4 points and \< 12);
  3. Able to start hemofiltration treatment within 12 hours of stroke onset.;
  4. Signed written informed consent in either Kazakh or Russian.

Exclusion criteria

Exclusion Criteria:

  1. Age below 18 years or above 75 years;
  2. Presentation over 12 hours from stroke onset;
  3. Decompensated coronary heart disease (unstable angina, acute myocardial infarction, heart failure - according to New York or Canadian classification, 3, blood disorders, known coagulopathy, platelet count less than75 000 / mmc;
  4. Pulmonary edema, shock, hemodynamic instability;
  5. Intracranial hemorrhage or lesions (brain abscess, tumors);
  6. Inability to obtain informed consent;
  7. Pregnancy;
  8. Contraindications for CT.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
37 participants (actual)

Study arms

  • Experimental
    Hemofiltration (treatment)

    Standard acute ischemic stroke treatment + hemofiltration Standard treatment included thrombolytic therapy for eligible candidates (tPA 0,9 mg/kg, max dose 90 mg)

    Device: Hemofiltration · Procedure: Standard acute ischemic stroke treatment

  • Active comparator
    Control

    Standard acute ischemic stroke treatment Standard treatment included thrombolytic therapy for eligible candidates (tPA 0,9 mg/kg, max dose 90 mg)

    Procedure: Standard acute ischemic stroke treatment

Interventions

  • DeviceHemofiltration
  • ProcedureStandard acute ischemic stroke treatment
05

What researchers measure

Primary outcomes

  1. Safety monitoring for adverse events

    The patients were screened continuously for the following adverse events: death, bleeding disorders, hemorrhagic transformation of acute ischemic stroke, central line-related blood stream infection, cardiac dysrhythmia within 28 days

    Time frame: 28 days

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: No — We will work on method of data sharing

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03454867
Lead sponsor
University Medical Center, Kazakhstan
Responsible party
Dmitriy Viderman (Attending anesthesiologist & intensivist, University Medical Center, Kazakhstan) — Principal investigator
First posted
Mar 6, 2018
Start date
Jun 1, 2014
Primary completion
Jan 31, 2015
Completion
Jan 31, 2015
Last update
Mar 6, 2018

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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