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Status unknownNCT04693442SIFTI-2Updated Jan 5, 2021

Relationship Between Neutrophil Function and Sepsis in Adults and Children With Severe Thermal Injuries

An observational study in Burns, sponsored by University Hospital Birmingham NHS Foundation Trust. Status unknown at 1 site in United Kingdom. Open to participants aged 1 Year to 99 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-01-05.

Sponsored by University Hospital Birmingham NHS Foundation Trust · Observational

The sponsor has not verified this record recently (last verified Dec 2020), so the status shown — last known as Recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
245
Ages
1 Year to 99 Years
Sex
All
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Study summary

The study aims to validate neutrophil function, immature granulocyte and plasma free DNA levels as predictive diagnostic biomarkers of sepsis in burn patients. Inclusion criteria includes healthy volunteers, patients aged 5-15 years old with burns affecting 20% or less Total Body Surface Area (TBSA) and patients aged 16 or above with burns affecting >15% TBSA. The study involves taking blood, tissue and urine samples.

Read the detailed description

The initial cohort for SIFTI-2 will be generated from patients attending the Birmingham Burns Centre at Queen Elizabeth Hospital Birmingham (QEHB) and Birmingham Children's Hospital (BCH). The cohort will be comprised of patients with moderate and severe burns (injury to more than 15% of the body surface area [TBSA] in adults and 20% TBSA in children). The investigators currently treat between 30-40 patients in this category each year. In order to thoroughly characterise the longitudinal neutrophil response to burn injury and to investigate its potential relationship with outcome post-burn, the ivestigators will measure the genomic, phenotypic and functional response of peripheral blood neutrophils across time in burn-injured patients.

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Conditions studied

  • Burns

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03

In context

Sepsis

1,899 studies on the registry are indexed under Sepsis; 462 are open to participants now.

This study's planned enrollment of 245 is above the median of 160 across 931 observational studies indexed under Sepsis.

Browse Sepsis studies →

Lead sponsor

University Hospital Birmingham NHS Foundation Trust is the lead sponsor of 35 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
1 Year to 99 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Probability sample

Study population

Subjects will be admitted to any Burn Centre participating in the study. This includes but not limited to:

Queen Elizabeth Hospital Birmingham; Birmingham Children's Hospital; Mid Essex NHS Trust, Broomfield Hospital, Chelmsford

The patients will be new burns patients presented within 24 hours of thermal injury. They will be identified by the admitting doctor from the Burns Team.

Inclusion criteria

  • Patients aged 1-15 years admitted with a ≥20%TBSA
  • Patients aged 16 and over admitted with a ≥15% TBSA
  • Patients presented within 24 hours of thermal injury

Exclusion criteria

Exclusion Criteria:

  • Associated multiple injuries with Injury severity score > 25
  • Decision not to treat made on admission due to the severity of the injury
  • Patients with chemical and deep electrical burns
  • Premorbid conditions
  • Active Malignancy
  • Patients receiving glucocorticoid treatment
  • Multiple limb amputations
  • Patients with known long term infections (i.e., Hepatitis B \& C, Human Immune Deficiency [HIV])
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
245 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Burn patients

    with the condition

    Other: taking of blood, urine and blood samples and objective scar assessment

  • Control group

    without the condition (blood sampling only for adults) and children undergoing general anaesthetic procedures that involve skin resections (blood sampling and excised skin)

Interventions

  • Othertaking of blood, urine and blood samples and objective scar assessment

    blood, urine and skin tissue sampling \& scar assessment questionnaires

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What researchers measure

Primary outcomes

  1. Diagnosis of sepsis

    Sepsis will be evaluated according to the 2007 American Burn Association (ABA) diagnostic criteria for sepsis in burns. Specifically, sepsis will be diagnosed when 3 of the following criteria are met along with a positive bacterial culture or when evidence of a clinical response to antibiotics is detected: 1. Temperature (\>39°C or \<36°C) 2. progressive tachycardia (\>110 beats per minute 3. progressive tachypnea (\>25 breaths per minute not ventilated or minute ventilation \>12 L/minute ventilated) 4. thrombocytopenia (\<100,000/μl; not applied until 3 days after initial resuscitation) 5. hyperglycaemia (untreated plasma glucose \>200 mg/dl, \>7 units of insulin/hr intravenous drip, or \>25% increase in insulin requirements over 24 hours) 6. feed intolerance \>24 hours (abdominal distension, residuals two times the feeding rate, or diarrhoea \>2500 ml/day)

    Time frame: 2 years

Secondary outcomes

  1. In-hospital mortality

    Death while in-hospital

    Time frame: 2 years

  2. Predictive mortality scores

    Predictive mortality scores are measured by Revised Baux Score, Abbreviated Burn Severity Index (ABSI), and APACHE II

    Time frame: 2 years

  3. Multiple Organ Failure/dysfunction syndrome (MOF/MODS)

    The presence of altered organ function where homeostasis cannot be maintained without intervention using Denver 2 and SOFA scores. For Denver score, MOF is defined as \> 3, two (2) organ system involved for 2 consecutive days while in SOFA, MOF\> = 4 , two (2) organ system involved for first 24 hours. In the subsequent time points, only cardiac scores for SOFA and Denver 2 are recorded.

    Time frame: 2 years

  4. Thromboembolic complications

    Clinical signs and symptoms associated with thrombosis, i.e., pulmonary embolism, deep vein thrombosis. Clinical investigation to confirm thrombosis will be based on any of the following imaging procedure: CTPA, VQ Scan, USS, Venogram, D-dimer results

    Time frame: 2 years

  5. Vancouver Scar Scale (VSS)

    This scale uses a numerical assessment of four skin characteristics including: Height (range, 0-4), Pliability (range, 0-4), Vascularity (range, 0-3), and Pigmentation (range, 0-3). The assessors choose a numerical value for each of these characteristics based on a comparison with normal skin.

    Time frame: 2 years

  6. Patient and Observer Scar Assessment Scale

    Patient and Observer Scar Assessment Scale (POSAS, version 2.0) - The POSAS questionnaire seeks to measure scar quality and is a subjective scar scale that consists of two parts: a Patient Scale and an Observer Scale. Both scales contain six items that are scored numerically on a ten-step scale and together they make up the 'Total Score' of the Patient and Observer Scale. The POSAS Patient scale assesses the scar in terms of pain, itching, scar colour, stiffness, thickness and irregularity and overall opinion. The POSAS Observer scale assesses the scar in terms of vascularity, pigmentation, thickness, relief, pliability, surface area and overall opinion.

    Time frame: 2 years

  7. Brisbane Burn Scar Impact Profile

    Brisbane Burn Scar Impact Profile (BBSIP, version 1.0) - This questionnaire assesses the health-related quality of life in people with burn scars. It consists of seven parts which measure; (a) the overall impact of burn scars (itch, pain and other sensations, and their impact on the subject), (b) the impact of the burn scars on work and daily activities, (c) the impact of the burn scars on relationships and social interactions, (d) the subjects perception of the impact of the burn scars on their appearance, (e) the subjects emotional reactions towards their scars and (f) the physical symptoms caused by the burn scars.

    Time frame: 2 years

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Study locations

1 of 1 sites recruiting
  • University Hospitals Birmingham NHS Foundation Trust
    Birmingham, United Kingdom
    Recruiting
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References and documents

Publications

  • Farina JA Jr, Rosique MJ, Rosique RG. Curbing inflammation in burn patients. Int J Inflam. 2013;2013:715645. doi: 10.1155/2013/715645. Epub 2013 May 20. PubMed 23762773 ↗
  • Xiao W, Mindrinos MN, Seok J, Cuschieri J, Cuenca AG, Gao H, Hayden DL, Hennessy L, Moore EE, Minei JP, Bankey PE, Johnson JL, Sperry J, Nathens AB, Billiar TR, West MA, Brownstein BH, Mason PH, Baker HV, Finnerty CC, Jeschke MG, Lopez MC, Klein MB, Gamelli RL, Gibran NS, Arnoldo B, Xu W, Zhang Y, Calvano SE, McDonald-Smith GP, Schoenfeld DA, Storey JD, Cobb JP, Warren HS, Moldawer LL, Herndon DN, Lowry SF, Maier RV, Davis RW, Tompkins RG; Inflammation and Host Response to Injury Large-Scale Collaborative Research Program. A genomic storm in critically injured humans. J Exp Med. 2011 Dec 19;208(13):2581-90. doi: 10.1084/jem.20111354. Epub 2011 Nov 21. PubMed 22110166 ↗
  • Jackson PC, Hardwicke J, Bamford A, Nightingale P, Wilson Y, Papini R, Moiemen N. Revised estimates of mortality from the Birmingham Burn Centre, 2001-2010: a continuing analysis over 65 years. Ann Surg. 2014 May;259(5):979-84. doi: 10.1097/SLA.0b013e31829160ca. PubMed 23598383 ↗
  • Mann EA, Baun MM, Meininger JC, Wade CE. Comparison of mortality associated with sepsis in the burn, trauma, and general intensive care unit patient: a systematic review of the literature. Shock. 2012 Jan;37(1):4-16. doi: 10.1097/SHK.0b013e318237d6bf. PubMed 21941222 ↗
  • Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G; SCCM/ESICM/ACCP/ATS/SIS. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003 Apr;31(4):1250-6. doi: 10.1097/01.CCM.0000050454.01978.3B. PubMed 12682500 ↗
  • Brinkmann V, Reichard U, Goosmann C, Fauler B, Uhlemann Y, Weiss DS, Weinrauch Y, Zychlinsky A. Neutrophil extracellular traps kill bacteria. Science. 2004 Mar 5;303(5663):1532-5. doi: 10.1126/science.1092385. PubMed 15001782 ↗
  • Mocsai A. Diverse novel functions of neutrophils in immunity, inflammation, and beyond. J Exp Med. 2013 Jul 1;210(7):1283-99. doi: 10.1084/jem.20122220. PubMed 23825232 ↗
  • Butler KL, Ambravaneswaran V, Agrawal N, Bilodeau M, Toner M, Tompkins RG, Fagan S, Irimia D. Burn injury reduces neutrophil directional migration speed in microfluidic devices. PLoS One. 2010 Jul 30;5(7):e11921. doi: 10.1371/journal.pone.0011921. PubMed 20689600 ↗
  • Arturson G. Neutrophil granulocyte functions in severely burned patients. Burns Incl Therm Inj. 1985 Jun;11(5):309-19. doi: 10.1016/0305-4179(85)90093-2. PubMed 4027746 ↗
  • Bjerknes R, Vindenes H, Laerum OD. Altered neutrophil functions in patients with large burns. Blood Cells. 1990;16(1):127-41; discussion 142-3. PubMed 2190644 ↗
  • Jones CN, Moore M, Dimisko L, Alexander A, Ibrahim A, Hassell BA, Warren HS, Tompkins RG, Fagan SP, Irimia D. Spontaneous neutrophil migration patterns during sepsis after major burns. PLoS One. 2014 Dec 9;9(12):e114509. doi: 10.1371/journal.pone.0114509. eCollection 2014. PubMed 25489947 ↗
  • The World Health Organisation. Burns [updated April 2014; cited 2015 06.10.2015]. Available from: http://www.who.int/mediacentre/factsheets/fs365/en/.
  • Campisi J. Aging, cellular senescence, and cancer. Annu Rev Physiol. 2013;75:685-705. doi: 10.1146/annurev-physiol-030212-183653. Epub 2012 Nov 8. PubMed 23140366 ↗
  • Hazeldine J, McGee KC, Al-Tarrah K, Hassouna T, Patel K, Imran R, Bishop JRB, Bamford A, Barnes D, Wilson Y, Harrison P, Lord JM, Moiemen NS. Multicentre, longitudinal, observational cohort study to examine the relationship between neutrophil function and sepsis in adults and children with severe thermal injuries: a protocol for the Scientific Investigation of the Biological Pathways Following Thermal Injury-2 (SIFTI-2) study. BMJ Open. 2021 Oct 22;11(10):e052035. doi: 10.1136/bmjopen-2021-052035. PubMed 34686556 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 5, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04693442
Lead sponsor
University Hospital Birmingham NHS Foundation Trust
Collaborators
The Scar Free Foundation, University of Birmingham
Responsible party
Naiem Moiemen (Burns and Plastics Consultant, University Hospital Birmingham NHS Foundation Trust) — Principal investigator
First posted
Jan 5, 2021
Start date
Nov 18, 2016
Primary completion
Jan 31, 2022 (estimated)
Completion
Jan 31, 2022 (estimated)
Last update
Jan 5, 2021

Study contacts

Amy Bamford, Registered Nurse
Contact
Amy.Bamford@uhb.nhs.uk
01213718226 ext. 18226
Minnie Ventura, MSc
Contact
Maximina.Ventura@uhb.nhs.uk
01213718220 ext. 18220
Naiem Moiemen, Surgeon
principal investigator · The Scar Free Foundation

Oversight

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

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