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RecruitingNCT06279793MODIFY CSXUpdated Jul 8, 2026

Intravenous Fish Oil Based Lipid Emulsion to Enhance Recovery in High-Risk Cardiac Surgery Patients

A Phase 2 interventional study of Fish Oil and Intravenous 0.9% Sodium Chloride in Intensive Care Unit, Coronary Artery Bypass Grafting (CABG) and High Risk Patients, sponsored by GCP-Service International West GmbH. Recruiting at 10 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-08.

Sponsored by GCP-Service International West GmbH · Phase 2, Interventional, and Prevention

From the registry’s dates

  • Started Feb 2024; still recruiting 2 years 8 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
550
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The MODIFY CSX study is a prospective, randomized, placebo-controlled trial conducted in heart centers in Germany and Italy.

A total of 550 high-risk cardiac surgery patients will receive either 0.20 g fish oil/kg body weight (BW) + standard of care versus same volume of placebo (NaCl) + standard of care.

Read the detailed description

The proposed hypothesis is that the therapeutic strategy tested in this randomized trial will decrease the occurrence of postoperative atrial fibrillation, which ultimately leads to faster time to discharge alive. This in turn significantly improves the patients' mid and long-term outcomes and dramatically reduces associated healthcare related costs.

Duration of intervention: until discharge from ICU, death or postoperative day 7 on ICU, whichever comes first.

Treatment Group: Patients will receive 0.20 g fish oil/kg BW/d (≙ 2 mL Omegaven®/kg BW/d).

Control Group: Patients will receive 0,9% NaCl in dose 2 mL/kg BW/d (placebo).

Follow-up per patient: at day 30, months 3, 6, and 12.

Primary endpoint (Phase II study):

The primary endpoint for this phase II clinical trial is the onset and occurence of atrial fibrillation after cardiac surgery (AFACS), incorporating atrial fibrillation, atrial flutter, and atrial tachycardia, until day 7 after surgery (on ICU and normal ward).

02

Conditions studied

  • Intensive Care Unit
  • Coronary Artery Bypass Grafting (CABG)
  • High Risk Patients
  • Cardiopulmonary Bypass
  • Elective Cardiac Surgery
  • Valvular Heart Surgery
  • Multiple Valve Surgeries
  • Combined Cardiac Procedures
  • Aortic Surgical Procedures
  • Adult Patients ≥ 18 Years
  • Combined Valve and CABG
  • Combined Cardiac and Aortic Surgical Procedures

Keywords

  • intensive care unit
  • elective cardiac surgery
  • fish oil
  • medical nutrition therapy
  • atrial fibrillation
  • atrial flutter
  • atrial tachycardia
03

In context

Atrial Fibrillation

4,009 studies on the registry are indexed under Atrial Fibrillation; 961 are open to participants now.

This study's planned enrollment of 550 is above the median of 150 across 2,476 interventional studies indexed under Atrial Fibrillation.

Browse Atrial Fibrillation studies →

Lead sponsor

GCP-Service International West GmbH is the lead sponsor of 3 studies on the registry; 1 is open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Written prior to study participation
  2. Adult patients (≥ 18 years)
  3. Patients scheduled to undergo elective cardiac surgery with the use of CPB, who are defined as high risk based on having (i) one of the following surgical procedures: valvular heart surgery only, CABG, combined valve and CABG, multiple valve surgeries, combined cardiac procedures, aortic surgical procedures (aortic arch and/or descending aorta; aortic valve+ascending aorta) and (ii) at least one of the following additional risk factors: (a) a high perioperative risk profile, defined as predicted operative mortality of ≥8% (EuroSCORE II), (b) age ≥70, (c) Clinical Frailty Score 4 or more, (d) urgent surgery (defined as to be performed within 24-48 hours after admission), (e) \<35%

Exclusion criteria

Exclusion Criteria:

  1. Known to fish oil/fish products or egg protein
  2. Pregnancy or lactation period
  3. Previous history of chronic atrial fibrillation, atrial flutter and/or atrial tachyarrhythmia
  4. Inability or unwillingness of individual to give written
  5. Not expected to survive an additional 48 hours from screening evaluation
  6. Lack of commitment to full, aggressive care (anticipated withholding or withdrawing treatments in the first week but isolated "Do not Resuscitate" [DNR] acceptable)
  7. Patients admitted with diabetic ketoacidosis or non-ketotic hyperosmolar coma
  8. Patients receiving extracorporeal mechanical assist device (e.g. ECLS, or IABP) or advanced heart failure therapies (e.g. TAH, VAD)
  9. Enrolment in any other interventional trial will be discussed with the coordinating investigator on a case-by-case scenario and requires sponsor approval before inclusion
  10. Already receiving special FO-enriched medical nutrition products
  11. Severe malnutrition (as defined by the \<18.5)
  12. Severe liver dysfunction defined by Class C.
  13. Severe chronic kidney dysfunction defined by the National Kidney Foundation (NKF) stage 4 and 5 by using the (GFR \<30ml/min)
  14. Known severe coagulation disorder
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
550 participants (estimated)

Study arms

  • Experimental
    Treatment group

    Patients will receive 0.20 g fish oil/kg BW/d (≙2 mL Omegaven®/kg BW/d).

    Drug: Fish Oil

  • Placebo comparator
    Control group

    Patients will receive 0,9% NaCl in volume 2 mL/kg BW/d (placebo).

    Drug: Intravenous 0.9% Sodium Chloride

Interventions

  • Omegaven® is a 10% fish oil emulsion with a high percentage of long-chain n-3 fatty acids - mainly eicosapentaenoic acid and docosahexaenoic acid. It optimises the fatty acid pattern in parenteral nutrition and is a source of polyunsaturated n-3 fatty acids as cell membrane components and precursors for eicosanoids. Omegaven® is manufactured by Fresenius-Kabi, Germany and is available in 100 mL bottles for study purpose. Each 100 mL of Omegaven® contains 10 g of fish oil (0.1 g/mL). Timeframe: Day -1: 0.20 g fish oil/kg BW/d (the treatment should be started 24 to 3 h before surgery, can be given as 3-6 hours infusion); intraoperative day 0: no dose; postoperative day 0: 0.20 g fish oil/kg BW/d; postoperative days 1 to max. 7): 0.20 g fish oil/kg BW/d

    Also known as: Omegaven®

  • DrugIntravenous 0.9% Sodium Chloride

    Intravenous 0.9% Sodium Chloride (volume 2 mL/kg BW/d) provided at the same timepoints as the intervention.

    Also known as: Saline Infusion

06

What researchers measure

Primary outcomes

  1. Atrial fibrillation

    The primary objective is to demonstrate superiority of fish oil compared to placebo in the prevention of atrial fibrillation after cardiac surgery (AFACS), incorporating atrial fibrillation, atrial flutter and atrial tachycardia, until 7 days after surgery. This clinical endpoint is assessed as part of the clinical practice.

    Time frame: Postoperative days 0-7

Secondary outcomes

  1. Mechanical ventilation

    Duration of mechanical ventilation

    Time frame: Postoperative days 0-7, ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery), day 30 follow-up

  2. Adverse Events

    AEs leading to discontinuation/AEs at least possibly related to the IMP/SAEs

    Time frame: Preoperative day -1 to 12 months follow-up

  3. Delta Sequential Organ Failure Assessment Score (SOFA) Score

    A scoring system that assesses the performance of several organ systems in the body (neurologic, blood, liver, kidney, and blood pressure/hemodynamics) and assigns a score based on the data obtained in each category.

    Time frame: Postoperative days 0-7

  4. Stroke

    Incidence of stroke

    Time frame: Postoperative days 0-7

  5. Inotropics/vasopressors

    Duration of inotropic/vasopressor support

    Time frame: Postoperative days 0-7, ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery), day 30 follow-up

  6. Acute Kidney Injury

    Kidney Disease: Improving Global Outcomes \[KDIGO\] stages 1-3

    Time frame: Postoperative days 0-7

  7. Infection rate

    Number of infections

    Time frame: Postoperative days 0-7

  8. Survival status

    Overall survival

    Time frame: ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery), day 30 follow-up, months 3, 6, and 12 follow-up

  9. Quality of Life (SF-36)

    To measure the quality of life

    Time frame: Screening (preoperative day -7 until day -1), day 30 follow-up, 3, 6, and 12 months follow-up

  10. Postoperative bleeding

    Bleeding after surgery

    Time frame: Postoperative days 0-7

  11. Time to ICU discharge alive

    Number of days alive in the ICU

    Time frame: ICU discharge (approximately 3-4 days after surgery)

  12. Time to hospital discharge alive

    Number of days alive in the hospital

    Time frame: Hospital discharge (approximately 1-2 weeks after surgery)

  13. Physical activity assessment

    Katz activities of daily living (ADL) and Lawton Instrumental ADL (IADL)

    Time frame: Screening (preoperative day -7 until day -1), day 30 follow-up, 3 and 6 months follow-up

  14. Days alive and out of hospital

    Time to be alive and discharge from hospital

    Time frame: Day 30 follow-up, 3, 6, and 12 months follow-up

  15. Time to discharge alive

    Time to be alive and discharged from ICU/hospital

    Time frame: ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  16. Weaning from cardiopulmonary bypass (CPB)

    Number of attempts to wean from CPB during surgery

    Time frame: Intraoperative day 0 (during surgery)

  17. Persistent Organ Dysfunction + Death

    Requiring supportive technologies during the convalescent phase of critical illness

    Time frame: Postoperative days 0-7, ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery), day 30 follow-up

  18. ICU Readmission rates

    Readmission to ICU

    Time frame: Day 30 follow-up, 3, 6, and 12 months follow-up

  19. Hospital Readmission rates

    Readmission to hospital

    Time frame: Day 30 follow-up, 3, 6, and 12 months follow-up

Other outcomes

  1. Optional tertiary endpoint: Ultrasound measurement of thigh skeletal muscle mass

    Ultrasound measurement of thigh skeletal muscle mass

    Time frame: Screening (preoperative day -7 until day -1), ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  2. Optional tertiary endpoint: Functional Status Score for Intensive Care Unit (FSS-ICU)

    Functional Status Score for Intensive Care Unit (FSS-ICU)

    Time frame: Screening (preoperative day -7 until day -1), ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  3. Optional tertiary endpoint: Short Physical Performance Battery test (SPPB)

    Short Physical Performance Battery test (SPPB)

    Time frame: Screening (preoperative day -7 until day -1), ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  4. Optional tertiary endpoint: Hand grip/held dynamometer

    Hand grip/held dynamometer

    Time frame: Screening (preoperative day -7 until day -1), ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  5. Optional tertiary endpoint: Inflammatory response

    Inflammatory response and immune function (measured by markers of the clinical routine (e.g. interleukin \[IL-\] -6, IL-1β, IL-2, IL-15, interferon \[IFN\] -γ, monocyte chemotactic protein \[MCP\] -1, Ferritin, D-Dimer , IL-10, C-reactive protein \[CRP\], white blood cell count \[WBC\], procalcitonin \[PCT\], tumor necrosis factor-α \[TNF-α\]).

    Time frame: Intraoperative day 0, postoperative days 0-7

  6. Optional tertiary endpoint: Left ventricular ejection fraction

    Left ventricular ejection fractLeft ventricular ejection fractionion

    Time frame: Preoperative day -1, hospital discharge (approximately 1-2 weeks after surgery), day 30 follow-up, 3 and 6 months follow-up

  7. Optional tertiary endpoint: Manual Muscle Testing (MMT)

    Manual Muscle Testing (MMT)

    Time frame: Screening (preoperative day -7 until day -1), ICU discharge (approximately 3-4 days after surgery), hospital discharge (approximately 1-2 weeks after surgery)

  8. Optional tertiary endpoint: Vasoactive-Inotropic Score (VIS)

    Vasoactive-Inotropic Score (VIS)

    Time frame: Postoperative days 0-7

  9. Optional tertiary endpoint: Therapeutic Intervention Scoring System (TISS)

    A method for measuring workload and calculating costs in the ICU

    Time frame: Postoperative days 0-7

  10. Optional tertiary endpoint: Development of delirium

    Assessed by the CAM ICU score

    Time frame: Postoperative days 0-7

  11. Optional tertiary endpoint: Hemodynamic parameters

    Adequate hemodynamic support, as defined by stable Cardiac Index, cardiac output (CO), Cardiac Power Index, mean arterial pressure (MAP), central vein pressure (CVP), pulmonary artery diastolic pressure (to be measured every 8 hours for first 72 hours post-op or until removal of pulmonary artery catheter, whatever comes first

    Time frame: Intraoperative day 0, postoperative days 0-7

  12. Optional tertiary endpoint: Clinical frailty scale

    A 9-point scale that quantifies frailty based on function in individual patients

    Time frame: Screening (preoperative day -1 until day -7), day 30 follow-up, 3 months follow-up

  13. Optional tertiary endpoint: Simplified Acute Physiology Score (SAPS)

    Estimates the probability of mortality for ICU patients on admission

    Time frame: Postoperative days 0-7

  14. Optional tertiary endpoints: Further routine biomarkers

    Further routine biomarkers: creatinine, urea, bilirubin, troponin, triglycerides if available

    Time frame: Intraoperative day 0, postoperative days 0-7

  15. Separate Sub-study

    Serial blood samples and - if available - tissue samples from patients (if these result from the routine surgical procedure) will be collected in concerning patients at the day before (only blood samples), during surgery (only tissue sample if available), and once daily after surgery while the patients are on ICU (only blood samples): * Specialized pro-resolving mediators (SPMs) and more specific markers of the inflammatory response, such as the production of leukotriene B5 (LTB5), leukotriene B4 (LTB4), 5-hydroxyeicosapentaenoic acid (5-HEPE) and production of 5-hydroxyeicosatetraenoic acid (5-HETE) * SPMs, such as maserins and resolvins * Oxidative stress (oxidative reduction potential, Malondialdehyde) * Membrane incorporation of PUFAs (white blood cells) \&amp;amp;amp;amp; tissue samples * Activation of survival kinases (such as extracellular-signal regulated

    Time frame: Preoperative day -1, intraoperative day 0, postoperative days 0-7, hospital discharge (approximately 1-2 weeks after surgery)

07

Study locations

9 of 10 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06279793
Lead sponsor
GCP-Service International West GmbH
Collaborators
University Hospital, Bonn, University Hospital Muenster, University Hospital Goettingen, Charite University, Berlin, Germany, Wuerzburg University Hospital, Johannes Gutenberg University Mainz, University Hospital Augsburg, Universitätsklinikum Hamburg-Eppendorf, University Medical Center Rostock, University Hospital Schleswig-Holstein, Robert Bosch-Krankenhaus Stuttgart
Responsible party
Sponsor
First posted
Feb 28, 2024
Start date
Feb 15, 2024
Primary completion
Mar 2030 (estimated)
Completion
Sep 2030 (estimated)
Last update
Jul 8, 2026

Study contacts

Christian Stoppe, Prof. Dr.
Contact
cstoppe@gcp-service.com
49-931-20130001
Ellen Dresen, Dr.
Contact
Dresen_E@ukw.de
+49 931-201 30392
Christian Stoppe, Prof. Dr.
study director · Wuerzburg University Hospital

Oversight

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

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