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L-Carnitine Administration in Early Sepsis

Information source: Carolinas Healthcare System
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Septic Shock

Intervention: L-Carnitine (Drug); Normal Saline (Drug)

Phase: Phase 1

Status: Terminated

Sponsored by: Carolinas Healthcare System

Official(s) and/or principal investigator(s):
Alan E Jones, MD, Principal Investigator, Affiliation: University of Mississippi and Carolinas Medical Center, Department of Emergency Medicine

Summary

Sepsis is a severe and overwhelming response to an infection in the body. Over 750,000 patients in the United States develop sepsis every year. As sepsis becomes progressively more severe, a patient's blood pressure drops to dangerous levels and the body cannot pump oxygen to the rest of the body, which is necessary for normal cell function. This is called septic shock. When someone develops septic shock, it is very common for the smallest blood vessels in the body called the microcirculation to clog, like a highway during rush hour. Even with the best medical care, more than one in three patients with septic shock will die. The major goal of this study is to test if intravenous replacement of a naturally occurring nutrient that is lost by the body during sepsis called L-carnitine can reduce how sick a patient with sepsis becomes. In our study, some patients will receive L-carnitine and others will receive saline. We will measure markers determining severity of illness in both groups and compare them to see if L-carnitine helps patients get better faster. Based on research already conducted, we believe L-carnitine will improve blood flow in the microcirculation, delivering more oxygen to cells, and help the body get better. To test if this is true, we will directly look at the microcirculation under the tongue with a special magnifying camera that looks at red blood cells, and compare both groups.

Clinical Details

Study design: Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: Reduction in organ failure

Secondary outcome:

Microcirculation

ICU and hospital length of stay

All-cause mortality

All-cause mortality

All-cause mortality

All-cause mortality

Change in inflammatory markers

Change in inflammatory markers

Change in inflammatory markers

Eligibility

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Suspected or confirmed infection

- Any two of four criteria of systemic inflammatory response

- Requirement for vasopressors to treat shock

- Enrollment within 12 hours of vasopressor initiation

- SOFA score of greater than or equal to 5 at the time of enrollment

Exclusion Criteria:

- Age <18 years

- Pregnancy or breastfeeding

- Any primary diagnosis other than sepsis

- Established Do Not Resuscitate status or advanced directives restricting aggressive

care or treating physician deems aggressive care unsuitable

- Any history of seizures or a known seizure disorder

- Any known inborn error of metabolism

- Anticipated requirement for surgery that would interfere with the 12 hour infusion

time

- Active participation in another interventional study

- Inability to obtain informed consent

- Cardiopulmonary resuscitation (chest compression or defibrillation) prior to

enrollment

- Known systemic allergy to carnitine

Locations and Contacts

University of Mississippi Medical Center, Jackson, Mississippi 39216, United States

Carolinas Medical Center, Charlotte, North Carolina 28203, United States

Additional Information

Starting date: September 2010
Last updated: March 8, 2012

Page last updated: August 23, 2015

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