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Efficacy of Enteral Iron Supplementation in Critical Illness

Primary Purpose

Anemic, Critically Ill Patients

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ferrous Sulfate
Placebo Oral Tablet
Sponsored by
Weill Medical College of Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anemic, Critically Ill Patients focused on measuring iron, critical illness, anemia, infection

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age > 18 years
  • Anemia (Hemoglobin < 13.0 g/dL)
  • ≤ 72 hours from hospital admission
  • Current tolerance of enteral medications
  • Expected ICU LOS > 5 days

Exclusion Criteria:

  • Active bleeding
  • Chronic inflammatory disease
  • End-stage renal disease
  • Hematologic disorders
  • Macrocytic anemia
  • Current use of erythropoietin
  • Pregnancy
  • Prohibition of RBC transfusions
  • Moribund state in which death is imminent
  • Enrollment in another clinical trial

Sites / Locations

  • Weill Medical College of Cornell University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Iron Group

Placebo Group

Arm Description

Ferrous sulfate 325 mg either by capsule or oral solution three times a day at 9 am, 1pm and 5 pm until hospital discharge or for 42 days, whichever occurs first.

Placebo capsule three times a day at 9 am, 1pm and 5 pm until hospital discharge or for 42 days, whichever occurs first.

Outcomes

Primary Outcome Measures

Hematocrit
Serum Iron Concentration
Serum Ferritin Concentration
Erythrocyte Zinc Protoporphyrin Concentration

Secondary Outcome Measures

Number of Subjects That Received at Least One RBC Transfusion During Admission to the Hospital
Number of Subjects That Incurred at Least One Infection Throughout Hospital Admission
Instance of Drug-related Constipation Throughout Hospital Admission
Average Number of Days That Subjects Were Taking Antibiotics
Hospital Mortality, as Measured by Number of Subject Deaths While Admitted to Hospital
Average Length of Stay in the Hospital

Full Information

First Posted
March 20, 2007
Last Updated
July 8, 2019
Sponsor
Weill Medical College of Cornell University
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1. Study Identification

Unique Protocol Identification Number
NCT00450177
Brief Title
Efficacy of Enteral Iron Supplementation in Critical Illness
Official Title
A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial of the Effects of Enteral Iron Supplementation on Anemia and Risk of Infection in Critical Illness
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
January 2006 (Actual)
Primary Completion Date
December 2007 (Actual)
Study Completion Date
January 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Weill Medical College of Cornell University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to investigate the efficacy of enteral iron supplementation for improving anemia, decreasing the risk of blood transfusion, and decreasing mortality in patients who are hospitalized in the intensive care unit. This study will also address any relationship between enteral iron supplementation and risk of infection.
Detailed Description
Critical illness is characterized by the anemia of inflammation, which is partially caused by sequestration of iron from bone marrow sites of erythropoiesis into storage within the reticuloendothelial system as ferritin. Also the majority of critically ill patients are hypoferremia, the efficacy of iron supplementation remains unknown. Furthermore, several retrospective studies have found an association between iron overload and infection. However, the relative risk/benefit profile of enteral iron supplementation with respect to infection has not been studied. The purpose of this study is to evaluate the efficacy of enteral iron supplementation in critically ill patients. The hypothesis is that enteral iron supplementation will result in both an improved hematocrit and a decreased need for blood transfusion, without increasing the risk of infection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anemic, Critically Ill Patients
Keywords
iron, critical illness, anemia, infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Iron Group
Arm Type
Experimental
Arm Description
Ferrous sulfate 325 mg either by capsule or oral solution three times a day at 9 am, 1pm and 5 pm until hospital discharge or for 42 days, whichever occurs first.
Arm Title
Placebo Group
Arm Type
Placebo Comparator
Arm Description
Placebo capsule three times a day at 9 am, 1pm and 5 pm until hospital discharge or for 42 days, whichever occurs first.
Intervention Type
Drug
Intervention Name(s)
Ferrous Sulfate
Intervention Description
Iron group
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Tablet
Intervention Description
Placebo group
Primary Outcome Measure Information:
Title
Hematocrit
Time Frame
Day 7, Day 14, Day 21, Day 28
Title
Serum Iron Concentration
Time Frame
Day 7, Day 14, Day 21, Day 28
Title
Serum Ferritin Concentration
Time Frame
Day 7, Day 14, Day 21, Day 28
Title
Erythrocyte Zinc Protoporphyrin Concentration
Time Frame
Day 7, Day 14, Day 21, Day 28
Secondary Outcome Measure Information:
Title
Number of Subjects That Received at Least One RBC Transfusion During Admission to the Hospital
Time Frame
Throughout hospital stay up to 6 weeks
Title
Number of Subjects That Incurred at Least One Infection Throughout Hospital Admission
Time Frame
Throughout hospital stay up to 6 weeks
Title
Instance of Drug-related Constipation Throughout Hospital Admission
Time Frame
Throughout hospital stay up to 6 weeks
Title
Average Number of Days That Subjects Were Taking Antibiotics
Time Frame
Throughout hospital stay up to 6 weeks
Title
Hospital Mortality, as Measured by Number of Subject Deaths While Admitted to Hospital
Time Frame
Throughout hospital stay up to 6 weeks
Title
Average Length of Stay in the Hospital
Time Frame
Throughout hospital stay up to 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age > 18 years Anemia (Hemoglobin < 13.0 g/dL) ≤ 72 hours from hospital admission Current tolerance of enteral medications Expected ICU LOS > 5 days Exclusion Criteria: Active bleeding Chronic inflammatory disease End-stage renal disease Hematologic disorders Macrocytic anemia Current use of erythropoietin Pregnancy Prohibition of RBC transfusions Moribund state in which death is imminent Enrollment in another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philip S Barie, MD, MBA
Organizational Affiliation
Weill Medical College of Cornell University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Weill Medical College of Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
19245362
Citation
Pieracci FM, Henderson P, Rodney JR, Holena DN, Genisca A, Ip I, Benkert S, Hydo LJ, Eachempati SR, Shou J, Barie PS. Randomized, double-blind, placebo-controlled trial of effects of enteral iron supplementation on anemia and risk of infection during surgical critical illness. Surg Infect (Larchmt). 2009 Feb;10(1):9-19. doi: 10.1089/sur.2008.043.
Results Reference
derived

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Efficacy of Enteral Iron Supplementation in Critical Illness

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