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Intravenous (IV) Solutions for Dehydration in Children With Gastroenteritis

Primary Purpose

Dehydration, Gastroenteritis

Status
Terminated
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
multiple electrolyte solution
saline
Sponsored by
Baxter Healthcare Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dehydration focused on measuring dehydration, gastroenteritis

Eligibility Criteria

6 Months - 10 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. AGE (etiology: viral or other) resulting in presentation to the ED deemed in need of IV rehydration. In the 24 hours prior to presentation, the subject experienced at least 3 episodes of diarrhea (loose and/or watery stools) and/or nonbilious vomiting.
  2. Moderate to severe dehydration (as assessed by Gorelick score13 ≥ 4
  3. ≥ 6 months to < 11 years of age.
  4. Healthy except for the underlying etiology of AGE.
  5. Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved written ICFs and privacy language per national regulations (eg, Health Insurance Portability and Accountability Act [HIPAA], Personal Information Protection and Electronic Documents Act [PIPEDA]) were obtained from the parent/guardian prior to any study-related procedures.

Exclusion Criteria:

  1. AGE that did not require IV rehydration per the clinician.
  2. Gorelick score ≤ 3
  3. Bilious vomiting.
  4. Received > 20 mL/kg IV fluid bolus within the 4 hours prior to study enrollment (ie, Hour -4 to Hour 0).
  5. Diarrhea lasting > 7 days prior to presentation to the ED.
  6. Chronic vomiting disorder.
  7. Grossly bloody diarrhea.
  8. Chronic diarrheal disorder.
  9. Known hyponatremia (sodium < 130 mmol/L [< 130 mEq/L]) within 72 hours prior to enrollment.
  10. Known hypernatremia (sodium > 155 mmol/L [> 155 mEq/L]) within 72 hours prior to enrollment.
  11. Known hypokalemia (potassium < 3.0 mmol/L [< 3.0 mEq/L]) within 72 hours prior to enrollment.
  12. Known hyperkalemia (potassium > 5.5 mmol/L [> 5.5 mEq/L]) within 72 hours prior to enrollment.
  13. The use of prohibited medications:

    • Antacids within 24 hours prior to presentation to the ED and during the study.
    • Anti-diarrhea medication within 24 hours prior to presentation to the ED and during the study.
    • The systemic use of corticosteroids/corticotropins was prohibited within 72 hours of enrollment.
  14. Chronic health condition affecting the ability to tolerate fluids or those that result in electrolyte abnormalities (eg, chronic renal, cardiac, or pulmonary diagnoses), or abnormalities of sodium or potassium handling (eg, endocrine disorders, medications).
  15. Any reason for urgent or emergency hospital admission or ED stays of > 12 hours within 14 days preceding presentation to the ED.
  16. Any medical condition likely to interfere with the subject's ability to fully complete all protocol-specified interventions, the ability to undergo all protocol-specified assessments, or likely to prolong the subject's need for medical attention beyond that required for treatment of dehydration.
  17. Participation in a study of any investigational drug or device concomitantly or within 30 days prior to enrollment in this study, including previous enrollment in this study.
  18. Subject with a > 50% expected chance of dying within 6 months, in the Investigator's opinion.
  19. Known hypersensitivity to either of the investigational products.
  20. Other serious acute or active conditions that, in the Investigator's opinion, precluded participation in this study.

Sites / Locations

  • Emory University/Children's Healthcare of Atlanta
  • Children's Hospital of Atlanta at Scottish Rite
  • Cincinnati Children's Hospital Medical Center
  • Cleveland Clinic Foundation
  • Oregon Health and Science University
  • Dell Children's Medical Center of Central Texas
  • Children's Hospital of Wisconsin
  • Alberta Children's Hospital
  • British Columbia Children's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

multiple electrolyte solution

saline

Arm Description

Subjects were randomized to receive either multiple electrolyte solution or saline. These solutions were administered IV at 10-20 mL/kg until the subject appeared clinically rehydrated as assessed by the clinician. The selected dose for these solutions is considered standard of care when treating clinical dehydration in children and is consistent with product labeling.

Subjects were randomized to receive either multiple electrolyte solution or saline. These solutions were administered IV at 10-20 mL/kg until the subject appeared clinically rehydrated as assessed by the clinician. The selected dose for these solutions is considered standard of care when treating clinical dehydration in children and is consistent with product labeling.

Outcomes

Primary Outcome Measures

Change From Baseline of Venous Serum Bicarbonate at 4 Hours From Start of Intravenous (IV)
The primary efficacy variable was venous serum bicarbonate (marker of metabolic acidosis) at Hour 4 (+/- 1 hour) from the start of the First IV Bolus.

Secondary Outcome Measures

Full Information

First Posted
November 3, 2010
Last Updated
March 28, 2018
Sponsor
Baxter Healthcare Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01234883
Brief Title
Intravenous (IV) Solutions for Dehydration in Children With Gastroenteritis
Official Title
A Double-Blind, Randomized, Comparative Efficacy and Safety Trial of Intravenous Solutions for the Treatment of Moderate to Severe Dehydration in Children With Acute Gastroenteritis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Terminated
Why Stopped
Insufficient enrollment
Study Start Date
June 2011 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
February 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxter Healthcare Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to compare the efficacy and safety of the use of a multiple electrolyte solution to the use of saline for the treatment of moderate to severe dehydration due to acute gastroenteritis (AGE) in children.
Detailed Description
The primary objective of this study was to compare the efficacy and safety of the use of Plasma Lyte A to the use of NS for the treatment of moderate to severe dehydration and amelioration of metabolic acidosis due to AGE in children (≥ 6 months to < 11 years of age) by measuring serum bicarbonate levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dehydration, Gastroenteritis
Keywords
dehydration, gastroenteritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
multiple electrolyte solution
Arm Type
Experimental
Arm Description
Subjects were randomized to receive either multiple electrolyte solution or saline. These solutions were administered IV at 10-20 mL/kg until the subject appeared clinically rehydrated as assessed by the clinician. The selected dose for these solutions is considered standard of care when treating clinical dehydration in children and is consistent with product labeling.
Arm Title
saline
Arm Type
Active Comparator
Arm Description
Subjects were randomized to receive either multiple electrolyte solution or saline. These solutions were administered IV at 10-20 mL/kg until the subject appeared clinically rehydrated as assessed by the clinician. The selected dose for these solutions is considered standard of care when treating clinical dehydration in children and is consistent with product labeling.
Intervention Type
Drug
Intervention Name(s)
multiple electrolyte solution
Other Intervention Name(s)
Plasma Lyte A Injection pH 7.4 (Multiple Electrolytes Injection, Type 1, USP)
Intervention Description
IV multiple electrolyte solution dosed as clinically indicated for rehydration
Intervention Type
Drug
Intervention Name(s)
saline
Other Intervention Name(s)
0.9% Normal Saline
Intervention Description
IV solutions dosed as clinically indicated for rehydration
Primary Outcome Measure Information:
Title
Change From Baseline of Venous Serum Bicarbonate at 4 Hours From Start of Intravenous (IV)
Description
The primary efficacy variable was venous serum bicarbonate (marker of metabolic acidosis) at Hour 4 (+/- 1 hour) from the start of the First IV Bolus.
Time Frame
Day 1 (4 Hours after start of IV)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
10 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: AGE (etiology: viral or other) resulting in presentation to the ED deemed in need of IV rehydration. In the 24 hours prior to presentation, the subject experienced at least 3 episodes of diarrhea (loose and/or watery stools) and/or nonbilious vomiting. Moderate to severe dehydration (as assessed by Gorelick score13 ≥ 4 ≥ 6 months to < 11 years of age. Healthy except for the underlying etiology of AGE. Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved written ICFs and privacy language per national regulations (eg, Health Insurance Portability and Accountability Act [HIPAA], Personal Information Protection and Electronic Documents Act [PIPEDA]) were obtained from the parent/guardian prior to any study-related procedures. Exclusion Criteria: AGE that did not require IV rehydration per the clinician. Gorelick score ≤ 3 Bilious vomiting. Received > 20 mL/kg IV fluid bolus within the 4 hours prior to study enrollment (ie, Hour -4 to Hour 0). Diarrhea lasting > 7 days prior to presentation to the ED. Chronic vomiting disorder. Grossly bloody diarrhea. Chronic diarrheal disorder. Known hyponatremia (sodium < 130 mmol/L [< 130 mEq/L]) within 72 hours prior to enrollment. Known hypernatremia (sodium > 155 mmol/L [> 155 mEq/L]) within 72 hours prior to enrollment. Known hypokalemia (potassium < 3.0 mmol/L [< 3.0 mEq/L]) within 72 hours prior to enrollment. Known hyperkalemia (potassium > 5.5 mmol/L [> 5.5 mEq/L]) within 72 hours prior to enrollment. The use of prohibited medications: Antacids within 24 hours prior to presentation to the ED and during the study. Anti-diarrhea medication within 24 hours prior to presentation to the ED and during the study. The systemic use of corticosteroids/corticotropins was prohibited within 72 hours of enrollment. Chronic health condition affecting the ability to tolerate fluids or those that result in electrolyte abnormalities (eg, chronic renal, cardiac, or pulmonary diagnoses), or abnormalities of sodium or potassium handling (eg, endocrine disorders, medications). Any reason for urgent or emergency hospital admission or ED stays of > 12 hours within 14 days preceding presentation to the ED. Any medical condition likely to interfere with the subject's ability to fully complete all protocol-specified interventions, the ability to undergo all protocol-specified assessments, or likely to prolong the subject's need for medical attention beyond that required for treatment of dehydration. Participation in a study of any investigational drug or device concomitantly or within 30 days prior to enrollment in this study, including previous enrollment in this study. Subject with a > 50% expected chance of dying within 6 months, in the Investigator's opinion. Known hypersensitivity to either of the investigational products. Other serious acute or active conditions that, in the Investigator's opinion, precluded participation in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Drew Jones, MD
Organizational Affiliation
Baxter Healthcare
Official's Role
Study Director
Facility Information:
Facility Name
Emory University/Children's Healthcare of Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Children's Hospital of Atlanta at Scottish Rite
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Dell Children's Medical Center of Central Texas
City
Austin
State/Province
Texas
ZIP/Postal Code
78723
Country
United States
Facility Name
Children's Hospital of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Alberta Children's Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
British Columbia Children's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 3V4
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
27480410
Citation
Allen CH, Goldman RD, Bhatt S, Simon HK, Gorelick MH, Spandorfer PR, Spiro DM, Mace SE, Johnson DW, Higginbotham EA, Du H, Smyth BJ, Schermer CR, Goldstein SL. A randomized trial of Plasma-Lyte A and 0.9 % sodium chloride in acute pediatric gastroenteritis. BMC Pediatr. 2016 Aug 2;16:117. doi: 10.1186/s12887-016-0652-4.
Results Reference
derived

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Intravenous (IV) Solutions for Dehydration in Children With Gastroenteritis

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