ASSET - a Double-Blind, Randomized Placebo-Controlled Clinical Investigation With Alteco® LPS Adsorber (ASSET)
Septic Shock
About this trial
This is an interventional treatment trial for Septic Shock
Eligibility Criteria
Inclusion Criteria:
Illness severity criteria: At enrolment subjects must meet inclusion criteria #1 through #3 listed below to be eligible to enter the clinical investigation:
- Subjects must have suspected severe infection of abdominal or urogenital origin for which the subject is receiving intravenous antimicrobial therapy as the main reason for organ support
- Subjects, males or females, must be 18 years or older.
Subjects or legally acceptable representatives, as appropriate, are willing and able to provide signed informed consent.
Treatment criteria: Prior to randomization, subjects must meet all inclusion criteria (#4 through #7) listed below to be assigned to a treatment group:
- Appropriate vascular access must have been obtained.
- Subjects must have received ≥ 30 mL/kg of intravenous fluid within the six (6) hours prior to randomization.
- Subjects must have plasma/serum lactate >2 mmol/L despite adequate resuscitation AND a continuous requirement for vasopressor support
- Subjects must be able to initiate the clinical investigation intervention within 12 hours of fulfilment of the illness severity criteria.
Exclusion Criteria:
- Subjects who meet any of the exclusion criteria listed below will NOT be permitted to enter the clinical investigation: Sepsis-induced organ dysfunction for longer than 12 hours prior to the time-point for achieving "Illness severity criteria fulfilled"
- Vasopressor therapy (at any dose) for longer than 12 hours (not included the time spent in the operation theatre) prior to the start of treatment with the investigational device.
Pre-existing uncorrectable medical condition as:
- Poorly controlled neoplasms or hematologic disease (i.e. indication of disseminated cancer outside the suspected primary tumour and hematologic disease not in remission,
- End-stage cardiac disease,
- Cardiac arrest requiring cardiopulmonary resuscitation or with pulseless electrical activity or asystole within the past 7 days
- End-stage lung disease
- End-stage liver disease
- HIV/AIDS with known end-stage processes
- Other uncorrectable medical condition(s) deemed by the Clinical Investigator to hinder the subject to adhere to the fulfilment of the activities described in the Clinical Investigation Plan.
- Extreme illness, i.e. subjects is moribund and death is perceived to be imminent (within 24 hours).
- Recent or current participation (≤ 30 days) in another interventional sepsis trial.
- Recent or current treatment (≤ 30 days) with an adsorption product, including Alteco® LPS Adsorber.
- Treatment with an investigational medicinal product for any indication within the last 30 days before enrolment in the clinical investigation.
- Pregnancy.
- Contraindications to the use heparin or protamine
- Other abdominal inflammatory conditions
- Perforation of hollow organ linked to trauma within 48 hours before enrolment in the clinical investigation.
- Laparotomy reveals isolated gastric ulcer.
- Subjects and/or their immediate family are directly affiliated to investigative site personnel in this clinical investigation. (Immediate family is defined as a spouse, parent, child, or sibling, whether biological or legally adopted).
Sites / Locations
- Kuopio University Hospital
- Tampere University Hospital
- Haukeland Universitetssykehus
- Oslo Universitetssykehus
- Linköping University Hospital
- Uppsala University Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
Alteco LPS Adsorber
Placebo
Hemoperfusion and Standard therapy
Placebo and Standard therapy. The placebo comparator device differs from Alteco® LPS Adsorber only in that no peptide component (i.e. active component) has been attached to the matrix.