Hypertonic Lactate After Cardiac Arrest (LATTE)
Primary Purpose
Cardiac Arrest, Ischemia Reperfusion Injury, Anoxic Brain Injury
Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Sodium Lactate Solution
Sponsored by
About this trial
This is an interventional treatment trial for Cardiac Arrest focused on measuring sodium lactate, cerebral metabolism
Eligibility Criteria
Inclusion Criteria:
- Age > 18 years old
- Sustained (> 20 minutes) return of spontaneous circulation (ROSC)
- Comatose (GCS < 9)
- Time to ROSC > 15'
Exclusion Criteria:
- Protected categories (Pregnant women, Prisoners)
- Anticipated withdrawal of support within 24 hours
- Traumatic cause of cardiac arrest
- time from ROSC to inclusion > 1hour
- Inclusion in any other interventional trial
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
standard of care
treatement group
Arm Description
Patients will receive the standard of care infusion (balanced crystalloids)
half molar sodium lactate infusion 15 µmol/Kg/min
Outcomes
Primary Outcome Measures
serum NSE
NSE serum levels
Secondary Outcome Measures
ICU free days
number of days free from intensive care unit
Mortality
mortality
Neurological outcome
Neurological outcome measured by Glasgow Outcome Scale at 90 days
Hospital length of stay
Hospital length of stay
Severe adverse events rate
Serious adverse events rate
Need for Vasopressors
Need for vasopressors during hospitalization
Seizure rate
Seizure rate
Changes in cardiac biomarkers
Troponin I serum levels
Changes in brain biomarkers
brain biomarkers including nfL and GFAP
Changes in brain metabolism
Brain metabolism measured by PET-IRM
Changes in brain perfusion
brain perfusion measured with early perfusion CT scan
Changes in echocardiographic parameters (systolic)
Changes systolic cardiac function assessed by echocardiography
Changes in echocardiographic parameters (diastolic)
Changes diastolic cardiac function assessed by echocardiography
identification of optimal perfusion pressure
identification of optimal perfusion pressure with invasive neuromonitoring
identification of optimal cerebral oxygen tension
identification of optimal cerebral oxygen tension with invasive neuromonitoring
Full Information
NCT ID
NCT05004610
First Posted
July 30, 2021
Last Updated
August 9, 2021
Sponsor
Erasme University Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05004610
Brief Title
Hypertonic Lactate After Cardiac Arrest
Acronym
LATTE
Official Title
Hypertonic Lactate After Cardiac Arrest
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 1, 2022 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
May 15, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Erasme University Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study is intended to test the hypothesis that sodium lactate infusion after resuscitation from a cardiac arrest will decrease the magnitude of brain damage, as measured by the serum biomarker concentration of NSE.
Detailed Description
Background: In resuscitated patients after cardiac arrest, ischemic brain injury and cardiac depression due to the reperfusion injury are accountable for high mortality rate and poor outcome. Hypertonic sodium lactate (HSL) solutions have been proven to be safe in healthy volunteers and they have shown some benefits in patients with traumatic brain injury and those with myocardial ischemia and could decrease the burden of hypoxic lesions in these organs. The aim of this phase II study is to investigate whether HSL administration could reduce organ damage related biomarkers in serum and if the administrations of these solutions is safe and feasible in resuscitated patients after cardiac arrest.
Design: an investigator initiated, randomized, controlled, open label phase II clinical trial to test the safety and efficacy of the infusion of HSL in resuscitated patients after cardiac arrest admitted to the hospital. After resuscitation from CA, comatose patients will be screened for eligibility and randomized to receive either study treatment as HSL 0.5M infusion for 24h or standard of care.
Expected outcomes: This controlled trial will assess the safety and efficacy of the 0.5 HSL infusion in a cohort of comatose resuscitated patients after cardiac arrest. The results of this trial may provide useful information for a larger phase III clinical trial.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cardiac Arrest, Ischemia Reperfusion Injury, Anoxic Brain Injury
Keywords
sodium lactate, cerebral metabolism
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
125 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
standard of care
Arm Type
No Intervention
Arm Description
Patients will receive the standard of care infusion (balanced crystalloids)
Arm Title
treatement group
Arm Type
Experimental
Arm Description
half molar sodium lactate infusion 15 µmol/Kg/min
Intervention Type
Drug
Intervention Name(s)
Sodium Lactate Solution
Other Intervention Name(s)
Hyperonic sodium lactate
Intervention Description
continuous intravenous infusion of half-molar sodium lactate
Primary Outcome Measure Information:
Title
serum NSE
Description
NSE serum levels
Time Frame
48 hours after randomization
Secondary Outcome Measure Information:
Title
ICU free days
Description
number of days free from intensive care unit
Time Frame
trough study completion, on average 30 days
Title
Mortality
Description
mortality
Time Frame
trough study completion before hospital discharge, on average 60 days
Title
Neurological outcome
Description
Neurological outcome measured by Glasgow Outcome Scale at 90 days
Time Frame
trough study completion, 90 days after randomization
Title
Hospital length of stay
Description
Hospital length of stay
Time Frame
trough study completion, on average 60 days
Title
Severe adverse events rate
Description
Serious adverse events rate
Time Frame
during study drug administration/day 28 or ICU discharge or death
Title
Need for Vasopressors
Description
Need for vasopressors during hospitalization
Time Frame
through study completion, on average 14 days
Title
Seizure rate
Description
Seizure rate
Time Frame
through study completion before ICU discharge, on average 14 days
Title
Changes in cardiac biomarkers
Description
Troponin I serum levels
Time Frame
at randomization, 24 hours, 48 hours and 72 hours after randomization
Title
Changes in brain biomarkers
Description
brain biomarkers including nfL and GFAP
Time Frame
at randomization, after 24 hours, 48 hours and 72 hours
Title
Changes in brain metabolism
Description
Brain metabolism measured by PET-IRM
Time Frame
within 24h after randomization
Title
Changes in brain perfusion
Description
brain perfusion measured with early perfusion CT scan
Time Frame
within 24h after randomization
Title
Changes in echocardiographic parameters (systolic)
Description
Changes systolic cardiac function assessed by echocardiography
Time Frame
at randomization, at 24 hours and 48 hours after randomization
Title
Changes in echocardiographic parameters (diastolic)
Description
Changes diastolic cardiac function assessed by echocardiography
Time Frame
at randomization, at 24 hours and 48 hours after randomization
Title
identification of optimal perfusion pressure
Description
identification of optimal perfusion pressure with invasive neuromonitoring
Time Frame
through study completion, on average 30 days
Title
identification of optimal cerebral oxygen tension
Description
identification of optimal cerebral oxygen tension with invasive neuromonitoring
Time Frame
through study completion, on average 30 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age > 18 years old
Sustained (> 20 minutes) return of spontaneous circulation (ROSC)
Comatose (GCS < 9)
Time to ROSC > 15'
Exclusion Criteria:
Protected categories (Pregnant women, Prisoners)
Anticipated withdrawal of support within 24 hours
Traumatic cause of cardiac arrest
time from ROSC to inclusion > 1hour
Inclusion in any other interventional trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Filippo Annoni, MD
Phone
0483141483
Email
filippo.annoni@erasme.ulb.ac.be
First Name & Middle Initial & Last Name or Official Title & Degree
Fabio S Taccone, MD,PhD
Email
fabio.tacconei@erasme.ulb.ac.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Filippo Annoni, MD
Organizational Affiliation
Hôpital Erasme
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
IPD may be available on reasonable request to other researchers
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Hypertonic Lactate After Cardiac Arrest
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