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Sponsors and Collaborators: |
University of British Columbia BC Research Inc. |
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Information provided by: | University of British Columbia |
ClinicalTrials.gov Identifier: | NCT00358748 |
The purpose of this study is to investigate the early use of hydrocortisone in hypotensive very low birth weight infants.
Based on the observations that:
Condition | Intervention | Phase |
---|---|---|
Neonatal Hypotension |
Drug: Hydrocortisone |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Early Use of Hydrocortisone in Hypotensive Very Low Birth Weight Infants |
Estimated Enrollment: | 40 |
Study Start Date: | July 2005 |
Estimated Study Completion Date: | December 2010 |
Estimated Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
Eligible infants will be randomly assigned to receive hydrocortisone or placebo, using sequentially numbered, preassigned treatment designations in sealed, opaque envelopes. The study drug will be randomly assigned to each patient number, in advance, using a computer-based random number generator.
Hydrocortisone and placebo doses will be prepared and provided by the hospital pharmacy following the assigned study number. Active and placebo drug solutions will be completely indistinguishable.
Infants of multiple gestations will be randomized as separate subjects. Crossover between study groups is not allowed. Physicians involved in the care of the infants will be blinded to treatment group allocation.
If the infant remains hypotensive after a Normal Saline (NS) bolus 10 ml/kg, blood for serum cortisol level determination will be drawn and hydrocortisone or an equivalent volume of NS placebo will be administered intravenously as follows: first dose immediately after randomization 2 mg/kg; 6 hours after 1 mg/kg q6h for 3 doses; followed by 0.5 mg/kg q6hs for 4 doses. If an infant responds to the initial dose of NS but becomes hypotensive within 1 hour after will also be randomized, otherwise another NS bolus could be administered.
Initiation and escalation of inotropes:
Concurrently with the first dose of study drug, dopamine infusion will be started at 5 mcg/kg/minute, increasing stepwise to a maximum of 15 mcg/kg/minute. If hypotension persists an epinephrine infusion at 0.05 mcg/kg/min will be added and increased stepwise if necessary. The aim is to maintain mean blood pressure (MBP) above the hypotensive limit defined in the inclusion criteria.
Weaning of inotropes:
Once normotension has been maintained for 1 hour or MBP > 40 mmHg for 15 minutes, weaning should be started. Dopamine infusion will be reduced first, as tolerated, to 5 mcg/kg/minute. If the subject is on epinephrine infusion the dose will be reduced stepwise to 0.05 mcg/kg/minute and discontinued. When the subject is off epinephrine and/or dopamine at 5 mcg/kg/minute, dopamine will be discontinued. If at any time hypotension recurs, weaning should be held and increased inotropes dose as per escalation algorithm.
Ages Eligible for Study: | up to 30 Weeks |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Horacio Osiovich | 604-875-2135 | hosiovich@cw.bc.ca |
Canada, British Columbia | |
Division of Neonatology, Children's and Women's Health Centre | Recruiting |
Vancouver, British Columbia, Canada | |
Contact: Horacio Osiovich, MD 604-875-2135 hosiovich@cw.bc.ca | |
Principal Investigator: Horacio Osiovich, MD |
Principal Investigator: | Horacio Osiovich, MD | The University of British Columbia |
Responsible Party: | University of British Columbia ( Dr. Horacio Osiovich ) |
Study ID Numbers: | C05-0006 |
Study First Received: | July 28, 2006 |
Last Updated: | September 22, 2008 |
ClinicalTrials.gov Identifier: | NCT00358748 |
Health Authority: | Canada: Health Canada |
Preterm hypotension steroids hydrocortisone |
Body Weight Birth Weight Hypotension Signs and Symptoms |
Hydrocortisone Cortisol succinate Vascular Diseases Hydrocortisone acetate |
Anti-Inflammatory Agents Therapeutic Uses Cardiovascular Diseases Pharmacologic Actions |