Cytokine REmoval in CRitically Ill PAtients Requiring Surgical Therapy for Infective Endocarditis (RECReATE)

Last updated: November 7, 2024
Sponsor: Insel Gruppe AG, University Hospital Bern
Overall Status: Active - Recruiting

Phase

N/A

Condition

Heart Disease

Sepsis And Septicemia

Low Blood Pressure (Hypotension)

Treatment

Treatment protocol with adsorption

Clinical Study ID

NCT03892174
RECREATE
  • Ages > 18
  • All Genders

Study Summary

Infectious endocarditis (IE) and other severe infections are well-known to induce significant changes in the immune response including immune functionality in a considerable number of affected patients. In fact, numerous patients with IE develop a persistent functional immunological phenotype that can best be characterized by a profound anti-inflammation and/or functional anergy. This was previously referred to as "injury-associated immunosuppression (IAI)" by Pfortmüller et al., published in Intensive Care Medicine Experimental 2017. IAI can be assessed by measurement of cellular (functional) markers. Persistence of IAI is associated with prolonged ICU length of stay, increased secondary infection rates, and death. Immunomodulation to reverse IAI was shown beneficial in immunostimulatory (randomized controlled) clinical trials. CytoSorb® treatment is currently used as standard of care in some institutions in surgically treated IE patients. The investigators aim to investigate two accepted treatment protocols and aim to explore whether adsorption with a cytokine adsorption filter can increase immune competence in treated individuals.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Subjects scheduled for routine cardiac surgery for infectious endocarditis (diagnosed according to the predefined "DUKE" criteria) with antibiotic therapy for ≤ 14 days.

  • Presence of informed consent

  • Age ≥18 yrs.

Exclusion

Exclusion Criteria:

  • Previous treatment (last 6 months) with immunologically-active biologicals orspecific immunomodulatory drugs (e.g. Rituximab)

  • high-dose chronic (i.e. before onset of infectious endocarditis) steroid medicationwith prednisone equivalent of >30 mg/d

  • Patients on Extracorporeal membrane oxygenation (ECMO), or any other (pre-operative)cardiac assist device

  • Moribund patient (life expectancy <14 days)

Study Design

Total Participants: 54
Treatment Group(s): 1
Primary Treatment: Treatment protocol with adsorption
Phase:
Study Start date:
November 14, 2019
Estimated Completion Date:
December 31, 2024

Connect with a study center

  • Dept of Intensive Care Medicine

    Bern, 3010
    Switzerland

    Active - Recruiting

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