Impact of Aspirin Use on the Severity of Organ Dysfunctions in Patients With Sepsis and Septic Shock: a Randomized, Double-blind, Placebo-controlled Trial - ASP-SEPSIS.
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 发起方
- 入组人数
- 167
- 试验地点
- 1
- 主要终点
- Difference between the Sequential Organ Failure Assessment (SOFA) Score on the seventh day of ICU stay and baseline (DeltaSOFA D7-D1).
研究概览
简要总结
This Randomized, pragmatic, multicentric with blinding of patients and health professionals, intention-to-treat analysis has by primary endpoint to evaluate whether the aspirin use reduces the intensity of organic dysfunction measured by the variation of the SOFA score starting from the day of admission to the seventh day. Secundary endpoint: To evaluate if the aspirin use reduces the time of mechanical ventilation, length of stay in the ICU and in the hospital. In addition, to evaluate the safety of its administration regarding the occurrence of bleeding.
The data will be collected directly from the chart of the patients admitted to the ICU.
Data quality assurance will be made through periodic verification, aiming for complete and consistent data. The centers will receive periodic reports for adequacy of potentially inconsistent or incomplete data.
The baseline SOFA of patients with sepsis is 8.8 with a standard deviation of 3. The expected reduction in the control group in the SOFA at day 7 is 2 points. Considering a power of 80% and a level of significance of 0.05, it is estimated that 109 patients will be needed in each group. A total of 218 patients will compose the sample.
All analyzes will follow the intention-to-treat principle. We will evaluate the effect of aspirin compared to placebo on primary and binary outcomes by means of relative risks, 95% confidence intervals and chi-square tests. For continuous outcomes with normal distribution, we will present the mean difference, 95% confidence interval and P value calculated by t test. For continuous outcomes with asymmetric distribution, we will perform Wilcoxon test.
详细描述
Design Randomized, pragmatic, multicentric with blinding of patients and health professionals.
Bias control Allocation secrecy with web randomization. Blinding of patients and health professionals. Intention-to-treat analysis.
Primary endpoint To evaluate whether the aspirin use reduces the intensity of organic dysfunction measured by the variation of the SOFA score starting from the day of admission to the seventh day.
Secondary endpoint To evaluate if the aspirin use reduces the time of mechanical ventilation, time with vasopressors, time in renal replacement therapy, length of stay in the ICU and in the hospital. In addition, to evaluate the safety of its administration regarding the occurrence of bleeding.
Eligibility
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
placebo
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- •Impossibility to use the intestinal tract
- •Death perspective in less than 24 hours
- •Patients in the end of their lives or in exclusive palliative care
- •Patients with active bleeding
- •Prior study participation
- •Known allergy to aspirin
- •Active peptic ulcer
- •Previous use of antiplatelet agents in the last 7 days
- •Previous use of AINEs in the last 7 days, except for dipyrone.
- •Hemorrhagic stroke in the last 7 days or central nervous system surgery in the last 72 hours.
- •Platelets <30,000 cells/mm
- •Large surgery in the last 24 hours if the attending surgeon judges that the risk of bleeding is high enough that aspirin cannot be used.
- •Ophthalmologic surgery postoperative and transurethral resection of the prostate at the discretion of the attending physician.
- •Hepatic cirrhosis or previous liver disease with altered prothrombin activity, manifested by INR above 2.0 or other previous coagulopathies.
- •Severe head injury in the last 7 days.
- •Use or indication of anticoagulation
研究组 & 干预措施
Placebo
Placebo 1tb / day/ 7days
干预措施: Aspirin (Drug)
Aspirin
Intervention aspirin 200 mg/day for 7 days
干预措施: Aspirin (Drug)
结局指标
主要结局
Difference between the Sequential Organ Failure Assessment (SOFA) Score on the seventh day of ICU stay and baseline (DeltaSOFA D7-D1).
时间窗: 7 days
To evaluate whether the aspirin use reduces the intensity of organic dysfunction. measured by the variation of the SOFA score starting from the day of admission to the seventh day. The Sequential Organ Failure Assessment (SOFA) Score ranges between 0 and 24.
次要结局
- Vasopressor free days(28 days)
- Mechanical ventilation free days;(28 days)
- Hospital free days(28 days)
- Intensive Care Unit (ICU) free days(28 days)
- Renal replacement therapy(28 days)
研究者
Flavia Ribeiro Machado
Professor of Intensive Care Medicine
Federal University of São Paulo
