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Extracorporeal Ultrafiltration (UF) vs. Usual and Customary Care for Patients With Severe Heart Failure (HF)

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ClinicalTrials.gov Identifier: NCT00288587
Recruitment Status : Completed
First Posted : February 8, 2006
Results First Posted : June 19, 2012
Last Update Posted : June 19, 2012
Sponsor:
Information provided by (Responsible Party):
NxStage Medical

Brief Summary:
The purpose of this study is to assess the ability of Ultrafiltration to influence the rate of hemodynamic improvement, as measured by the decline in the pulmonary artery occlusion pressure, in patients with NYHA class III/IV Heart Failure.

Condition or disease Intervention/treatment Phase
Heart Failure CHF Drug: IV loop diuretic Device: NxStage System One Phase 4

Detailed Description:
This study will be preformed in a specialized heart failure unit at the Cleveland Clinic Foundation (CCF) and will include both the UF-treated group and a control group receiving usual and customary care. Patients will be stratified according to renal function at the time of admission. Therapies will be guided by specific hemodynamic criteria routinely used at the study institution.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 36 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: CP0007: Extracorporeal Ultrafiltration (UF) vs. Usual and Customary Care for Patients With Severe Heart Failure (HF)
Study Start Date : October 2003
Actual Primary Completion Date : September 2008
Actual Study Completion Date : January 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure
U.S. FDA Resources

Arm Intervention/treatment
Active Comparator: Ultrafiltration
Patients treated with Extracorporeal Ultrafiltration upon hospital admission for treatment of decompensated heart failure.
Device: NxStage System One
Patients treated with Extracorporeal Ultrafiltration upon hospital admission for treatment of decompensated heart failure.
Active Comparator: Usual & Customary
Patients treated with conventional diuretic therapy upon hospital admission for treatment of decompensated heart failure.
Drug: IV loop diuretic
Use of conventional diuretic therapy upon hospital admission for treatment of decompensated heart failure.



Primary Outcome Measures :
  1. Time Required for the Pulmonary Artery Occlusion Pressure (PAOP) to be Maintained at a Value of Less Than or Equal to 18 mmHg for at Least Four Consecutive Hours (+/- 30 Minutes) During the Intervention Period. [ Time Frame: 4 consecutive hours (+/- 30 minutes) ]

Secondary Outcome Measures :
  1. Time to Discharge From the Heart Failure (HF) Unit, and Time to Discharge From the Hospital. [ Time Frame: Time from admission to endpoint achievement ]
  2. Total Volume Removal During the Intervention Period [ Time Frame: Intervention start to end. ]
  3. Volume Removal Rate. [ Time Frame: Intervention start to end. ]
    Hours of therapy required to remove 1 liter of fluid normalized to body weight.

  4. Composite Endpoint of Hospital Readmissions, Emergency Department Visits, and Deaths [ Time Frame: Hospital discharge to 90 days after discharge ]
    Number of patients experiencing at least one of the composite endpoint measures within 90 days of hospital discharge.



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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Admitted to Heart Failure Unit (H-22) with NYHA class III/IV HF and pulmonary artery catheter in situ
  • Left ventricular ejection fraction <40%
  • Mean Pulmonary Artery Occlusion Pressure ≥20 mm Hg
  • Able to give informed consent

Exclusion Criteria:

  • Currently on renal replacement therapy or determined to need renal replacement therapy at the time of enrollment
  • Estimated glomerular filtration rate (GFR) <15 mL/min
  • Systolic blood pressure (SBP) <80 mm Hg
  • Acute coronary syndrome
  • Hematocrit >50%
  • Malignancy other than prostrate or skin
  • Chronic edematous states other than HF, including nephritic syndrome and cirrhosis
  • Chronic inflammatory or infectious condition
  • Pregnancy
  • Previous enrollment in this study
  • Expectation of need for heart transplantation or cardiac assist device within one week
  • Pulmonary failure requiring intubation and mechanical ventilation
  • Known or suspected hypersensitivity to dialysis membranes
  • Severe aortic stenosis or regurgitation
  • Severe mitral stenosis

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00288587


Locations
United States, Ohio
The Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
Sponsors and Collaborators
NxStage Medical
Investigators
Study Director: Alan Hull, MD NxStage Medical

Publications of Results:
Responsible Party: NxStage Medical
ClinicalTrials.gov Identifier: NCT00288587     History of Changes
Other Study ID Numbers: CP0007
First Posted: February 8, 2006    Key Record Dates
Results First Posted: June 19, 2012
Last Update Posted: June 19, 2012
Last Verified: May 2012

Keywords provided by NxStage Medical:
Heart Failure
Congestive Heart Failure
CHF

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases
Diuretics
Sodium Potassium Chloride Symporter Inhibitors
Natriuretic Agents
Physiological Effects of Drugs
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action