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L-citrulline Supplementation During Sepsis

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified September 2010 by Maastricht University Medical Center.
Recruitment status was:  Not yet recruiting
ZonMw: The Netherlands Organisation for Health Research and Development
Information provided by:
Maastricht University Medical Center Identifier:
First received: February 26, 2008
Last updated: September 2, 2010
Last verified: September 2010
The purpose of this study is to study the stimulating effects of prolonged (8h) enteral L-citrulline supplementation on the normalisation of the plasma citrulline concentrations and the Arginine-NO metabolism, the microcirculation, the systemic hemodynamics, vascular permeability, and organ function and disease severity scores.

Condition Intervention Phase
Sepsis Multiple Organ Failure Dietary Supplement: L-citrulline supplementation Dietary Supplement: L-alanine Phase 3

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Arginine and Nitric Oxide (NO) Metabolism in Sepsis; L-citrulline Enteral Supplementation for the Normalisation of the Arginine-NO Metabolism

Resource links provided by NLM:

Further study details as provided by Maastricht University Medical Center:

Primary Outcome Measures:
  • To study stimulating effects of prolonged (8h) enteral L-citrulline supplementation on the normalisation of the arginine-NO metabolism [ Time Frame: 8 hours ]

Secondary Outcome Measures:
  • Secondary study endpoints are the microcirculation, the vascular permeability and organ function scores. [ Time Frame: within 8 hours ]

Estimated Enrollment: 48
Study Start Date: January 2011
Estimated Study Completion Date: January 2013
Estimated Primary Completion Date: January 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: AA
24 ICU patients with severe sepsis will get a L-citrulline 8 h enteral supplementation.
Dietary Supplement: L-citrulline supplementation
L-citrulline, 1.8micromol/kg/min, during 8 hours continuously supplemented
Active Comparator: AB
24 ICU patients with severe sepsis will get an alternative isocaloric amino acid supplementation (L-alanine) during 8 hours
Dietary Supplement: L-alanine
L-alanine enteral infusion, isocaloric dosage (3.6 micromol/kg/min), during 8 hours, continuously supplemented

Detailed Description:
NO synthesis is compromised during sepsis through lack of arginine de novo synthesis and may thereby contribute to impaired microcirculation and organ dysfunction. Supplementation of L-citrulline in septic patients will increase NO production without increased arginase activity and these effects will be studied on arginine-NO metabolism,improved organ function, vascular permeability and microcirculation.

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

Inclusion Criteria:

  • Written informed consent from close relative
  • Age > 18 years
  • Patient meets the general criteria for severe sepsis or septic shock, diagnosed less than 48 h prior to study inclusion.
  • Patient must be relatively hemodynamically stable, defined as stable blood pressure (variation in mean arterial pressure <15 mm Hg) during 2h without necessity of increasing the vasopressor dose, inotropic support or rate of fluid administration.
  • Systemic arterial catheter in place with continuous pressure monitoring.
  • Patients in whom the clinician is prepared to provide full life support during the duration of the study

Exclusion Criteria:

  • Shock due to any cause other than sepsis (e.g. drug reaction or drug overdose, pulmonary embolus, burn injury etc.)
  • Prolonged or high dose corticosteroid use
  • Liver cirrhosis
  • Chronic pancreatitis
  • Insulin-dependent diabetes mellitus
  • Metastases, haematological malignancies or chemotherapy
  • Patients on dialysis (CVVH or other)
  • Pre-existent renal failure (on dialysis)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00628381

Contact: Nina Wijnands, MD, PhD-student +31-43-3884502
Contact: Martijn Poeze, MD, PhD +31-43-3874425

University Hospital Maastricht Not yet recruiting
Maastricht, Limburg, Netherlands, 6202 AZ
Contact: Martijn Poeze, MD, PhD    +31-43 3876543   
Contact: Nina Wijnands, MD, PhD-student    +31-43-3884502   
Sponsors and Collaborators
Maastricht University Medical Center
ZonMw: The Netherlands Organisation for Health Research and Development
Principal Investigator: Martijn Poeze, MD, PhD Department of Surgery
  More Information

Responsible Party: M.Poeze, MD, PhD,, Department of surgery, University hospital Maastricht Identifier: NCT00628381     History of Changes
Other Study ID Numbers: MEC-08
ZON/NW 40-00806-98-114
Study First Received: February 26, 2008
Last Updated: September 2, 2010

Keywords provided by Maastricht University Medical Center:
nitric oxide

Additional relevant MeSH terms:
Multiple Organ Failure
Systemic Inflammatory Response Syndrome
Pathologic Processes
Nitric Oxide
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Free Radical Scavengers
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Endothelium-Dependent Relaxing Factors
Vasodilator Agents
Protective Agents processed this record on August 23, 2017