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The AVERT Sepsis Investigation (AVERT)

This study has been completed.
Therapeutic Monitoring Systems
MaRS Discovery District, Government of Ontario
Information provided by (Responsible Party):
Christiana Care Health Services Identifier:
First received: October 21, 2013
Last updated: July 6, 2016
Last verified: July 2016

The overall objective of this study is to utilize heart rate variability and respiratory rate variability in patients with sepsis to predict clinical deterioration and death.

Our specific objectives are:

  1. To study the ability of a change in composite variability (∆CVI) assessment to act as a prognostic aid in predicting disease progression in sepsis.
  2. To study the effect that standard resuscitation interventions will have on the direction and magnitude of ∆CVI in patients with sepsis.

B. Hypotheses H1: In the initial resuscitation of sepsis, a low or declining multi-parameter composite variability index (CVI) over 4 hours will predict a significant increase in the combined outcome of overt shock, organ dysfunction, and mortality.

H2: In the initial resuscitation of sepsis, low volume fluid resuscitation (<20 cc/kg) over 4 hours will be associated with a low or declining CVI.

Sepsis Severe Sepsis

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: The AVERT Sepsis Investigation: Assessment of Variability in Early Resuscitation and Treatment of Sepsis

Resource links provided by NLM:

Further study details as provided by Christiana Care Health Services:

Primary Outcome Measures:
  • Progressive organ failure [ Time Frame: 72 hours ]
    A. SOFA score increase by ≥ 1 from baseline B. Overt shock C. Mortality (all-cause, in-hospital)

Enrollment: 100
Study Start Date: August 2012
Study Completion Date: April 2015
Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
ED patients with suspected infection


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients admitted through the ED for suspected infection as primary reason for admission.

Inclusion Criteria:

  • 1. Antibiotics ordered or administered (as surrogate for suspected or confirmed infection as primary reason for hospital admission as determined by the primary team) 2. Serum lactate ≥ 2.0 mmol/L or transient hypotension (any systolic blood pressure < 100 mmHg).

    3. Identification within 12 hours of a qualifying lactate measurement or hypotension episode 4. Hospital admission planned for suspected infection as primary reasons for admission (per emergency medicine team).

Exclusion Criteria:

  • 1. Age < 18 years 2. Pregnancy 3. Non-sinus cardiac rhythm (atrial fibrillation, active pacemaker, SVT) 4. Evidence of Overt Shock upon enrollment:

    • Hypotension: SBP < 90 mmHg for ≥ 60 minutes
    • Any vasopressor or inotrope use (e.g. norepinephrine, dopamine, vasopressin, dobutamine) 5. Acute respiratory support (BiPAP or mechanical ventilation) before enrollment 6. Inability to obtain written informed consent from patient or legally authorized representative 7. Inability to wear Zephyr Bioharness device
  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: NCT01968746

United States, Colorado
Denver Health Medical Center
Denver, Colorado, United States, 80204
United States, Delaware
Christiana Health System
Newark, Delaware, United States, 19718
United States, Montana
Billings Clinic
Billings, Montana, United States, 59101
United States, New Jersey
Cooper University Hospital
Camden, New Jersey, United States, 08103
Canada, Ontario
The Ottawa Hospital
Ottawa, Ontario, Canada
Sponsors and Collaborators
Christiana Care Health Services
Therapeutic Monitoring Systems
MaRS Discovery District, Government of Ontario
Principal Investigator: Ryan Arnold, MD Christiana Care Health Services
Study Chair: Andrew JE Seely, MD, PhD Ottawa Hospital
  More Information

Responsible Party: Christiana Care Health Services Identifier: NCT01968746     History of Changes
Other Study ID Numbers: 602039
Study First Received: October 21, 2013
Last Updated: July 6, 2016

Keywords provided by Christiana Care Health Services:

Additional relevant MeSH terms:
Systemic Inflammatory Response Syndrome
Pathologic Processes processed this record on September 21, 2017