Home » Trials » SLCTR/2014/005


A randomized placebo controlled trial on the effect of insulin in reducing skeletal muscle reperfusion injury.

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SLCTR Registration Number

SLCTR/2014/005


Date of Registration

21 Feb 2014

The date of last modification

Mar 03, 2019



Application Summary


Scientific Title of Trial

A randomized placebo controlled trial on the effect of insulin in reducing skeletal muscle reperfusion injury.


Public Title of Trial

Study to assess the impact of insulin on reperfusion injury after skeletal muscle ischaemia


Disease or Health Condition(s) Studied

Reperfusion injury


Scientific Acronym

None


Public Acronym

None


Brief title

None


Universal Trial Number

None


Any other number(s) assigned to the trial and issuing authority

EC-11-166 (Ethics Review Committee of the Faculty of Medicine, University of Colombo)


Trial Details


What is the research question being addressed?

What is the effect of insulin in reducing skeletal muscle reperfusion injury?


Type of study

Interventional


Study design

Allocation

Randomized controlled trial


Masking

Single blinded


Control

Placebo


Assignment

Parallel


Purpose

Prevention


Study Phase

Phase 2


Intervention(s) planned

Consenting participants will be randomized into two arms.

The intervention arm will receive at the point of diagnosis a glucose-insulin-potassium (GIK) infusion (40 mmol KCl, in 1 liter of 10% dextrose at 60 ml/hr and human regular insulin [Novo Nordisk Pharmaceuticals] at 2.5 U/hr separately) until 12 hours post-reperfusion. GIK infusions will be titrated to maintain glucose between 80 and 180 mg/dl by hourly capillary blood sugar measurements via a standardized single glucometer. The potassium levels are to be maintained between 4 and 5 mmol/L. The range of glucose and potassium aforementioned are devised according to standard guidelines

Participants of the control arm will receive 1L normal saline at 60 ml/hr until 24 hours post-reperfusion.

Other supportive therapy will continue as indicated for both arms.


Inclusion criteria

  1. Patients undergoing a vascular surgical intervention requiring clamping of aortic / iliac or femoral blood vessels for more than 30 minutes duration and/or
  2. Patients with acute limb ischaemia, (Class ll Acute Limb Ischaemia, Society for Vascular Surgery) needing revascularization.

Exclusion criteria

  1. Patients with any of the following. a) Insulin-treated diabetes mellitus b) glucocorticoid treatment c) systemic infection d) congestive heart failure.
  2. Patients for whom amputation rather than revascularization is indicated.
  3. Patients below the age of 18 years


Primary outcome(s)

1.

Absolute difference from baseline (pre perfusion) concentration of 1. Tumour Necrosis Factor (TNF)-alpha
2. Myeloperoxidase
3. Soluble P- Selectin
4. Serum Potassium
5. Serum Lactate Dehydrogenase
6. Serum Creatinephosphokinase
7. C-Reactive Protein

[

Pre perfusion (baseline) and post-perfusion at 0, +2, +4, +6, +12 hours post-reperfusion

]

Secondary outcome(s)

1.
  1. Non cardiogenic pulmonary oedema determined by the presence of dyspnoea, orthopnoea, bi-basal lung fine crepitations

  2. Acute tubular necrosis determined by the presence of oliguric renal failure despite adequate hydration with elevated serum creatine and urea

  3. Compartment pressures via compartment pressure manometry when clinically determined. Clinical evidence of compartment syndrome includes assessment of colour, warmth, pulses, sensation and muscle weakness)

  4. Fasciotomy

  5. Major amputation

  6. Death

[

at 48 hours post reperfusion

]

Target number/sample size

24


Countries of recruitment

Sri Lanka


Anticipated start date

2014-04-01


Anticipated end date

2015-04-01


Date of first enrollment


Date of study completion


Recruitment status

Pending


Funding source

None


Regulatory approvals



State of Ethics Review Approval


Status

Approved


Date of Approval

2012-01-19


Approval number

EC-11-166


Details of Ethics Review Committee

Name: Ethics Review Committee, Faculty of Medicine, University of Colombo
Institutional Address:No. 25, Kynsey Road, Colombo 00800 Sri Lanka
Telephone:+94-11-2695300 (Extension: 240)
Email: ethicscommitteemfc@gmail.com

Contact & Sponsor Information


Contact person for Scientific Queries/Principal Investigator

Dr. Thushan Gooneratne
Registrar in Surgery
Postgraduate Institute of Medicine No. 160, Norris Canal Road Colombo 7

0094772004092

thushey@hotmail.com

Contact Person for Public Queries

Prof. Mandika Wijeyaratne
Professor in Surgery
Professorial Surgical Unit National Hospital of Sri Lanka
009411-2691111


mandika59@hotmail.com


Primary study sponsor/organization

Professorial Surgical Unit

National Hospital of Sri Lanka Colombo 10
+9411-2691111


http://www.nationalhospital.lk

Secondary study sponsor (If any)

None





Trial Completion details


Do the investigators plan to share identified individual clinical trial participant-level data (IPD)?


IPD sharing plan description


Study protocol available


Protocol version and date

Not Available


Protocol URL

Not Available


Results summary available

No


Date of posting results


Date of study completion


Final sample size


Date of first publication


Link to results


Brief summary of results