RecruitingPhase 2ACTRN12621000247875

Assessing the Efficacy of Treatment with Vitamin C and Hydrocortisone in Children Admitted to Intensive Care Unit with Septic Shock.

Resuscitation in Paediatric Sepsis using Vitamin C and Hydrocortisone - A Randomized Controlled Multicentre Trial - assessing the effect on time alive and free of vasopressors


Sponsor

The University of Queensland

Enrollment

384 participants

Start Date

Dec 19, 2021

Study Type

Interventional

Conditions

Summary

Globally, a child dies from sepsis every 30 seconds. In Australia, one child dies every week, and many surviving children experience long term disability. We hypothesise that treatment of septic children with vitamin C and hydrocortisone will result in earlier shock resolution. We will perform a worldwide randomised controlled trial in paediatric sepsis which will test the use of Vitamin C (100 mg/kg 6 h) and Hydrocortisone (1 mg/kg 6 h) which has shown some promise in improving patient-centred outcomes in adults. The study will assess functional outcomes and quality of life, consumer engagement, and sepsis related costs. The wide dissemination of findings will increase awareness of sepsis and could save lives. In addition, we aim to establish a biobank of patient samples enrolled in the trial for sepsis biomarker studies.


Eligibility

Sex: Both males and femalesMin Age: 7 DayssMax Age: 17 Yearss

Plain Language Summary

Simplified for easier understanding

Sepsis — a life-threatening overreaction of the body to infection — kills a child somewhere in the world every 30 seconds. In children who survive, long-term disability is common. This worldwide clinical trial is testing whether giving children in intensive care with septic shock a combination of intravenous vitamin C and hydrocortisone (a steroid) can help the shock resolve faster and improve outcomes. This combination has shown some promise in adults with sepsis, and researchers believe it may work similarly in children. The trial will recruit children aged 7 days to 17 years who are admitted to a paediatric intensive care unit and are already on vasopressor or inotrope medications (drugs needed to maintain blood pressure in shock) for more than one hour. Children with G6PD deficiency, oxalate kidney problems, or malaria are excluded. The study will measure whether children who receive the treatment recover faster, have better physical function, and have improved quality of life after their illness — as well as tracking costs related to sepsis care. A biobank of samples will also be collected to help future research into understanding sepsis.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

Patients will be allocated in a 1:1:1 ratio to the RESPOND treatment groups. Arm 1 - Intervention 1 - Early intravenous resuscitation with Vitamin C and Hydrocortisone. After initial shock treatment

Patients will be allocated in a 1:1:1 ratio to the RESPOND treatment groups. Arm 1 - Intervention 1 - Early intravenous resuscitation with Vitamin C and Hydrocortisone. After initial shock treatment including fluids and a first intravenous inotrope, patients then receive concomitant treatment with Vitamin C and Hydrocortisone. Ascorbic acid (Vitamin C): the dosing schedule is 100 mg/kg (maximum 5,000 mg per dose) intravenously every 6 hours for the duration of study treatment and will be infused over 60 minutes. Hydrocortisone: The dosing schedule is 1 mg/kg (maximum 50 mg per dose) intravenously infused over 5 minutes every 6 hours for the duration of study treatment given as a slow bolus. Arm 2 - Intervention 2 - Hydrocortisone only. Hydrocortisone: the dosing schedule is 1mg/kg (maximum 50 mg per dose) intravenously infused over 5 minutes every 6 hours for the duration of study treatment given as a slow bolus. All three arms will be monitored for adherence to interventions by a formal data monitoring and audit of the medication records. Duration of treatment After shock resolution - defined as cessation of inotropes for at least 4 hours - or after a maximum of 72hours study drugs should be ceased. The treatment will continue until (whichever occurs first): - Septic shock resolves defined as ability to cease inotropes for less than 4 hours with good perfusion and no signs of shock. - 72 hours of treatment has been administered - The patient is discharged from ICU - Contraindications to Vitamin C or Hydrocortisone therapy arise - Death occurs - Serious adverse events suspected to be secondary to the intervention therapy develop


Locations(15)

Queensland Children's Hospital - South Brisbane

NSW,QLD,SA,WA,VIC, Australia

Gold Coast University Hospital - Southport

NSW,QLD,SA,WA,VIC, Australia

Sunshine Coast University Hospital - Birtinya

NSW,QLD,SA,WA,VIC, Australia

Perth Children's Hospital - Nedlands

NSW,QLD,SA,WA,VIC, Australia

Womens and Childrens Hospital - North Adelaide

NSW,QLD,SA,WA,VIC, Australia

Sydney Children's Hospital - Randwick

NSW,QLD,SA,WA,VIC, Australia

The Children's Hospital at Westmead - Westmead

NSW,QLD,SA,WA,VIC, Australia

The Royal Childrens Hospital - Parkville

NSW,QLD,SA,WA,VIC, Australia

Auckland, New Zealand

Chonnan, Korea, Republic Of

São Paulo, Brazil

Porto Alegre, Brazil

Chandigarh, India

Vellore, India

Bangalore, India

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