Acute Respiratory Distress Syndrome
Conditions
Keywords
COVID-19, Diffuse Alveolar Damage, DAD, Acute Respiratory Distress Syndrome, ARDS, NOA-001, Hemoperfusion
Brief summary
The primary object of this clinical study is to investigate the efficacy and the safety of NOA-001 in patients with ARDS (ARDS caused by Non-COVID-19 or COVID-19).
Detailed description
(ARDS caused by Non-COVID-19 cohort): The objectives of this clinical study is to investigate the efficacy and safety of NOA-001 in patients with ARDS caused by Non-COVID-19. The number of patients enrolled is 30 (20 patients in the NOA-001 group and 10 patients in the standard therapy group). (ARDS caused by COVID-19 cohort): The objectives of this clinical study is to investigate the efficacy and the safety of NOA-001 in patients with ARDS caused by COVID-19. The number of patients enrolled is 15 (in the NOA-001 group only).
Interventions
DEVICENOA-001
NOA-001 will be replaced regularly (at 22 to 24 hours after the initiation of procedure), and will be continuously performed until 168 hours from the enrollment.
Sponsors
Toray Industries, Inc
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(ARDS caused by Non-COVID-19 cohort) Inclusion Criteria: At Informed Consent 1. Patients with ARDS confirmed by the Berlin definition based on the following diagnostic criteria (a)-(d): 1. Patients within 7 days from invasion or exacerbation of respiratory symptoms or acute onset of ARDS. 2. Patients with respiratory failure not fully explained by cardiac failure or fluid overload; Need objective assessment (e. g., echo-cardiography) to exclude hydrostatic edema if no risk factor present 3. Patients with bilateral opacities not fully explained by effusions, lobar/ lung collapse, or nodules on chest X-ray or CT scan 4. Patients with PaO2/ FiO2 ratio ≤ 300 mmHg (PEEP ≥ 5 cmH2O) 2. Patients who are intubated and mechanically ventilated 3. Patients who can be enrolled in the study within 96 hours after initiation of mechanical ventilation 4. Patients aged ≥ 16 years at informed consent (Signed informed consent form from legally acceptable representative must be available if patient is aged \< 20 years) At Enrollment 1. Patients with PaO2/ FiO2 ratio ≥ 50 mmHg and ≤ 200 mmHg (PEEP ≥ 5 cmH2O) 2. Patients with bilateral opacities not fully explained by effusions, lobar/ lung collapse, or nodules on CT scan within 48 hours before enrollment 3. Patients who are intubated and mechanically ventilated 4. Patients who can be enrolled in the study within 96 hours after initiation of mechanical ventilation
Exclusion criteria
At Informed Consent 1. Patients who are considered to be extremely unlikely to withdraw from mechanical ventilation 2. Patients who are treated with ECMO or HFOV 3. Patients with renal dialysis therapy for chronic renal failure 4. Patients with congestive heart failure (NYHA class IV) 5. Patients with acuter left ventricular failure 6. Patients with liver failure (Child-Pugh grade C) 7. Patients who have burns in excess of 15% total body surface area 8. Patients after resuscitation from cardiac arrest 9. Patients with a history of hypersensitivity to the anticoagulants (Heparin or Nafamostat mesylate) 10. Patients who have received cytapheresis, blood purification therapy with cytokine adsorbing devices or endotoxin removal therapy within 7 days prior to informed consent 11. Patients with pregnancy or lactating 12. Patients tested positive for COVID-19 At Enrollment 1. Patients who are considered to be extremely unlikely to withdraw from mechanical ventilation 2. Patients who are treated with ECMO or HFOV after obtaining informed consent prior to enrollment 3. Patients with platelet count ≤ 50,000 /mm3 by the latest blood test 4. Patients who have received cytapheresis, blood purification therapy with cytokine adsorbing devices or endotoxin removal therapy between informed consent and enrollment 5. Patients whose life expectancy is ≤ 24 hours after enrollment 6. Patients after resuscitation from cardiac arrest between informed consent and enrollment 7. Patients tested positive for COVID-19 between informed consent and enrollment (ARDS caused by COVID-19 cohort) Inclusion Criteria: At Informed Consent 1. Patients tested positive for COVID-19 2. Patients with ARDS confirmed by the Berlin definition based on the following diagnostic criteria (a)-(d): 1. Patients within 7 days from invasion or exacerbation of respiratory symptoms or acute onset of ARDS. 2. Patients with respiratory failure not fully explained by cardiac failure or fluid overload; Need objective assessment (e. g., echo-cardiography) to exclude hydrostatic edema if no risk factor present 3. Patients with bilateral opacities not fully explained by effusions, lobar/ lung collapse, or nodules on chest X-ray or CT scan 4. Patients with PaO2/ FiO2 ratio ≤ 300 mmHg (PEEP ≥ 5 cmH2O) 3. Patients who are intubated and mechanically ventilated 4. Patients who can be enrolled in the study within 96 hours after initiation of mechanical ventilation 5. Patients aged ≥ 16 years at informed consent (Signed informed consent form from legally acceptable representative must be available if patient is aged \< 20 years) At Enrollment 1. Patients with PaO2/ FiO2 ratio ≥ 50 mmHg and ≤ 200 mmHg (PEEP ≥ 5 cmH2O) 2. Patients who are intubated and mechanically ventilated 3. Patients who can be enrolled in the study within 96 hours after initiation of mechanical ventilation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ventilator Free Days (VFD, Days alive and ventilator-free) | Day 28 | VFD is a composite measure of all-cause mortality and the number of days free of mechanical ventilation (VFD) within 28 days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause Mortality | Up to Day 28, 60 and 90 | Fatalities, mortality all-causes |
| Mortality in ICU | Up to Day 28 | All-cause mortality for patients who died in Intensive Care Units. |
| Mortality in Hospital | Up to Day 28 | The number of patients who died in hospital |
| Changes in PaO2/ FiO2 ratio | Up to Day 28 | — |
Countries
Japan
Contacts
Primary ContactNOA-001 Team
Outcome results
None listed