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Trial registered on ANZCTR
Registration number
ACTRN12617001553369p
Ethics application status
Submitted, not yet approved
Date submitted
31/10/2017
Date registered
13/11/2017
Date last updated
20/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
The Effect of Intravenous Sodium Ascorbate on Secondary Brain Injury in a Cohort of Severe Traumatic Brain Injury patients: The Orange Concentrate Randomised Control Trial.
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Scientific title
A double-blinded pilot randomized control trial comparing the effect of intravenous vitamin C versus placebo on secondary neurological injury in a cohort of severe traumatic brain injury patients.
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Secondary ID [1]
293237
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none
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Universal Trial Number (UTN)
U1111-1204-3877
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Severe Traumatic Brain Injury
305281
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Condition category
Condition code
Injuries and Accidents
304590
304590
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0
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Other injuries and accidents
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Neurological
304591
304591
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: 3g Sodium Ascorbate in 100 ml 0.9% Saline solution intravenous infusion every 6 hours for 7 days
Arm 2: 6g Sodium Ascorbate in 100 ml 0.9% Saline intravenous infusion every 6 hours for 7 days
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Intervention code [1]
299495
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Treatment: Drugs
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Comparator / control treatment
100 ml 0.9% Saline every 6 hours for 7 days
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Protocol adherence rate assessed by review of medication charts and patient records
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Assessment method [1]
303808
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Timepoint [1]
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daily for 7 days
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Primary outcome [2]
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Protocol enrolment rate - total number of enrolled patients versus total number of suitable but not enrolled patients admitted to the unit over the 12 month period of study.
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Assessment method [2]
303827
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Timepoint [2]
303827
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daily over the 12 month period of the trial.
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Secondary outcome [1]
340207
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Change in serum concentration of Neuron-Specific Enolase
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Assessment method [1]
340207
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Timepoint [1]
340207
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every second day for 7 days
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Secondary outcome [2]
340208
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ICU length of stay assessed by review of patient and ICU records
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Assessment method [2]
340208
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Timepoint [2]
340208
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total number of days by day 28.
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Secondary outcome [3]
340230
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Continuous EEG seizure activity (seizure episodes per day)
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Assessment method [3]
340230
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Timepoint [3]
340230
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daily for 7 days
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Secondary outcome [4]
340312
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Change in serum concentration of S100B
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Assessment method [4]
340312
0
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Timepoint [4]
340312
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every second day for 7 days
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Eligibility
Key inclusion criteria
Non-penetrating Severe Traumatic Brain Injury (GCS 8 or lower)
Predicted to require at least 48 hrs of mechanical ventilatory support in ICU.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Chronic Renal Impairment (eGFR less than 90)
Glucose-6-Phosphate Dehydrogenase Deficiency
Current Pregancy
Moribund/not expected to survive for more than 48 hrs
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised generated sequence
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Pilot study.
Total enrolment target: 24 (8 in each group)
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
8/01/2018
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Actual
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Date of last participant enrolment
Anticipated
8/01/2019
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Actual
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Date of last data collection
Anticipated
14/03/2019
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
9294
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment postcode(s) [1]
17959
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3050 - Parkville
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Funding & Sponsors
Funding source category [1]
297866
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Hospital
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Name [1]
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Royal Melbourne Hospital Intensive Care Research Fund
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Address [1]
297866
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Royal Melbourne Hospital
Department of Intensive Care
300 Grattan Street
Parksville, Victoria 3050
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Country [1]
297866
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Australia
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Primary sponsor type
Individual
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Name
Professor Rinaldo Bellomo
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Address
Royal Melbourne Hospital
Department of Intensive Care
300 Grattan Street
Parksville, Victoria 3050
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Country
Australia
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Secondary sponsor category [1]
296911
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None
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Name [1]
296911
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Address [1]
296911
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Country [1]
296911
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
298917
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
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Office for Research Level 2 South West 300 Grattan Street Parkville, Victoria, 3050
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Ethics committee country [1]
298917
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Australia
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Date submitted for ethics approval [1]
298917
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29/11/2017
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Approval date [1]
298917
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Ethics approval number [1]
298917
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Summary
Brief summary
In response to the onset of significant inflammatory signalling following severe traumatic brain injury, ascorbate (vitamin C) concentrations rapidly fall to levels associated with severe deficiency. Without replacement, the ascorbate levels remain reduced for the duration of the inflammatory response. There is mounting evidence that replacing ascorbate plasma levels during an inflammatory response may be beneficial, particularly to the brain. Ascorbate is known to be an essential co-factor in several brain metabolic processes. These processes include reducing oxidative stress, maintaining microcirculatory homeostasis and maintaining normalm function of several key enzyme systems, including endothelial nitric oxide synthase (eNOS). In addition, ascorbate is involved in brain energy production, and is required for the production of a significant number of neurotransmitters. It is clear from multiple animal and human studies that deficiency in ascorbate leads to a pro-inflammatory state and worsening organ failure. In response to traumatic brain injury, brain ascorbate levels fall markedly in line with body concentrations. The magnitude of plasma level ascorbate decrease, which often reaches levels associated with scurvy in critical illness, has been shown to correlate with severity of both neurological injury and more general injury severity. Ascorbate supplementation has been shown to reduce the severity of secondary brain injury in multiple animal studies. There is a need to further evaluate the role of intravenous sodium ascorbate in the setting of human brain injury. To this end the authors propose to conduct a small feasibility study in the Australian setting to establish the efficacy of the proposed intervention and to evaluate the effect of intravenous sodium ascorbate on patients suffering from severe traumatic brain injury.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Adam Deane
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Address
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Royal Melbourne Hospital
Department of Intensive Care
Level 6
B Building
300 Grattan Street
Parkville, Victoria, 3050
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Country
78638
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Australia
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Phone
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+61 3 9342 9100
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Fax
78638
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Email
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adam.deane.mh.org.au
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Contact person for public queries
Name
78639
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Adam Deane
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Address
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Royal Melbourne Hospital
Department of Intensive Care
Level 6
B Building
300 Grattan Street
Parkville, Victoria, 3050
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Country
78639
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Australia
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Phone
78639
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+61 3 9342 9100
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Fax
78639
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Email
78639
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[email protected]
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Contact person for scientific queries
Name
78640
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Robert McNamara
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Address
78640
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Royal Melbourne Hospital
Department of Intensive Care
Level 6
B Building
300 Grattan Street
Parkville, Victoria, 3050
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Country
78640
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Australia
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Phone
78640
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+61427534453
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Fax
78640
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Email
78640
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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