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    Clinical Trial Results:
    Balanced 6 % HES 130/0.4 vs. balanced crystalloid-based infusion in patients undergoing colorectal surgery

    Summary
    EudraCT number
    2009-017595-25
    Trial protocol
    DE  
    Global end of trial date
    20 Apr 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    05 May 2016
    First version publication date
    05 May 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    04-AnIt-09/UKM09_0031
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01303250
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    University HospitalMuenster
    Sponsor organisation address
    Albert-Schweitzer-Campus 1, D5, Münster, Germany, 48149
    Public contact
    Dept. of Anaesthesiology, University Hospital Muenster, +49 25183-47267, wempe-c@anit.uni-muenster.de
    Scientific contact
    Dept. of Anaesthesiology, University Hospital Muenster, +49 25183-47267, wempe-c@anit.uni-muenster.de
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    01 Feb 2016
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    29 May 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    20 Apr 2015
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To compare two goal directed infusion therapies for patients undergoing open colorectal surgery with Volulyte (colloid treatment group) or Jonosteril (crystalloid control group). Comparison between the two groups will be based on the amount of fluids (mL) required to achieve hemodynamic stabilization.
    Protection of trial subjects
    At the screening visit the patients who were considered potential candidates for the study were asked to provide a written informed consent. The patients were informed in writing about their right to withdraw from the study at any time without specification of reasons. Written patient information was given to each patient before enrolment. Patients could only participate if their eligibility had been proven. The study could also be terminated prematurely for medical or ethical reasons following consultation with the investigators. Patients who were withdrawn due to one or more (serious) AEs were to be treated and followed-up according to established medical practice to evaluate the course of the AE, and to ensure reversibility or stabilisation of the event.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    11 Apr 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 29
    Worldwide total number of subjects
    29
    EEA total number of subjects
    29
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    20
    From 65 to 84 years
    9
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Patients were recruited from April 2011 (First Patient In) until May 2013 and followed up until May 2013 (Last Patient Out).

    Pre-assignment
    Screening details
    In total 233 patients were screened.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Volulyte 6 % Arm
    Arm description
    6% Hydroxyethylstarch (HES) 130/0.4 i.v.
    Arm type
    Experimental

    Investigational medicinal product name
    Volulyte 6% Solution for Infusion
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The investigational drug Volulyte was administrated on day of surgery. Intraoperatively fluid administration and optimization based on cardiac output findings during surgery. Postoperative volume requirement and blood loss were compensated with Volulyte. The maximum dosage was 50 mL/kg body weight / day.The maximum dosage was 50 mL/kg body weight / day.

    Arm title
    Balanced Crystalloid Arm
    Arm description
    Balanced Crystalloid
    Arm type
    Active comparator

    Investigational medicinal product name
    Jonosteril
    Investigational medicinal product code
    Other name
    Trade name: Jonosteril® Infusionslösung 500 ml
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The comparator Jonosteril was administrated on day of surgery. Intraoperatively fluid administration and optimization based on cardiac output findings during surgery. Postoperative volume requirement and blood loss were compensated with Jonosteril. The maximum dosage was 50 mL/kg body weight / day.

    Number of subjects in period 1
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Started
    14
    15
    Completed
    14
    15

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Volulyte 6 % Arm
    Reporting group description
    6% Hydroxyethylstarch (HES) 130/0.4 i.v.

    Reporting group title
    Balanced Crystalloid Arm
    Reporting group description
    Balanced Crystalloid

    Reporting group values
    Volulyte 6 % Arm Balanced Crystalloid Arm Total
    Number of subjects
    14 15 29
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    10 10 20
        From 65-84 years
    4 5 9
        85 years and over
    0 0 0
        18-64 years
    0 0 0
        from 65 - 84 years
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    52.79 ( 19.96 ) 48.93 ( 19.96 ) -
    Gender categorical
    Units: Subjects
        Female
    10 8 18
        Male
    4 7 11
    Height
    Units: cm
        arithmetic mean (standard deviation)
    175.4 ( 9.4 ) 177.1 ( 8.9 ) -
    Weight
    Units: kg
        arithmetic mean (standard deviation)
    85 ( 20.2 ) 83.5 ( 14.3 ) -
    Body Mass Index
    Units: kg/m²
        arithmetic mean (standard deviation)
    27.4 ( 5.1 ) 26.8 ( 5 ) -

    End points

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    End points reporting groups
    Reporting group title
    Volulyte 6 % Arm
    Reporting group description
    6% Hydroxyethylstarch (HES) 130/0.4 i.v.

    Reporting group title
    Balanced Crystalloid Arm
    Reporting group description
    Balanced Crystalloid

    Primary: Total volume of fluid required intraoperatively

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    End point title
    Total volume of fluid required intraoperatively [1]
    End point description
    End point type
    Primary
    End point timeframe
    intraoperatively
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The study was terminated. Only 29 patients were randomised and analyzed. Therefore a confirmatoric analysis was not performed.
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    14
    15
    Units: ml
        arithmetic mean (standard deviation)
    2188 ( 977 )
    2414 ( 1110 )
    No statistical analyses for this end point

    Secondary: Total volume of study medication

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    End point title
    Total volume of study medication
    End point description
    End point type
    Secondary
    End point timeframe
    Study drug was used intraoperatively and postoperatively on surgery day
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    14
    15
    Units: ml
        arithmetic mean (standard deviation)
    1496 ( 565 )
    1517 ( 504 )
    No statistical analyses for this end point

    Secondary: Postoperative complications until day 28

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    End point title
    Postoperative complications until day 28
    End point description
    End point type
    Secondary
    End point timeframe
    From day of surgery until day 28 postoperatively
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    10
    11
    Units: number of subjects
        Woundhealing disturbance
    6
    8
        Dehiscences at the suture
    0
    1
        Anastomosis insufficiency
    1
    1
        Renal disease
    1
    1
        Infections
    1
    0
        Respiratoric complications
    1
    0
        Cardiac complications
    1
    0
        Miscellaneous complications
    1
    4
    No statistical analyses for this end point

    Secondary: Postoperative complications until day 90

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    End point title
    Postoperative complications until day 90
    End point description
    End point type
    Secondary
    End point timeframe
    From day of surgery until day 90 postoperatively
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    6
    7
    Units: Number of patients
        Wound healing disturbances
    1
    2
        Miscelleanous disturbances
    3
    3
    No statistical analyses for this end point

    Secondary: Occurance of PONV (Postoperative Nausea and Vomiting)

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    End point title
    Occurance of PONV (Postoperative Nausea and Vomiting)
    End point description
    End point type
    Secondary
    End point timeframe
    Day of Surgery
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    14
    15
    Units: Number of patients
    5
    7
    No statistical analyses for this end point

    Secondary: Estimated length of stay in hospital

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    End point title
    Estimated length of stay in hospital
    End point description
    End point type
    Secondary
    End point timeframe
    From day of surgery until estimated length of stay in hospital
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    13
    15
    Units: days
        median (confidence interval 95%)
    10 (8 to 13)
    12 (7 to 14)
    No statistical analyses for this end point

    Other pre-specified: Total volume of fluid balance intraoperatively

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    End point title
    Total volume of fluid balance intraoperatively
    End point description
    End point type
    Other pre-specified
    End point timeframe
    interaoperatively
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    14
    15
    Units: ml
        arithmetic mean (standard deviation)
    1399 ( 680 )
    1732 ( 908 )
    No statistical analyses for this end point

    Other pre-specified: Difference of BUN

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    End point title
    Difference of BUN
    End point description
    Difference of blood urea nitrogen (BUN 1 day after surgery - BUN baseline)
    End point type
    Other pre-specified
    End point timeframe
    1 day after surgery
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    9
    9
    Units: mg/100 ml
        arithmetic mean (standard deviation)
    2.67 ( 8.02 )
    2.78 ( 6.67 )
    No statistical analyses for this end point

    Other pre-specified: urine production

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    End point title
    urine production
    End point description
    End point type
    Other pre-specified
    End point timeframe
    Day of Surgery
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    13
    15
    Units: Number of patients
        >= 0.5 ml/kg/h (> 6 h)
    11
    9
        < 0.5 ml/kg/h (> 6h)
    0
    2
        < 0.5 ml/kg/h (> 12h)
    2
    4
    No statistical analyses for this end point

    Other pre-specified: Difference of serum creatinine

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    End point title
    Difference of serum creatinine
    End point description
    Difference of serum creatinine (1 day after surgery - baseline)
    End point type
    Other pre-specified
    End point timeframe
    Day of Surgery
    End point values
    Volulyte 6 % Arm Balanced Crystalloid Arm
    Number of subjects analysed
    9
    15
    Units: mg/100 ml
        arithmetic mean (standard deviation)
    -0.06 ( 0.1 )
    0.03 ( 0.24 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse event recording was performed throughout the first time of administration of study medication until 8 days after surgery or discharge of hospital (whichever falls earlier)
    Adverse event reporting additional description
    Regular assessment by Pharmacovigilance and Safety Assessor
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    Volulyte 6 %
    Reporting group description
    -

    Reporting group title
    Balanced crystalloid arm
    Reporting group description
    -

    Serious adverse events
    Volulyte 6 % Balanced crystalloid arm
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 14 (21.43%)
    6 / 15 (40.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Injury, poisoning and procedural complications
    Anastomotic leak
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suture related complication
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    pain in stoma site
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    atrial fibrillation
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Systemic inflammatory response syndrome
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Anal haemorrhage
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 14 (7.14%)
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Prerenal failure
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal abscess
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Perirectal abscess
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    2 / 14 (14.29%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    septic shock
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    wound infection
         subjects affected / exposed
    1 / 14 (7.14%)
    2 / 15 (13.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Volulyte 6 % Balanced crystalloid arm
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    12 / 14 (85.71%)
    14 / 15 (93.33%)
    Investigations
    serum creatinine increased
         subjects affected / exposed
    2 / 14 (14.29%)
    2 / 15 (13.33%)
         occurrences all number
    2
    2
    Transaminases increased
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Anastomotic leak at the gastrointestinal tract
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    Vomiting in association with a procedure
         subjects affected / exposed
    2 / 14 (14.29%)
    4 / 15 (26.67%)
         occurrences all number
    2
    4
    Nausea in assocition with a procedure
         subjects affected / exposed
    2 / 14 (14.29%)
    4 / 15 (26.67%)
         occurrences all number
    2
    4
    Wound dehiscence
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Hernia
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    delayed healing
         subjects affected / exposed
    2 / 14 (14.29%)
    5 / 15 (33.33%)
         occurrences all number
    2
    5
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    5 / 14 (35.71%)
    4 / 15 (26.67%)
         occurrences all number
    5
    4
    Gastrointestinal disorder
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    Ileus paralytic
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    Constipation
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    Nausea
         subjects affected / exposed
    6 / 14 (42.86%)
    7 / 15 (46.67%)
         occurrences all number
    6
    7
    Respiratory, thoracic and mediastinal disorders
    Hypoxia
         subjects affected / exposed
    7 / 14 (50.00%)
    8 / 15 (53.33%)
         occurrences all number
    7
    8
    Renal and urinary disorders
    Oliguria
         subjects affected / exposed
    3 / 14 (21.43%)
    8 / 15 (53.33%)
         occurrences all number
    3
    8
    Disorder in emptying the bladder
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Candida infection
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    Postoperative wound infection
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0
    Wound infection
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 15 (6.67%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Hyperkaliaemia
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 15 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    25 Jul 2013
    The final decision of the review of hydroxyethyl starch-containing solution shall be awaited.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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