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SepsisPhase 3ADAPTNCT04166331

Adjunctive DobutAmine in sePtic Cardiomyopathy With Tissue Hypoperfusion

A Phase 3 study testing Dobutamine in people with Sepsis and Cardiomyopathies, run by University Hospital, Limoges at 21 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Sepsis induces both a systolic and diastolic cardiac dysfunction. The prevalence of this septic cardiomyopathy ranges between 30 and 60% according to the timing of assessment and definition used. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sepsis, Cardiomyopathies, Hypoperfusion
What is being tested?
Dobutamine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
136 participants
Where
21 sitesFrance
Study dates
20 Sep 2020to 1 Jul 2025
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age > 18 years hospitalized in ICU
  • > Septic shock (Sepsis-3 definition):
  • Clinically suspected or documented acute infection
  • Responsible for organ dysfunction(s): change in SOFA ≥ 2 points
  • With persisting hypotension (systolic and/or mean arterial pressure < 90 / < 65 mmHg) despite adequate fluid resuscitation (≥ 30 mL/kg, unless presence of pulmonary venous congestion)
  • Requiring vasopressor support (Norepinephrine) to maintain steady mean arterial pressure ≥ 65 mmHg
Show all 9Show fewer
  • And lactate > 2 mmol/L
  • Septic cardiomyopathy: echocardiographically measured LV ejection fraction (EF) ≤ 40% and LV outflow tract velocity-time integral < 14 cm
  • Informed consent

Who cannot join

  • Pregnancy or breast feeding
  • Hypersensitivity to Dobutamine, 5% Dextrose, or to the excipients
  • Ventricular rate > 130 bpm (sinus rhythm or not)
  • Severe ventricular arrhythmia
  • Obstructive cardiomyopathy with pressure gradient at rest ≥ 50 mmHg unrelated to uncorrected hypovolemia
  • Severe aortic stenosis: mean gradient > 40 mmHg, peak aortic jet velocity > 4 m/s, aortic valve area < 1 cm² (aortic valve area index < 0.6 cm²/m²)
Show all 10Show fewer
  • Acute coronary syndrome
  • Decision to limit care or moribund status (life expectancy < 24 h)
  • Absence of affiliation to Social Security
  • Subjects under juridical protection.

Trial locations and contacts

21 sites in 1 country.

21 sites in 1 country

France21 sites
  • Angouleme Hospital

    Angoulême, 16959

  • Argenteuil Hospital

    Argenteuil, 95107

  • CH de Bethune

    Béthune

  • University Hospital

    Brest, 29200

  • CH de Brive

    Brive-la-Gaillarde, 19100

  • CH de Cannes

    Cannes

  • Aphp - Henri Mondor

    Créteil, 94010

  • Dijon university hospital

    Dijon, 21033

  • CH d'Haguenau

    Haguenau, 67500

  • Le Mans Hospital

    Le Mans, 72000

  • Lille University Hospital

    Lille, 59045

  • Limoges University Hospital

    Limoges, 87042

  • HCL

    Lyon

  • Montpellier University Hospital

    Montpellier, 34295

  • Nice University Hospital

    Nice, 06202

  • CHU Orléans - service de Réanimation

    Orléans, Orleans, 47067

  • Aphp - Ambroise Paré

    Paris, 75010

  • Poitiers University Hospital

    Poitiers, 86000

  • CHU Strasbourg - service de Réanimation

    Strasbourg, Strasbourg, 67000

  • CH de Toulon

    Toulon, 83000

  • CHU Tours - Service de Réanimation

    Tours, Tours, 37044

Other trials in France

About this study

Official title: Adjunctive DobutAmine in sePtic Cardiomyopathy With Tissue Hypoperfusion: a Randomized Controlled Multi-center Trial

Sepsis induces both a systolic and diastolic cardiac dysfunction. The prevalence of this septic cardiomyopathy ranges between 30 and 60% according to the timing of assessment and definition used. Although the prognostic role of septic cardiomyopathy remains debated, sepsis-induced left ventricular (LV) systolic dysfunction may be severe and associated with tissue hypoperfusion, while it appears to fully recover in survivors. Accordingly, optimization of therapeutic management of septic cardiomyopathy may contribute to improve tissue hypoperfusion in increasing oxygen delivery, and to reduce related organ dysfunctions in septic shock patients.

Echocardiography is currently the recommended first-line modality to assess patients with acute circulatory failure.

Read more

Current Surviving Sepsis Campaign strongly recommends Norepinephrine as the first-choice vasopressor in fluid-filled patients with septic shock. In contrast, the use of Dobutamine is only suggested (weak recommendation, low quality of evidence) in patients with persistent tissue hypoperfusion despite adequate fluid resuscitation and vasopressor support. Levosimendan, an alternative inodilator, has failed preventing acute organ dysfunction in septic patients and has induced more supraventricular tachyarrhythmias than in the control group. Data supporting Dobutamine in this setting are scarce and primarily physiologic and based on monitored effects of this drug on hemodynamics and indices of tissue perfusion.

No randomized controlled trials have yet compared the effects of Dobutamine versus placebo on clinical outcomes. In open-labelled, small sample trials, the ability of septic patients to increase their oxygen delivery during Dobutamine administration appears to be associated with lower mortality.

The tested hypothesis in the ADAPT trial is that Dobutamine will reduce tissue hypoperfusion and associated organ dysfunctions in patients with septic shock and associated septic cardiomyopathy. In doing so, it may participate in improving clinical outcomes.

Being tested
Placebos, Dobutamine
Keywords
sepsis, Cardiomyopathies, Hypoperfusion, Left Ventricular Systolic Dysfunction
Medical subject headings
Sepsis, Cardiomyopathies, Ventricular Dysfunction, Left

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PlacebosDrug

    Placebo will initially be started at a dose of 2.5 µg/kg/min and subsequently titrated using incremental steps (predefined durations) of 2.5 µg/kg/min, up to a maximal dose of 10 µg/kg/min. Dose adaptation will be left at the discretion of attending physician.

  • DobutamineDrug

    Dobutamine will initially be started at a dose of 2.5 µg/kg/min and subsequently titrated using incremental steps (predefined durations) of 2.5 µg/kg/min, up to a maximal dose of 10 µg/kg/min. Dose adaptation will be left at the discretion of attending physician.

Study groups in NCT04166331
Study groupRoleWhat they receive
ControlPlacebo comparatorPlacebo will initially be started at a dose of 2.5 µg/kg/min and subsequently titrated using incremental steps (predefined durations) of 2.5 µg/kg/min, up to a maximal dose of 10 µg/kg/min
Receives: Drug: Placebos
ExperimentalExperimentalDobutamine will initially be started at a dose of 2.5 µg/kg/min and subsequently titrated using incremental steps (predefined durations) of 2.5 µg/kg/min, up to a maximal dose of 10 µg/kg/min
Receives: Drug: Dobutamine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sequential Organ Failure Assessment (SOFA) score evolution

    Evolution of a modified Sequential (Sepsis-Related) Organ Failure Assessment (SOFA) score (no gradation of the neurologic system) between baseline (before randomization) and Day 1, Day 2 and Day 3 after randomization. Min value =0. Max value =20 . The highest score means the worst situation

    Measured: Day 0 to Day 3

Secondary outcomes (33)
  1. Circulating lactate level measurement

    Biological indices of tissue dysoxia at baseline, hour 6, Day1, Day 2 and Day 3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  2. Central venous oxygen saturation (ScvO2) measurement

    Biological indices of tissue dysoxia at baseline, hour 6, Day1, Day 2 and Day 3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  3. Open-labelled Dobutamine dayly maximal dose used as rescue therapy

    Requirement of organ function supports during ICU stay. Maximal dose in mcg/kg/min of open-labelled Dobutamine used as rescue therapy

    Measured: through study completion, an average 90 days

  4. Open-labelled Dobutamine duration used as rescue therapy

    Requirement of organ function supports during ICU stay. Duration in days of open-labelled Dobutamine used as rescue therapy

    Measured: through study completion, an average of 90 days

  5. Vasopressor support duration

    Requirement of organ function supports during ICU stay. Duration in days of vasopressor support

    Measured: through study completion, an average of 90 days

  6. Vasopressor support dayly maximal dose

    Requirement of organ function supports during ICU stay. Maximal dose in mg/h by day of vasopressor support

    Measured: through study completion, an average of 90 days

  7. Invasive mechanical ventilation duration

    Requirement of organ function supports during ICU stay. Duration of invasive mechanical ventilation

    Measured: through study completion, an average of 90 days

  8. Renal replacement therapy number

    Requirement of organ function supports during ICU stay. Number of session of renal replacement therapy (excluding hemodialysis patient for chronic renal failure at the time of randomization)

    Measured: through study completion, an average of 90 days

  9. Renal replacement therapy duration

    Requirement of organ function supports during ICU stay. Duration of renal replacement therapy (excluding hemodialysis patient for chronic renal failure at the time of randomization)

    Measured: through study completion, an average of 90 days

  10. Arterial pressure measurement

    Systolic, diastolic and mean arterial blood pressure (in mmHg) at Baseline, h6, Day 1, Day 2 and Day3after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  11. heart rate measurement

    Heart rate measurement in bpm at Baseline, Hour 6, Day 1, Day 2 and Day3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  12. Central venous pressure measurement

    Central venous pressure in cm H2O at Baseline, Hour 6, Day 1, Day 2 and Day3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  13. Cardiac index measurement

    Cardiac index measurement in L/min/m2 at Baseline, Hour 6, Day 1, Day 2 and Day3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  14. Stroke volume measurement

    Stroke volume measurement in mL status at Baseline, Hour 6, Day 1, Day 2 and Day3 after initiating Dobutamine / placebo

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  15. Hypotension measurement

    Severe cardiovascular adverse events from inform consent to ICU discharge : Hypotension related to worsened vasoplegia

    Measured: Hour 0, Hour 6, Day 1, Day 2 and Day 3

  16. Supraventricular arrhythmias measurement

    Severe cardiovascular adverse events from inform consent to ICU discharge. Supraventricular arrhythmias with ventricular rate > 140 bpm

    Measured: through study completion, an average of 90 days

  17. Ventricular arrhythmias measurement

    Severe cardiovascular adverse events from inform consent to ICU discharge. Ventricular arrhythmias

    Measured: through study completion, an average of 90 days

  18. Occurence of Acute coronary syndrome

    Severe cardiovascular adverse events from inform consent to ICU discharge. Acute coronary syndrome

    Measured: through study completion, an average of 90 days

  19. Occurence of Stroke

    Severe cardiovascular adverse events during ICU stay. Stroke

    Measured: through study completion, an average of 90 days

  20. Mortality

    Number of death

    Measured: Day 90

  21. Mortality causes

    Cause of death

    Measured: Day 90

  22. Organ function free supports

    Number of days free from vasopressor support, invasive mechanical ventilation, renal replacement therapy from inform consent to ICU discharge

    Measured: Day 90

  23. Number of days in ICU and hospital

    Length of ICU and hospital stay

    Measured: Day 90

  24. echocardiographic assessment of left ventricular systolic function

    ejection fraction measurement

    Measured: Day 0 and Day 1

  25. Leucocyte subsets level

    Leucocyte subsets level according to the severity of the sepsis-induced LV systolic dysfunction and hemodynamic effects of the study drug administration

    Measured: Hour 6

  26. Cytokines level

    tumor necrosis factor (TNF) -α, Interferon ɣ, Interleukin-6, 8 and 10 cytokines concentration will be assess according to the severity of the sepsis-induced LV systolic dysfunction and hemodynamic effects of the study drug administration. Result for each cytokine concentration will be given in picograms per milliliter.

    Measured: Hour 6

  27. LV global longitudinal strain measurement

    LV segmental deformation longitudinal analysis

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  28. RV free wall strain measurement

    deformation of right ventricular myocardial tissue / routinely using with echocardiography or post exam analysis

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  29. LV volume measurement

    Ratio between systolic and diastolic left ventricular volume / routinely using with echocardiography

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  30. LV ejection fraction measurement

    Cardiac output measurement with echocardiography Doppler (in centers routinely using transpulmonary thermodilution). Quality of left ventricular contraction

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  31. RV volume measurement

    Ratio between systolic and diastolic right ventricular volume / routinely using with echocardiography

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  32. RV ejection fraction measurement

    Cardiac output measurement with echocardiography Doppler (in centers routinely using transpulmonary thermodilution). Quality of right ventricular contraction

    Measured: Hour 6, Day 1, Day 2 AND Day 3

  33. Transpulmonary thermodilution measurement

    In selected centers routinely using continuous monitoring of cardiac output using transpulmonary thermodilution: agreement of cardiac output measurement with echocardiography Doppler.

    Measured: Hour 6, Day 1, Day 2 AND Day 3

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Nov 2019
  2. Study start20 Sep 2020
  3. Primary completion1 Jul 2025
  4. Study completion1 Jul 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
136 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04166331
Sponsor's protocol ID
87RI18_0012 (ADAPT)
Acronym
ADAPT
Status last verified
Nov 2025
First submitted
25 Oct 2019
Last updated
21 Nov 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vignon P, Leger J, Evrard B, Goudelin M, Vaidie J, Brit S, Giraudeau B. Adjunctive dobutamine in patients with septic cardiomyopathy and tissue hypoperfusion: a blinded randomised controlled multicentre trial study protocol of the ADAPT-dobutamine trial. BMJ Open. 2025 Jun 30;15(6):e101200. doi: 10.1136/bmjopen-2025-101200.

    PubMed 40588393

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Dobutamine in people with Sepsis and Cardiomyopathies, run by University Hospital, Limoges at 21 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sequential Organ Failure Assessment (SOFA) score evolution (time frame: Day 0 to Day 3). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04166331, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2025.

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ADAPT Clinical Trial NCT04166331 | AzTrials