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Sepsis Induced CardiomyopathyKetoSICNCT06952140

Hemodynamic Effects of Ketone Esters in Patients With Sepsis Induced Cardiomyopathy

A study testing Ketone ester in people with Sepsis Induced Cardiomyopathy, run by Tor Biering-Sørensen.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record

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Trial summary

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection and is associated with a high mortality rate in the ICU. Sepsis induced cardiomyopathy (SICM) is a multi-factorial process that appears in approximately 50% of patients with sepsis/septic shock and is associated with… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sepsis Induced Cardiomyopathy
What is being tested?
Ketone ester
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
12 participants
Where
No sites listed yet
Study dates
10 Mar 2026to 31 Dec 2027
Phase
Interventional

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

  • Patients ≥ 18 years of age admitted to the the intensive care unit (ICU)
  • LVEF < 50% determined by a screening echocardiography and analysed according to the Simpson biplane method
  • Ability for study personnel to perform transthoracic echocardiography
  • Suspected or documented infection (suspected infection is defined as ongoing antibiotic treatment and/or body fluid culture sampling performed within 72 hours before screening)

Who cannot join

  • Diagnosis of heart failure with reduced ejection fraction prior to ICU admission according to health records
  • Surgical cause of ICU admission
  • For patients in shock: Other primary causes of shock than sepsis (i.e. hypovolemia, haemorrhage, cardiogenic etiology, pulmonary embolism, anaphylaxis)
  • Blood pH < 7.20
  • Severe gastroparesis
  • Inability to position a nasogastric tube

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

About this study

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection and is associated with a high mortality rate in the ICU. Sepsis induced cardiomyopathy (SICM) is a multi-factorial process that appears in approximately 50% of patients with sepsis/septic shock and is associated with increased mortality. It is suggested that ketone bodies are more efficient substrates of energy metabolism than glucose, with a lower oxygen consumption per ATP-molecule produced and that the failing human heart increases the capacity to metabolize ketones. Previous studies have found acute beneficial hemodynamic effects of ketone esters in patients with chronic heart failure and cardiogenic shock, respectively. Improved hemodynamics and reduced systemic oxygen consumption as an effect of ketone esters might be of great benefit in patients admitted to the ICU. Thus, the investigators aim to investigate the hemodynamic effects of ketone esters in patients with sepsis induced cardiomyopathy in this randomized, placebo-controlled, double-blinded, cross-over, acute intervention study. .

Being tested
Ketone ester, Placebo
Keywords
Sepsis induced cardiomyopathy, Sepsis, Hemodynamics, Ketone ester, Ketones, Echocardiography, Randomized controlled trial, Cross-over trial, Cardiovascular
Medical subject headings
Sepsis, Ketosis

What participants receive

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

  • Ketone esterDietary supplement

    Ketone ester: 3-hydroxybutyrate as enteral bolus (500 mg/kg)

  • PlaceboDietary supplement

    Maltodextrin (isovolumic and isocaloric placebo) as enteral bolus

Study groups in NCT06952140
Study groupRoleWhat they receive
Ketone ester followed by placeboExperimentalNot described
Receives: Dietary Supplement: Ketone ester; Dietary Supplement: Placebo
Placebo followed by ketone esterExperimentalNot described
Receives: Dietary Supplement: Ketone ester; Dietary Supplement: Placebo

What is being measured

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

  1. Global longitudinal strain

    Echocardiographic measure obtained from transthoracic echocardiography

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

Secondary outcomes (7)
  1. Left ventricular ejection fraction

    Echocardiographic measure obtained from transthoracic echocardiography

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  2. Mean arterial pressure

    Obtained from invasive blood pressure measurement (arterial line)

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  3. Cardiac output

    Obtained from transthoracic echocardiography

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  4. Peripheral blood oxygen saturation

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  5. Arterial blood pH

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  6. Arterial blood lactate

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

  7. Accumulated norepinephrine

    Measured: From intervention to 3 hours after intervention (this is assessed for both treatment arms)

Timeline

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

  1. First posted30 Apr 2025
  2. Study start10 Mar 2026 (estimated)
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
As this is a cross-over trial participants will receive both active treatment and placebo. Participants will be randomized 1:1 to receive A) active treatment followed by placebo or B) placebo followed by active treatment.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
12 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06952140
Sponsor's protocol ID
KetoSIC
Acronym
KetoSIC
Status last verified
Mar 2026
First submitted
23 Apr 2025
Last updated
4 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

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