RECRUITING
Phase 3
ClinicalTrials.gov
Canadian Critical Care Comparative Effectiveness Platform
Sponsor: Université de Sherbrooke • ClinicalTrials.gov ID: NCT06605144
Registry updated: 2026-09-22
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Check Eligibility →Description
The Canadian Critical Care Comparative Effectiveness Platform(e) d'Évaluation Clinique Comparée en soins Critiques (CEPEC) is an international multi-centered randomized adaptive platform clinical trial. CEPEC will evaluate supportive care interventions that are used routinely in intensive care units throughout the world.
Interventions
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1- Vasopressor - Mean arterial pressure 56-60
(Drug)
Vasopressor(s) will be titrated according to 56-60 range.
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2- Vasopressor - Mean arterial pressure 61-65
(Drug)
Vasopressor(s) will be titrated according to 61-65 range.
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3- Vasopressor - Mean arterial pressure 66-70
(Drug)
Vasopressor(s) will be titrated according to 66-70 range.
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4- Vasopressor - Mean arterial pressure 71-75
(Drug)
Vasopressor(s) will be titrated according to 71-75 range.
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1- Platelet less than 10 x 109/L
(Other)
Once randomized, the participant will receive a platelet transfusion if their most recent platelet count is less than 10 x 109/L at the time of the planned procedure.
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2- Platelet less than 20 x 109/L
(Other)
Once randomized, the participant will receive a platelet transfusion if their most recent platelet count is less than 20 x 109/L at the time of the planned procedure.
-
3- Platelet less than 30 x 109/L
(Other)
Once randomized, the participant will receive a platelet transfusion if their most recent platelet count is less than 30 x 109/L at the time of the planned procedure.
-
4- Platelet less than 40 x 109/L
(Other)
Once randomized, the participant will receive a platelet transfusion if their most recent platelet count is less than 40 x 109/L at the time of the planned procedure.
-
5- Platelet less than 50 x 109/L
(Other)
Once randomized, the participant will receive a platelet transfusion if their most recent platelet count is less than 50 x 109/L at the time of the planned procedure.
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Enteral nutrition - Boluses
(Other)
Given 3 times a day.
-
Enteral nutrition - Continuous
(Other)
Given over 24-hour period
Eligibility criteria
VASOPRESSOR DOMAIN There is no minimum age limit in the Vasopressor Domain.
Inclusion criteria:
1. Ongoing vasopressor infusion to treat hypotension, or would be used to treat clinician-defined hypotension as part of usual care;
2. MAP \<75 mmHg at any point;
3. Patient expected to be in the ICU for \>24 hours.
Exclusion criteria:
1. Treating team does not have equipoise for at least two contiguous MAP target ranges in the CEPEC Vasopressor Domain;
2. Acute traumatic brain injury (within 7 days or ongoing active treatment for elevated intracranial pressure);
3. Acute subarachnoid hemorrhage (within 21 days);
4. Acute spinal cord injury (within 7 days of injury or ongoing vasopressor therapy for suspected spinal cord ischemia);
5. Lung, heart, liver, kidney transplant recipient (within 7 days);
6. Patient expected to become an organ donor (Donor Neurologic Death - DND or Donation After Circulatory Death - DCD);
7. More than 24 hours since meeting inclusion criteria in the ICU;
8. Previously randomized into the CEPEC Vasopressor Domain or a confounding trial.
PLATELET DOMAIN
Inclusion criteria:
1. Adult patients (age ≥18 years) admitted to the ICU;
2. Latest platelet count in this hospital admission \<50×109/L;
3. Planned to undergo a specified low-moderate bleeding risk invasive procedure.
Exclusion criteria:
1. Ongoing major hemorrhage requiring blood products and/or surgical/ radiological intervention;
2. Intracranial hemorrhage within prior 72 hours;
3. Contraindications to platelet transfusion (e.g. thrombotic microangiopathies, heparin-induced thrombocytopenia, recent history of immune thrombocytopaenia, congenital platelet function defects);
4. Known advance decision of refusing blood/blood component transfusions;
5. Acute promyelocytic leukemia (APML);
6. Death perceived as imminent or admission for palliation;
7. Previously randomized into the CEPEC Platelet Domain or the T4P Trial;
8. Fulfilled all the inclusion criteria and none of the exclusion criteria ≥72 hours.
NUTRITION DOMAIN
Inclusion criteria:
1. Critically ill patients ≥18 years of age;
2. Are invasively mechanically ventilated (including endotracheal tube or tracheostomy);
3. Orogastric/nasogastric tube in place; or have an in dwelling percutaneous gastric tube (with confirmed placement);
4. Treating team has started or has the intention of providing enteral nutrition.
Exclusion criteria:
1. Patients who have had gastrointestinal (GI) surgery; in the last 3 months and deemed not ready to receive possible bolus nutrition;
2. Bowel obstruction or ischemia; active;
3. Has a post-pyloric small bowel feeding tube;
4. Active GI bleeding;
5. Patient who is chronically receiving enteral nutrition.
Conditions
Intensive Care Unit ICU
Vasopressor
Platelet
Nutrition
Locations
- Centre hospitalier universitaire Dr-Georges-L.-Dumont — Moncton, New Brunswick, Canada
- Hamilton Health Sciences - Juravinski Hospital — Hamilton, Ontario, Canada
- The Ottawa Hospital — Ottawa, Ontario, Canada
- Scarborough Health Network — Scarborough Village, Ontario, Canada
- Niagara Health — St. Catharines, Ontario, Canada
- Sunnybrook Health Sciences Centre — Toronto, Ontario, Canada
- Centre hospitalier de l'Université de Montréal (CHUM) — Montreal, Quebec, Canada
- CIUSSS NIM - Hôpital du Sacré-Coeur-de-Montréal — Montreal, Quebec, Canada
- CIUSSS de l'Estrie - CHUS — Sherbrooke, Quebec, Canada
- Auckland City Hospital — Auckland, New Zealand
- Intensive Care National Audit and Research Centre (coordinating centre for sites in UK. Sites to be determined) — London, United Kingdom
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Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.
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