VBI-S for the Treatment of Hypotension in Hypovolemic Septic Shock Patients
VBI-S for the Treatment of Hypotension in Hypovolemic Septic Shock Patients
This study is being conducted to evaluate the safety and effectiveness of VBI-S in elevating
 the blood pressure of septic shock patients with absolute or relative hypovolemia.
PURPOSE OF THE STUDY This study is being conducted to evaluate the safety and effectiveness
 of VBI-S in elevating the blood pressure of septic shock patients with absolute or relative
 hypovolemia.

 STUDY TREATMENT Sepsis is a serious condition resulting from the presence of harmful
 microorganisms in the blood or other tissues and the body's response to their presence,
 leading to the malfunctioning of various organs. When hypotension due to sepsis cannot be
 reversed with the infusion of fluids the patient is in a state of septic shock. Septic shock
 is therefore an acute medical emergency and delayed therapy can lead to organ injury. VBI-S
 is intended to raise blood pressure in patients with septic shock.

 Randomization and blinding: This is an open label study, randomization and blinding are not
 applicable to this study. All patients entering this study will be treated with VBI-S.

 Data Safety Monitoring Board: A Data Safety Monitoring Board (DSMB) will review the study
 data.

 Analysis Populations: * Safety Analysis Set (SAF): all patients who have received any amount
 of VBI-S. * Intent to treat (ITT) population: all patients who have received any amount of
 VBI-S
Inclusion Criteria:

 1. Male or female at least 18 years of age

 2. Evidence of bacterial infection demonstrated by positive blood culture and/or a known
 source of infection or an elevated procalcitonin.

 3. Patient has a mean blood pressure < 65 mmHg that is unresponsive to fluids currently
 available on the market.

 4. Patient is on two or more pressor drugs at the following minimal doses: Levophed =20
 mcg/minute, epinephrine 10 mcg/minute, dopamine 20 mcg/kg/minute, phenylephrine
 180mcg/minute, vasopressin 4 units/hour, at full dose required to maintain a mean
 blood pressure of 65 mmHg or Patient is on Levophed or its equivalent at 55 mcg/min
 with conversion factors for other vasopressors to Levophed being 5.6 x Vasopressin (
 in units/hour), 0.5 x dopamine( in mcg/kg/minute) epinephrine ( in mcg/minute) 0.1 x
 phenylephrine ( in mcg/minute) at full dose to maintain a mean blood pressure of 65
 mmHg. (Predicted mortality >80%)

 5. Sequential Organ Failure Assessment (SOFA) score >=15 (Predicted mortality >80%)

 6. Systolic blood pressure < 90 mm Hg (or a drop of > 40 mm Hg from baseline)

 7. Sepsis diagnosis

 Exclusion Criteria:

 1. Patients with a ventricular assist device

 2. Acute coronary syndrome

 3. Pregnant

 4. Bronchospasm

 5. Mesenteric ischemia

 6. Emergency surgery

 7. History of liver disease (Hepatitis B and C), chronic hepatic failure and /or
 cirrhosis

 8. Liver failure with a Model for End-Stage Liver Disease (MELD) score ≥ 19

 9. Clinically significant hematologic or coagulation disorders including thrombocytopenia
 (platelet count <50,000)

 10. Absolute neutrophil count of < 1000 mm3

 11. Current participation or participation in another experimental or device study within
 the last 30 days before the start of this study

 12. Patients with a known allergy to soybeans or eggs