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Trial registered on ANZCTR
Registration number
ACTRN12624000070538
Ethics application status
Approved
Date submitted
16/12/2023
Date registered
29/01/2024
Date last updated
29/01/2024
Date data sharing statement initially provided
29/01/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Carbon dioxide removal with PrismaLung in patients with respiratory failure in intensive care unit.
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Scientific title
Measuring the impact of extracorporeal carbon dioxide removal using PrismaLung on ventilator induced lung injury in mechanically ventilated patients
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Secondary ID [1]
311198
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute respiratory failure
332376
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Condition category
Condition code
Respiratory
329088
329088
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
No specific exposure intervention that will be evaluated in this study. It investigates how effective is the intervention (ECCO2R with PrismaLung) that is being used on the patient in reducing the lung injury known to associated with mechanical ventilation.
This study includes patients already receiving ECCO2R with PrismaLung as part of their standard mechanical ventilation treatment,
Driving pressures on the ventilator prior to initiation of PrismaLung will be compared with the driving pressures while the patients are receiving PrismaLung for up to 144 hours.
Arterial blood gasses and cytokine profile will be compared prior to initiation and after initiation of PrismaLung for up to 144 hours. All data will be available from the medical records.
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Intervention code [1]
327650
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Not applicable
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Comparator / control treatment
No control group.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Changes in driving airway pressures at 72 and 144 hours post initiation of ECCO2R
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Assessment method [1]
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Driving pressure is calculated by plateau pressure (breath hold at end inspiration) minus positive end-expiratory pressure (breath hold at end of expiration) on the ventilator.
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Timepoint [1]
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72 and 144 hours post initiation of ECCO2R
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Secondary outcome [1]
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Changes in pulmonary (Lung) inflammation by assessing the interleukins in bronchial fluid
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Assessment method [1]
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Bronchial fluid analysis
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Timepoint [1]
430117
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at 72 and 144 hours of initiation of PrismaLung
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Secondary outcome [2]
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Changes in pulmonary (Lung) inflammation by assessing the interleukins in blood samples
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Assessment method [2]
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Blood sample analysis
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Timepoint [2]
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at 72 and 144 hours of initiation of PrismaLung
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Eligibility
Key inclusion criteria
1. Adult patients (18 years or older) with diagnosis of ARDS as per the Berlin Definition.(Ref Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA. 2012; 307: 2526-33.)
2. Driving pressure ( P) > 14 and/or Plateau >/= 25 (P is calculated using as plateau pressure minus positive end-expiratory pressure). (Ref: Combes A, Auzinger G, Capellier G, et al. ECCO2R therapy in the ICU: consensus of a European round table meeting. Critical Care. 2020; 24: 490)
3. Respiratory rate > 20 breaths per minute
4. pH < 7.25 and PaCO2 >45
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. ARDS lasting more than 72 hours at the time of inclusion
2. High pressure (Plateau pressure >30 cm H2O) or high FiO2 (>0·8) ventilation for more than 168 h (7 days);
3. Severe hemodynamic instability as defined by ongoing arrhythmias that is not responsive to treatment
4 Contraindication to limited anticoagulation
5. Treatment limitation including not for resuscitation and not for reintubation
6. Patients with potentially irreversible respiratory failure
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Data will be presented as mean and SD of the mean or median and interquartile (25th and 75th percentile) range as appropriate. The primary outcome driving airway pressures will be analysed using linear mixed effects models (PROC MIXED procedure in SAS) fitting main effect for time (24, 48, 72 and 144 hours) with results reported as means and 95% confidence intervals (95% CI). To facilitate specific comparisons time will be treated as a categorical variable. Post-hoc comparisons will be performed to assess changes between time points. All calculated p values will be two tailed and a p < 0.05 will be considered to be statistically significant. Analyses will be performed with SAS software version 9.4 (SAS Institute, Cary, NC, USA).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/02/2024
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Actual
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Date of last participant enrolment
Anticipated
31/01/2026
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Actual
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Date of last data collection
Anticipated
1/12/2026
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Actual
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Sample size
Target
15
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
25950
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Frankston Hospital - Frankston
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Recruitment postcode(s) [1]
41784
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3199 - Frankston
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Funding & Sponsors
Funding source category [1]
315460
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Commercial sector/Industry
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Name [1]
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BAXTER
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Address [1]
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One Baxter Parkway/Deerfield, Illinois 60657
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Country [1]
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United States of America
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Primary sponsor type
Hospital
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Name
Peninsula Health
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Address
Hastings road, Frankston,VIC,3199, Australia
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Country
Australia
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Secondary sponsor category [1]
317529
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None
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Name [1]
317529
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Address [1]
317529
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Country [1]
317529
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314368
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Peninsula Health Human Research Ethics Committe
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Ethics committee address [1]
314368
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Hasting road, Frankston, VIC 3199
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Ethics committee country [1]
314368
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Australia
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Date submitted for ethics approval [1]
314368
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24/03/2022
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Approval date [1]
314368
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27/06/2022
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Ethics approval number [1]
314368
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HREC/85711/PH-2022
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Summary
Brief summary
Some patients when receiving such mechanical ventilation develop hypercapnia and associated hypercapnic acidosis. Such patients have an increased risk of mortality. While the exact reasons of such increase in mortality is not known, it is recommended to minimise hypercapnia and hypercapnic acidosis during lung protective ventilation. Minimally invasive extracorporeal carbon dioxide removal (ECCO2R) devices are shown to reduce hypercapnia and hypercapnic acidosis. There are several devices that are currently available in the current clinical practice. However the effect of these devices on reduction in ventilator induced lung injury is not clearly demonstrated. This study aims to assess the reduction in ventilator induced lung injury with the use of ECCO2R device called Prismalung that is currently used in our intensive care unit. This assessment is done by measuring of pulmonary interleukins and blood interleukin levels as well as clinical assessment including the reduction of driving pressure.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Ravindranath Tiruvoipati
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Address
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Department of Intensive Care Medicine, Frankston Hospital, Frankston,VIC 3199
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Country
131330
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Australia
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Phone
131330
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+61 431279347
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Fax
131330
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Email
131330
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[email protected]
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Contact person for public queries
Name
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Ravindranath Tiruvoipati
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Address
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Department of Intensive Care Medicine, Frankston Hospital, Frankston,VIC 3199
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Country
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Australia
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Phone
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+61 431279347
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Fax
131331
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ravindranath Tiruvoipati
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Address
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Department of Intensive Care Medicine, Frankston Hospital, Frankston,VIC 3199
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Country
131332
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Australia
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Phone
131332
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+61 431279347
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Fax
131332
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Email
131332
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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