Mechanical Ventilation ComplicationNCT02599350
Assessing Gas Exchange in Intensive Care Patients on a Ventilator
An observational study of Mechanical Ventilation Complication, run by University of Aberdeen at 1 site in United Kingdom.
Trial summary
In an attempt to standardise the degree of impairment of gas exchange in the lungs of ICU patients a number of indices of oxygen exchange have been developed. These include: the arterial-alveolar oxygen tension ratio (a/APO2), the arterial oxygen tension-inspired oxygen concentration ratio (PaO2/FIO2), the respiratory… Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Mechanical Ventilation Complication
- How many people
- 30 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- May 2009to Aug 2012
- Phase
- Observational
- 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 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: 30 adult patients admitted to Aberdeen Royal Infirmary ICU, requiring invasive mechanical ventilation and with impaired gas exchange will be recruited.
Who may be able to join
- FIO2 on enrollment = 0.4-0.6, PEEP 5cm H2O, "Stable" respiratory failure - same or less FIO2 for 2 hours prior to enrollment.
Who cannot join
- Age < 16 years
- Pregnancy
- Known intracranial disease
- Prone position
- Nitric oxide therapy
- Pneumothorax/bronchopleural fistula/intercostal drain in situ
- Severe respiratory failure (FIO2 0.7), OR
- Severe haemodynamic instability (escalating inotrope requirements, fluid resuscitation > 1 litre/hour in 2 hours prior to commencing intervention, mean arterial blood pressure < 65 mmHg).
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
Aberdeen Royal Infirmary
Aberdeen, Aberdeenshire, AB25 2ZD
About this study
Official title: Evaluation of a New Computer Slide Rule Method for Assessing Gas Exchange in Intensive Care Patients on a Ventilator
In an attempt to standardise the degree of impairment of gas exchange in the lungs of ICU patients a number of indices of oxygen exchange have been developed. These include: the arterial-alveolar oxygen tension ratio (a/APO2), the arterial oxygen tension-inspired oxygen concentration ratio (PaO2/FIO2), the respiratory index (RI), [A-a)DO2/PaO2) and the alveolar-arterial oxygen tension difference [A-a)DO2). These are used clinically despite the fact that they do not accurately predict gas exchange particularly with changing the amount of inspired oxygen or when there is mixing of oxygenated blood with unoxygenated blood in the patient (called shunt). None of the indices reliably reflect the behaviour of the physiological shunt. In a pilot study as inspired oxygen (FIO2) was increased incrementally from 0.30 to 1.00, up to 55 per cent of the measured changes in these indices were opposite in direction to the corresponding changes in the physiological shunt. The investigators have developed a computer algorithm and a slide rule to try and improve on these clinical measures. The investigators wish to test their slide rule on ventilated patients by altering the inspired oxygen to see if it will predict what the actual change in oxygen will be.
Read the detailed description
30 adult patients admitted to Aberdeen Royal Infirmary ICU, requiring invasive mechanical ventilation and with impaired gas exchange will be recruited and the following baseline demographic data will be recorded: cause of respiratory failure, APACHE II score, cardiovascular shock (presence / absence), duration of mechanical ventilation prior to inclusion, duration of respiratory failure prior to inclusion. Also the following baseline physiological data will also be recorded: FIO2, SaO2, PEEP, arterial blood pressure, central venous pressure, haemoglobin, PaO2, PaCO2, arterial pH and inotrope / vasopressor infusion rates.
The FIO2 will then be varied in random steps to 0.35, 0.4, 0.45, 0.5, 0.55, 0.6 and 0.65. After changing the FIO2 a 3-4 minute equilibration period will be allowed prior to taking an arterial blood gas sample for analysis. In the event of a PaO2 < 8kPa being recorded, further reductions in FIO2 will not be undertaken.
The data collected will then be utilised using a slide rule computer programme to generate FIO2 vs. SpO2 graphs. Other indices of gas exchange, e.g. PaO2/FIO2 ratios will also be generated from the data. Predicted versus actual PaO2 will be plotted and a correlation coefficient obtained.
Patients will then be followed for up to 5 days and depending on progression the same procedures will be repeated between days 3 and 5.
- Conditions
- Mechanical Ventilation Complication
- Keywords
- Ventilation, Gas exchange, V/Q ratio, Requirement for mechanical ventilation
- Medical subject headings
- Respiratory Aspiration
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| 1 | Patients receiving mechanical ventilation |
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Nov 2015 (estimated)
- Study startMay 2009
- Primary completionJul 2012
- Study completionAug 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mechanical Ventilation ComplicationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Aberdeen
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Nigel R Webster, MB PhD, Principal investigator, University of Aberdeen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02599350
- Sponsor's protocol ID
- 09/MRE00/32
- Status last verified
- Nov 2015
- First submitted
- 30 Apr 2009
- Last updated
- 6 Nov 2015
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of a New Computer Slide Rule Method for Assessing Gas Exchange in Intensive Care Patients on a Ventilator
- ClinicalTrials.gov ID
- NCT02599350
- Acronym / sponsor ID
- 09/MRE00/32
- Conditions
- Mechanical Ventilation Complication
- Keywords
- Ventilation, Gas exchange, V/Q ratio, Requirement for mechanical ventilation
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- University of AberdeenUniversity, hospital or other
- Study start
- May 2009
- Primary completion
- Jul 2012 (actual)
- Study completion
- Aug 2012 (actual)
- First posted
- 6 Nov 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In an attempt to standardise the degree of impairment of gas exchange in the lungs of ICU patients a number of indices of oxygen exchange have been developed. These include: the arterial-alveolar oxygen tension ratio (a/APO2), the arterial oxygen tension-inspired oxygen concentration ratio (PaO2/FIO2), the respiratory index (RI), [A-a)DO2/PaO2) and the alveolar-arterial oxygen tension difference [A-a)DO2). These are used clinically despite the fact that they do not accurately predict gas exchange particularly with changing the amount of inspired oxygen or when there is mixing of oxygenated blood with unoxygenated blood in the patient (called shunt). None of the indices reliably reflect the behaviour of the physiological shunt. In a pilot study as inspired oxygen (FIO2) was increased incrementally from 0.30 to 1.00, up to 55 per cent of the measured changes in these indices were opposite in direction to the corresponding changes in the physiological shunt. The investigators have developed a computer algorithm and a slide rule to try and improve on these clinical measures. The investigators wish to test their slide rule on ventilated patients by altering the inspired oxygen to see if it will predict what the actual change in oxygen will be.
Detailed description
30 adult patients admitted to Aberdeen Royal Infirmary ICU, requiring invasive mechanical ventilation and with impaired gas exchange will be recruited and the following baseline demographic data will be recorded: cause of respiratory failure, APACHE II score, cardiovascular shock (presence / absence), duration of mechanical ventilation prior to inclusion, duration of respiratory failure prior to inclusion. Also the following baseline physiological data will also be recorded: FIO2, SaO2, PEEP, arterial blood pressure, central venous pressure, haemoglobin, PaO2, PaCO2, arterial pH and inotrope / vasopressor infusion rates.
The FIO2 will then be varied in random steps to 0.35, 0.4, 0.45, 0.5, 0.55, 0.6 and 0.65. After changing the FIO2 a 3-4 minute equilibration period will be allowed prior to taking an arterial blood gas sample for analysis. In the event of a PaO2 < 8kPa being recorded, further reductions in FIO2 will not be undertaken.
The data collected will then be utilised using a slide rule computer programme to generate FIO2 vs. SpO2 graphs. Other indices of gas exchange, e.g. PaO2/FIO2 ratios will also be generated from the data. Predicted versus actual PaO2 will be plotted and a correlation coefficient obtained.
Patients will then be followed for up to 5 days and depending on progression the same procedures will be repeated between days 3 and 5.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| 1 | – | –Patients receiving mechanical ventilation |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- 30 adult patients admitted to Aberdeen Royal Infirmary ICU, requiring invasive mechanical ventilation and with impaired gas exchange will be recruited.
Key inclusion criteria (1 listed)
- FIO2 on enrollment = 0.4-0.6, PEEP 5cm H2O, "Stable" respiratory failure - same or less FIO2 for 2 hours prior to enrollment.
Key exclusion criteria (8 listed)
- Age < 16 years
- Pregnancy
- Known intracranial disease
- Prone position
- Nitric oxide therapy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Nov 2015.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nigel R Webster, MB PhD principal investigator
University of Aberdeen
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Mechanical Ventilation Complication, run by University of Aberdeen at 1 site in United Kingdom.
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 1 inclusion and 8 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 6 Nov 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
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.
Where can I read the original study information?
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 6 Nov 2015.