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Acute Respiratory InsufficiencyPANDORA-childNCT04791501

Prevalence AND Outcome of Acute Hypoxemic Respiratory fAilure in CHILDren (PANDORA-CHILD)

An observational study of Acute Respiratory Insufficiency, run by Yolanda Lopez Fernandez at 23 sites in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The present study is aimed to establish the epidemiological characteristics and clinical outcomes of mechanically ventilated children with acute hypoxemic respiratory failure (AHRF), defined as PaO2/FiO2 ≤300 mmHg on PEEP≥5 cmH2O and FiO2≥0.3, admitted in a network of pediatric hospitals in Spain. Read more about this study

Who is it for?
Ages 7 days to 16 years
Conditions the study is for
Acute Respiratory Insufficiency
What is being tested?
Mechanical ventilation
Type of treatment
Medical device
How many people
150 participants
Where
23 sitesSpain
Study dates
1 Oct 2019to 30 Oct 2021
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 7 days to 16 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: All consecutive patients from 7 days to 16 years old admitted in the PICU with an acute episode (within 7 days of a clinical insult) of hipoxemia defined as PaO2/FiO2 ≤ 300 mmHg (or SpO2/FiO2 ≤ 264), and on invasive mechaniccal ventilatio with a PEEP ≥ 5 cmH2O and FiO2 ≥ 0.3.

Who may be able to join

  • Patients from 7 days to 16 years old admitted in the PICU.
  • Acute episode (within 7 days of a clinical insult)
  • On invasive mechanical ventilatory support
  • PaO2/FiO2 ≤ 300 mmHg (or SpO2/FiO2 ≤ 264)
  • Positive end-expiratory pressure (PEEP) ≥ 5 cmH2O and FiO2 ≥ 0.3.

Who cannot join

  • Non-invasive respiratory support *Aged >16 years or < 7 days.

Trial locations and contacts

23 sites in 1 country.

Amelia Martinez de Azagra, MD contact

0034630122450

ameliamartinezdeazgra@gmail.com

23 sites in 1 country

Spain23 sites, 23 recruiting
  • Cruces University Hospital

    Barakaldo, Bizkaia, 48903

    Yolanda M López-Fernández, MD, 0034946000000 ext. 6582, yolandamarg.lopezfernandez@osakidetza.eus

    Yolanda M Lopez Fernandez, MD

    Recruiting
  • Hospital Universitario

    Burgos

    María González, MD, lapuris@hotmail.com

    María García, MD

    Recruiting
  • Hospital Universitario Puerta del Mar

    Cadiz

    Patricia Rodriguez, p.r.campoy@gmail.com

    Patricia Rodriguez, MD

    Recruiting
  • Hospital Universitario Reina Sofia

    Córdoba

    Ignacio Ibarra, MD, igibarrarosa@gmail.com

    Ignacio Ibarra, MD

    Recruiting
  • Complejo Hospitalario Donosti

    Donostia / San Sebastian, Gipuzkoa

    Eider Oñate, eider.oñatevergara@osakidetza.eus

    Eider Oñate, MD, PhD

    Recruiting
  • Hospital Universitario

    Las Palmas de Gran Canaria

    Rocio Nuñez, MD, rocio.nuñez.borrero@gmail.com

    Rocio Nuñez, MD

    Recruiting
  • Hospital Universitario 12 de Octubre

    Madrid

    Juan I Sanchez, MD, juanigancio.sanchez@madrid.salud.org

    Juan I Sanchez, MD

    Recruiting
  • Hospital Universitario Gregorio Marañón

    Madrid

    Laura Herrera, MD, laura.herreracastillo@gmail.com

    Laura Herrera, MD

    Recruiting
  • Hospital Universitario La Paz

    Madrid

    Ana Gomez Zamora, MD, agzamora77@gmail.com

    Ana Gomez Zamora, MD

    Recruiting
  • Hospital Universitario Ramón y Cajal

    Madrid

    Ana Coca, MD, pdacoca@gmail.com

    Ana Coca, MD

    Recruiting
  • Hospital Universitario Virgen de la Arrixaca

    Madrid

    Susana B Reyes, MD, PhD, susanareyes.3110@gmail.com

    Susana B Reyes, MD, PhD

    Recruiting
  • Niño Jesús University Hospital

    Madrid

    Amelia Martínez de Azagra, MD, ameliamartinezdeazagra@gmail.com

    Amelia Martinez de Azagra, MD

    Recruiting
  • Hospital Universitario

    Málaga

    Jose M Gonzalez, josemagogo@hotmail.com

    Jose M Gonzalez, MD

    Recruiting
  • Hospital Central de Asturias

    Oviedo

    Alberto Medina, MD, PhD, amedinavillanueva@gmail.com

    Alberto Medina, MD, PhD

    Recruiting
  • Hospital Universitario Virgen del Camino

    Pamplona

    Mikel Mendizabal, MD, mmendizabaldiez@gmail.com

    Mikel Mendizabal, MD

    Recruiting
  • Hospital Universitario de Salamanca

    Salamanca

    Francisco Fernández, MD, pacojum@gmail.com

    Francisco Fernández, MD

    Recruiting
  • Hospital Universitario Tenerife

    Santa Cruz de Tenerife

    Luis Perez, luisperbae@gmail.com

    Luis Perez, MD

    Recruiting
  • Hospital Universitario Santiago de Compostela

    Santiago de Compostela

    Antonio Rodriguez, MD, antonio.rodruiguez.nuñez@sergas.es

    Antonio Rodriguez, MD, PhD

    Recruiting
  • Hospital Universitario Virgen del Rocio

    Seville

    Julio Parrilla, MD, julioparril@hotmail.com

    Julio Parrilla, MD

    Recruiting
  • Hospital Universitario Virgen de la Salud

    Toledo

    David Arjona, MD, daroja@sescam.jccm.es

    David Arjona

    Recruiting
  • Hospital Universitario La fe

    Valencia

    Vicent Modesto, vicent.modesto@gmail.com

    Vicent Modesto, MD, PhD

    Not yet recruiting
  • Hospital Clinico Universitario

    Valladolid

    Marta Brezmes, martabrezmes@hotmail.com

    Marta Brezmes, MD

    Recruiting
  • Hospital Universitario Miguel Servet

    Zaragoza

    Paula Madurga, MD, paumare@hotmail.com

    Paula Madurga, MD

    Recruiting

Other trials in Spain

About this study

Official title: Prevalence and Outcome of Acute Hypoxemic Respiratory Failure in Children.

The present study is aimed to establish the epidemiological characteristics and clinical outcomes of mechanically ventilated children with acute hypoxemic respiratory failure (AHRF), defined as PaO2/FiO2 ≤300 mmHg on PEEP≥5 cmH2O and FiO2≥0.3, admitted in a network of pediatric hospitals in Spain.

Read the detailed description

Prospective, multicenter, observational study focused on the prevalence and outcomes of Acute Hypoxemic Respiratory Failure in children. From a total of 40 pediatric ICUs in Spain, 22 PICUs agreed to participate.

All consecutive patients from 7 days to 16 years old admitted in the PICU will have been enrolled if they fulfilled the following criteria: 1) acute episode (within 7 days of a clinical insult), 2) on invasive mechanical ventilatory support, 3) PaO2/FiO2 ≤ 300 mmHg (or SpO2/FiO2 ≤ 264), 4) Positive end-expiratory pressure (PEEP) ≥ 5 cmH2O and FiO2 ≥ 0.3.

This study is considered an audit, and informed consent is waived.

Period of study: 2 years (October 2019 to September 2021). Recruitment period: two consecutive months (i.e October-November followed by a period of no recruitment) until complete 12 months of recruitment (September 2021).

All investigators have received guidelines outlining the study design and the methods for data collection. All PICU admissions are screened daily for AHRF. Onset of AHRF was defined as the day on which the patient first met all inclusion criteria. All data are collected on standardized forms. Demographics, comorbidities, reason for initiation of IMV, arterial blood gases, laboratory, radiographic, hemodynamic and ventilator data were collected at study entry and during the first three days of AHRF diagnosis (T0 or time of inclusion in the study, 24 hours, days 2 and 3). Chest imaging (chest radiographs, lung ultrasound or computed tomography) were evaluated daily for the presence or absence of infiltrates, atelectasis, acute pulmonary edema, pleural effusion or pneumothorax. Tidal volume (VT) was calculated on the basis of the predicted body weight (PBW). Plateau pressure (Pplat) was determined after the application of a 0.5- to 1.0-sec end-inspiratory hold. Driving pressure was calculated as the difference between Pplat and PEEP. Patients meeting pediatric ARDS criteria were stratified into a mild, moderate, and severe according to PALICC definition and/or berlin definition. All patients are followed until PICU and hospital discharge.

Data are initially collected and stored at each center and then sent to study coordinators at the time of patient's hospital discharge.

Although patient care is not strictly protocolized, physicians are asked to follow the current standards of pediatric critical care management. For ventilatory management, it was recommended that all patients be ventilated with a VT of 6-8 mL/kg PBW, at a ventilatory rate to maintain PaCO2 at 35-50 mm Hg, a Pplat <30 cm H2O, and PEEP and FiO2 combinations to maintain PaO2 >60 mm Hg or SpO2 >90%.

Statistical Analysis: for the main objective of the study, a descriptive analysis including clinical variables, mechanical ventilation data, respiratory settings and ancillary measures will be performed.

Being tested
Mechanical ventilation
Keywords
respiratory failure, mechanical ventilation, children
Medical subject headings
Respiratory Insufficiency

What participants receive

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

  • Mechanical ventilationDevice

    Ventilatory support

Study groups in NCT04791501
Study groupRoleWhat they receive
Hypoxemic Respiratory FailureConsecutive intubated patients receiving invasive mechanical ventilation with a PaO2/FiO2 ≤300 mmHg under a PEEP of 5 cmH2O or more and FiO2 of 0.3 or more.
Receives: Device: Mechanical ventilation

What is being measured

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

  1. Prevalence of hypoxemic acute respiratory failure.

    The investigators will calculate the prevalence in relation to: (i) total number of ICU admissions during the study period in all participating centers; (ii) total number of mechanically ventilated patients during the study period in all participating centers, and (iii) per ICU bed available in the participating centers over the study period.

    Measured: 12 months

Secondary outcomes (1)
  1. Death in the ICU and in the hospital

    Outcome after discharge from ICU and before discharge to home (overall and in each category of acute hypoxemic respiratory failure).

    Measured: through study completion, an average of 60 days

Timeline

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

  1. First posted10 Mar 2021
  2. Study start1 Oct 2019
  3. Primary completion30 Sep 2021 (estimated)
  4. Study completion30 Oct 2021 (estimated)

Resources

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
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04791501
Sponsor's protocol ID
PI201935
Acronym
PANDORA-child
Status last verified
Mar 2021
First submitted
2 Mar 2021
Last updated
10 Mar 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lopez-Fernandez Y, Azagra AM, de la Oliva P, Modesto V, Sanchez JI, Parrilla J, Arroyo MJ, Reyes SB, Pons-Odena M, Lopez-Herce J, Fernandez RL, Kacmarek RM, Villar J; Pediatric Acute Lung Injury Epidemiology and Natural History (PED-ALIEN) Network. Pediatric Acute Lung Injury Epidemiology and Natural History study: Incidence and outcome of the acute respiratory distress syndrome in children. Crit Care Med. 2012 Dec;40(12):3238-45. doi: 10.1097/CCM.0b013e318260caa3.

    PubMed 22990455
  • Villar J, Blanco J, Anon JM, Santos-Bouza A, Blanch L, Ambros A, Gandia F, Carriedo D, Mosteiro F, Basaldua S, Fernandez RL, Kacmarek RM; ALIEN Network. The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med. 2011 Dec;37(12):1932-41. doi: 10.1007/s00134-011-2380-4. Epub 2011 Oct 14.

    PubMed 21997128
  • Kopczynska M, Sharif B, Pugh R, Otahal I, Havalda P, Groblewski W, Lynch C, George D, Sutherland J, Pandey M, Jones P, Murdoch M, Hatalyak A, Jones R, Kacmarek RM, Villar J, Szakmany T, On Behalf Of The Pandora-Wales Investigators. Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study. J Clin Med. 2020 Oct 31;9(11):3521. doi: 10.3390/jcm9113521.

    PubMed 33142837
  • Lopez-Fernandez YM, Martinez-de-Azagra A, Reyes-Dominguez SB, Gomez-Zamora A, Herrera-Castillo L, Coca-Perez A, Parrilla-Parrilla J, Medina A, Garcia-Iniguez JP, Brezmes-Raposo M, Hernandez-Yuste A, Llorente de la Fuente AM, Ibarra de la Rosa I, Leon-Gonzalez JS, Trastoy-Quintela J, Arjona-Villanueva D, Gonzalez-Martin JM, Szakmany T, Villar J; Prevalence AND Outcome of acute hypoxemic Respiratory fAilure in children (PANDORA-CHILD) Network. The Prevalence and Outcome of Acute Hypoxemic Respiratory Failure (PANDORA) Study in Mechanically Ventilated Children: Prospective Multicenter Epidemiology in Spain, 2019-2021. Pediatr Crit Care Med. 2025 Jun 1;26(6):e759-e772. doi: 10.1097/PCC.0000000000003743. Epub 2025 Apr 25.

    PubMed 40277417

Questions about this trial

What is this clinical trial studying?

An observational study of Acute Respiratory Insufficiency, run by Yolanda Lopez Fernandez at 23 sites in Spain.

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 5 inclusion and 1 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: status not confirmed, as of the sponsor's last update on 10 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in Spain. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Yolanda M López-Fernández, MD (0034946006000 ext. 6582, yolandamarg.lopezfernandez@osakidetza.eus), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of hypoxemic acute respiratory failure. (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04791501, which also lists 4 linked publications.

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 10 Mar 2021.

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