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Bronchoalveolar Lavage FluidNCT06333379

Aspergillosis Detection Via EBC-GM in Ventilated Patients

An observational study of Bronchoalveolar Lavage Fluid and Sensitivity and Specificity, run by Lin Chen at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Brief Research Proposal: Non-Invasive Detection of Invasive Pulmonary Aspergillosis in ICU Patients Background: Invasive Pulmonary Aspergillosis (IPA) is a critical threat to patients in ICUs, especially those undergoing mechanical ventilation. Traditional diagnostic methods are invasive and carry risks. Read more about this study

Who is it for?
Ages 18 to 85 years
What is being tested?
Compare the levels of Galactomannan (GM) levels in exhaled breath condensate (EBC) and BALF
How many people
75 participants
Where
1 siteChina
Study dates
2 Jan 2023to 10 Jan 2024
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 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Investigators at Sichuan Provincial Hospital study mechanically ventilated adults for Invasive Pulmonary Aspergillosis (IPA) risks. They classify participants into IPA and control groups. IPA patients meet EORTC/MSG criteria, showing new lung lesions, positive Aspergillus cultures in LRT, positive galactomannan in BALF, and supporting BALF NGS evidence. The control group includes ventilated patients without Aspergillus, confirmed by negative cultures and NGS in BALF. The study aims to assess EBC-GM's diagnostic accuracy for IPA, comparing it with BALF-GM for early, non-invasive detection.

Who may be able to join

  • Age: Between 18 and 85 years old. Antifungal Medication Use: Participants who have not used any antifungal medications within the three months prior to enrollment.
  • Mechanical Ventilation Status: Patients who have been undergoing mechanical ventilation treatment for more than three days.

Who cannot join

  • Inadequate Clinical Data: Inability to provide reliable diagnostic measurements or insufficient clinical information.
  • Early Mortality: Patients who die within the first three days of ICU (Intensive Care Unit) admission or during the initial phase of the study.
  • Pregnancy: To avoid potential confounding effects on immune function and the composition of EBC (Exhaled Breath Condensate), pregnant women are excluded.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Sichuan Provincial People's Hospital

    Chengdu, Sichuan, 86610072

Other trials in China

About this study

Official title: Non-Invasive Detection of Aspergillosis in Ventilated Patients: Galactomannan Analysis in Exhaled Breath

Brief Research Proposal: Non-Invasive Detection of Invasive Pulmonary Aspergillosis in ICU Patients Background: Invasive Pulmonary Aspergillosis (IPA) is a critical threat to patients in ICUs, especially those undergoing mechanical ventilation. Traditional diagnostic methods are invasive and carry risks. This study proposes a non-invasive, innovative approach utilizing galactomannan (GM) analysis in Exhaled Breath Condensate (EBC) for early IPA detection.

Objective: To evaluate the diagnostic accuracy of measuring GM levels in EBC for detecting IPA in mechanically ventilated patients, comparing it against the conventional Bronchoalveolar Lavage Fluid (BALF)-GM measurements.

Read more

Methods: A clinical trial will be conducted with 75 mechanically ventilated patients suspected of having IPA. The study will compare the effectiveness of EBC-GM levels against BALF-GM levels in diagnosing IPA, focusing on sensitivity, specificity, and diagnostic accuracy. The novel, self-designed EBC collection device will facilitate the safe and efficient collection of EBC from patients.

Expected Outcomes:

Validation of EBC-GM Diagnostic Accuracy: Anticipate demonstrating that EBC-GM levels provide a comparable diagnostic accuracy to BALF-GM, establishing a non-invasive, safer alternative for IPA detection.

Implementation of a Non-Invasive Diagnostic Tool: The study aims to introduce a non-invasive diagnostic approach that can potentially replace more risky, invasive methods, improving patient care in ICUs.

Contribution to Clinical Practice: By providing a new method for early and safer detection of IPA, the study is expected to influence clinical guidelines and practices in the management of critically ill, ventilated patients.

Significance: This research has the potential to revolutionize the diagnosis of fungal infections in critically ill patients by offering a non-invasive, accurate, and safer diagnostic tool, thereby improving patient outcomes and reducing the risks associated with invasive diagnostic procedures.

Read the detailed description

Research Proposal: Advancing the Diagnosis of Invasive Pulmonary Aspergillosis through Exhaled Breath Condensate Analysis in Ventilated Patients Background: Invasive Pulmonary Aspergillosis (IPA) remains a formidable challenge in the management of critically ill, immunocompromised patients, especially those requiring mechanical ventilation in Intensive Care Units (ICUs). The high morbidity and mortality rates associated with IPA underscore the urgent need for early and accurate diagnostic methods. Traditional diagnostic approaches, though effective, are invasive and pose significant risks to already vulnerable patients. This study introduces a novel, non-invasive diagnostic methodology by measuring galactomannan (GM) levels in Exhaled Breath Condensate (EBC), potentially revolutionizing the early detection of IPA.

Objective: To evaluate the effectiveness of a non-invasive diagnostic approach by analyzing galactomannan levels in exhaled breath condensate (EBC) for detecting Invasive Pulmonary Aspergillosis (IPA) in mechanically ventilated ICU patients.

Methods:

Study Design: A prospective clinical trial involving 75 mechanically ventilated patients suspected of having IPA within the Medical Intensive Care Unit (MICU) of a tertiary hospital.

Data Collection: Utilizing a self-designed EBC collection device, EBC samples will be collected from participants and analyzed for GM levels. These will be compared to Bronchoalveolar Lavage Fluid (BALF) GM levels, considered the current gold standard in IPA diagnostics.

Analytical Approach: The study will focus on assessing the diagnostic accuracy of EBC-GM measurements by determining sensitivity, specificity, and overall concordance with BALF-GM levels. The potential enhancement of diagnostic precision with the inclusion of cytokine measurements will also be explored.

Innovation: By leveraging a cutting-edge EBC collection device, this research aims to bypass the complications associated with invasive diagnostic procedures, offering a safer, more patient-friendly alternative. This innovative approach has the potential to significantly impact clinical practices in ICU settings by facilitating early and accurate IPA diagnosis without the need for bronchoscopy.

Expected Outcomes:

Diagnostic Performance: Investigators anticipate demonstrating that EBC-GM levels provide a reliable, non-invasive marker for IPA, with diagnostic accuracy comparable to BALF-GM measurements.

Clinical Impact: The successful validation of EBC-GM as a diagnostic tool for IPA will offer a significant advancement in the management of critically ill patients, reducing the need for invasive procedures and associated risks.

Guideline Integration: Findings from this study are expected to support the integration of EBC-GM analysis into clinical guidelines as a recommended diagnostic approach for IPA in mechanically ventilated patients.

Significance: This research has the potential to transform IPA diagnostics in ICU settings, promoting a shift towards non-invasive, risk-free methods that can lead to earlier detection and improved patient outcomes. By minimizing invasive diagnostic interventions, the study aims to enhance the safety and efficacy of IPA management in critically ill populations.

Ethics and Dissemination: The study adheres to the highest ethical standards, with approval from the institutional review board ensuring the protection and well-being of participants. Results will be actively disseminated through peer-reviewed journals and conference presentations, contributing to global efforts in improving ICU patient care in the context of fungal infections.

Being tested
Compare the levels of Galactomannan (GM) levels in exhaled breath condensate (EBC) and BALF
Keywords
Exhaled breath condensation, Bronchoalvelar lavage fluid, Galactomannan, Invasive Pulmonary Aspergillosis, Non-invasive diagosis
Medical subject headings
Hypersensitivity, Critical Illness, Respiratory Insufficiency, Invasive Pulmonary Aspergillosis

What participants receive

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

  • Compare the levels of Galactomannan (GM) levels in exhaled breath condensate (EBC) and BALFOther

    Investigators tested EBC-GM levels and BALF-GM levels in patients with confirmed IPA to compare the diagnostic value of EBC-GM versus BALF-GM.

Study groups in NCT06333379
Study groupRoleWhat they receive
IPA groupInvestigators enrolled patients who meet diagnostic criteria for IPA according to EORTC/MSG: new exudative lung lesions unresponsive to antimicrobial therapy; positive Aspergillus on LRT and/or BALF microscopy cultures, positive BALF GM and positive BALF NGS results for Aspergillus. Investigators will test and compare the EBC-GM and BALF-GM levels in these patients.
Receives: Other: Compare the levels of Galactomannan (GM) levels in exhaled breath condensate (EBC) and BALF
control groupInvestigators enrolled patients who were mechanically ventilated patients without Aspergillus infection or colonization. BALF and EBC samples from the same patients were collected less than 4 hours apart, and BALF samples were used for NGS and microbiological cultures. Investigators will test and compare the EBC-GM and BALF-GM levels in these patients.
Receives: Other: Compare the levels of Galactomannan (GM) levels in exhaled breath condensate (EBC) and BALF

What is being measured

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

  1. Diagnostic accuracy of EBC-GM vs. BALF-GM

    The diagnostic accuracy of Galactomannan (EBC-GM) levels in Exhaled Breath Condensate vs. Bronchoalveolar Lavage Fluid (BALF-GM) levels was measured by Receiver Operating Characteristic (ROC) area under the curve (AUC) assessment. Accuracy of Galactomannan (BALF-GM) levels in the diagnosis of Invasive Pulmonary Aspergillosis (IPA).

    Measured: EBC and BALF samples were collected simultaneously on the day of patient admission.

  2. EBC-GM levels:

    Evaluate sensitivity and specificity in differentiating patients with IPA from mechanically ventilated patients with non-aspergillosis infections, and determining the critical value of EBC-GM in the diagnosis of IPA.

    Measured: The stability of the patients' vital signs was observed within 72 hours to assess the diagnostic accuracy of EBC-GM and BALF-GM.

Secondary outcomes (1)
  1. Correlation between EBC-GM and BALF-GM levels

    To assess the correlation between EBC-GM levels and BALF-GM levels in mechanically ventilated IPA patients.

    Measured: Based on samples collected on the same day, followed by 72 hours of observation.

Timeline

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

  1. First posted27 Mar 2024
  2. Study start2 Jan 2023
  3. Primary completion30 Dec 2023
  4. Study completion10 Jan 2024

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
Retrospective
Enrolment
75 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06333379
Sponsor's protocol ID
SichuanPPHLC04
Other IDs
2020LY01
Status last verified
Mar 2024
First submitted
18 Mar 2024
Last updated
27 Mar 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: This study tests a non-invasive method for detecting Invasive Aspergillosis (IPA) in ICU patients using ventilators. By analyzing galactomannan in exhaled breath, we aim to identify IPA without invasive procedures. Phase 1 involves testing a new breath collection device on rats. Phase 2 applies this device to 75 ICU patients, comparing results with traditional lung fluid tests. Approval from an ethics committee ensures patient safety. Successful outcomes could lead to safer IPA diagnosis, enhancing treatment and reducing risks associated with current methods.

Publications

  • Tang X, Yang L, Zhang R, Fang H, Tang H, Xie Q, Wang H, Chen L, Yang Y. Non-invasive detection of Aspergillosis in ventilated patients: Galactomannan analysis in exhaled breath. Diagn Microbiol Infect Dis. 2024 Sep;110(1):116420. doi: 10.1016/j.diagmicrobio.2024.116420. Epub 2024 Jun 29.

    PubMed 38954860

Questions about this trial

What is this clinical trial studying?

An observational study of Bronchoalveolar Lavage Fluid and Sensitivity and Specificity, run by Lin Chen at 1 site in China.

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 2 inclusion and 3 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 27 Mar 2024. 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 China. 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.

What does the primary outcome measure?

Diagnostic accuracy of EBC-GM vs. BALF-GM (time frame: EBC and BALF samples were collected simultaneously on the day of patient admission.). The study lists 2 primary outcomes in all. 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 NCT06333379, which also lists 1 linked publication.

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 27 Mar 2024.

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