The PALP™-COPD Trial (Low-Flow CO2-Removal (ECCO2-R) in Exacerbated COPD)

Chronic Obstructive Pulmonary Disease Clinical Trial

— PALP-COPD  

Official title:

A Multicenter Randomized Control Trial (RCT) to Determine Safety and Efficacy of PALP™ for ECCO2-R in Conjunction With Liberation From Mechanical Ventilation (MV) Compared to MV Alone in COPD Exacerbation and Respiratory Failure

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02107222
• Other study ID #: MAQ/COPD/PALP/2012
• Status: Withdrawn
• Phase: N/A
• First received: March 28, 2014
• Last updated: March 31, 2016

Study information

• Verified date: March 2016
• Source: Maquet Cardiopulmonary AG
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

A Multicenter, Randomized, Controlled Trial to Determine Safety and Efficacy of Pump Assisted Lung Protection (PALP™) for Low Flow Carbon Dioxide (CO2) Removal in Conjunction with Liberation from Mechanical Ventilation Compared to Mechanical Ventilation Alone in Patients with COPD Exacerbation and Respiratory Failure

Description:

Primary Study Objectives

• To evaluate the clinical effect of PALP™ in reducing the time on invasive ventilation in patients with an exacerbation of COPD requiring invasive mechanical ventilation.

Secondary Study Objectives

• To evaluate the safety and tolerability of PALP™ in patients with an exacerbation of COPD requiring invasive mechanical ventilation.

• To determine if rates of adverse events (AEs) are reduced in patients who receive PALP™ and invasive mechanical ventilation vs invasive mechanical ventilation alone.

• To determine mortality rates in patients who receive PALP™ and invasive mechanical ventilation vs invasive mechanical ventilation alone.

• To determine if PALP™ will effectively reduce the number of subsequent acute decompensations requiring hospital admission for ventilatory support (invasive or noninvasive).

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. primary completion date: December 2016
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Male or female, and =40 years of age

2. Known history of COPD

3. Currently experiencing an exacerbation of COPD

4. P/F ratio >150 mmHg

5. Currently endotracheally intubated and requiring invasive mechanical ventilation (must have been on invasive mechanical ventilation for 24-48 hours)

6. Able to tolerate large bore intravenous (IV) cannulation required for proper operation of study device

7. For female patients of child-bearing potential, a negative urine or serum pregnancy test at screening; all female patients will be considered of child-bearing potential unless they are post menopausal for at least 1 year or have been surgically sterilized (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy)

8. Written informed consent obtained according to local regulations; or, if unable to provide written informed consent due to incapacitation, a legally authorized representative is able to provide written informed consent on behalf of the patient

Exclusion Criteria:

1. Any end-stage medical conditions with expected survival <6 months

2. Tracheostomy

3. Unable to provide central venous access

4. Acute brain injury

5. Any legally authorized document(s) that may restrict aggressive medical management such as "Do Not Resuscitate," "Do Not Intubate," etc.

6. Risk of bleeding or clotting such as:

• Known bleeding diathesis or abnormal clotting

• Recent or current use of medications known to increase risk of bleeding

7. Screening platelet count of <75,000/mm3 or international normalized ratio (INR) >1.5 or activated partial thromboplastin time (aPTT) >1.5 times the upper limit of normal (ULN) range for their respective laboratory values

8. Any recognized contra indications to systemic anticoagulation therapy or use of heparin

9. Body mass index (BMI) >35

10. Any form of chronic hyperventilation not related to COPD

11. Hemodynamic instability or requiring significant vasopressor support

12. Cardiogenic or noncardiogenic pulmonary edema as the primary reason for respiratory failure

13. High risk cardiac conditions

14. Oxygen tension in arterial blood (PaO2) <50 mmHg via arterial blood gas (ABG) or any condition in which hypoxemia is a significant component of the respiratory failure

15. Any other medical cause for acute respiratory failure not directly related to a COPD exacerbation

16. Use of or treatment with an investigational drug, therapy, or device within 1 month (30 days) of baseline

17. Female patients who are pregnant or breastfeeding

18. Patients who are immuno-compromised

19. Current active malignancy or history of malignancy within the past 5 years

20. Patients in chronic dialysis

21. Patients requiring extra-corporeal life support (ECLS) as a bridge to transplant

22. Patients who, in the opinion of the investigator, would not be able to comply with the requirements of the study

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Chronic Obstructive Pulmonary Disease
• COPD
• Lung Diseases, Obstructive
• Pulmonary Disease, Chronic Obstructive

Intervention

Device:
• CO2-Removal (PALP-Device/MaquetCP)
extracorporeal circuit to remove CO2 out of the blood

Locations

Country	Name	City	State
Germany	MAQUET Cardiopulmonary AG	Rastatt

Sponsors (1)

Lead Sponsor	Collaborator
Maquet Cardiopulmonary AG

Country where clinical trial is conducted

Germany, 

References & Publications (1)

Abrams DC, Brenner K, Burkart KM, Agerstrand CL, Thomashow BM, Bacchetta M, Brodie D. Pilot study of extracorporeal carbon dioxide removal to facilitate extubation and ambulation in exacerbations of chronic obstructive pulmonary disease. Ann Am Thorac Soc — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Difference in time of mechanical ventilation	• To evaluate the clinical effect of PALP™ in reducing the time on invasive ventilation in patients with an exacerbation of COPD requiring invasive mechanical ventilation.	720 hours	No