Predictive Values of Plasma Soluble RAGE Levels and RAGE Polymorphisms for the Onset of Acute Respiratory Distress Syndrome in Critically Ill Patients

Intensive Care Unit Clinical Trial

— PrediRAGE  

Official title:

Predictive Values of Plasma Soluble RAGE Levels and RAGE Polymorphisms for the Onset of Acute Respiratory Distress Syndrome in Critically Ill Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02070536
• Other study ID #: CHU-0182
• Status: Completed
• Start date: February 2014
• Est. completion date: December 2016

Study information

• Verified date: February 2014
• Source: University Hospital, Clermont-Ferrand
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Current clinical prediction scores for acute respiratory distress syndrome (ARDS) have limited positive predictive value. No studies have evaluated predictive kinetics of plasma biomarkers and receptor for advanced glycation end products (RAGE) polymorphisms in a broad population of critically ill patients or as an adjunct to clinical prediction scores.

The main objective of the investigators study is to evaluate the predictive values of plasma soluble RAGE levels for the onset of ARDS in a high risk population of patients admitted to the intensive care unit (ICU).

One of the investigators goals is to improve early identification of patients at risk for ARDS in order to better implement preventive stategies prior to ARDS development.

The primary outcome is the occurrence of ARDS during the first week after admission to the ICU.

Description:

BACKGROUND :

ARDS is a major cause of morbidity and mortality in critically ill patients. Only few pharmacological treatments are available, with limited evidence of efficacy.

The development of efficient preventive stategies is limited by the investigators inability to predict which patients are likely to develop ARDS. The Lung Injury predicition Score (LIPS) has been developed to identify patients at high risk for ARDS, but its predictive value remains limited.

The receptor for advanced glycation end product (RAGE) is now identified as a marker of alveolar type I cell injury. RAGE is a member of the immunoglobulin superfamily that acts as a multiligand receptor which is involved in propagating inflammatory responses. Plasma levels of sRAGE are correlated with clinical and radiologic severity in ARDS patients.

The investigators main objective is to assess the predictive values of plasma sRAGE and esRAGE levels, as well as their evolution over the first 24 hours after admission, for the onset of ARDS in high risk patients.

The secondary objectives are to :

• to evaluate the predictive value of RAGE polymorphisms (_429 T/C, _374 T/A, 2184 A/G, Gly82Ser) for the onset of ARDS

• to evaluate the predictive value of maximal plasma levels of RAGE soluble forms for the onset of ARDS

• to test the relationship between RAGE polymorphisms and plasma sRAGE and esRAGE levels

• to test whether serial sRAGE measurements would improve the discrimination of the LIP Score or not

• to evaluate the prognostic value of plasma levels of RAGE soluble forms for : duration of mechanical ventilation, length of stay in the ICU and 30-day mortality.

DESIGN NARRATIVE :

The purpose of this prospective observational study is to test the values of RAGE polymorphism and soluble forms plasma levels for ARDS prediction in high risk ICU patients

Recruitment information / eligibility

• Status: Completed
• Enrollment: 500
• Est. completion date: December 2016
• Est. primary completion date: March 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients admitted to the ICU

• Patients presenting with risk factors for ARDS : high risk surgery, sepsis, shock, panceatitis, pneumonia, aspiration, drowning, massive transfusion, pulmonary contusion, serious burn, severe trauma.

• Informed consent

Exclusion Criteria:

• Pregnancy

• Age < 18 years

• Criteria for ARDS at admission to the ICU

• Expected survival under 48 hours

Related Conditions & MeSH terms

• Acute Lung Injury
• Intensive Care Unit
• Population at High Risk for ARDS Development
• Respiratory Distress Syndrome, Adult
• Respiratory Distress Syndrome, Newborn

Intervention

Other:
• sRAGE

Locations

Country	Name	City	State
France	CHU de Clermont-Ferrand	Clermont-Ferrand

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Clermont-Ferrand

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	development of ARDS	The development of ARDS, based on Berlin definition criteria, during the first week after admission to the ICU	during the first week after admission to the ICU
Secondary	Plasma sRAGE and esRAGE levels		at ICU admission (Day 0)
Secondary	Plasma sRAGE and esRAGE levels		(Day 1)
Secondary	Evolution of plasma sRAGE levels		between day 0 and day 1
Secondary	Maximal plasma levels of sRAGE and esRAGE		during the first 24 hours after ICU admission
Secondary	Development of ARDS		during at day 14 and day 30 after ICU admission
Secondary	Total duration of mechanical ventilation		at day 1
Secondary	Length of stay in ICU		at day 1