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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05843123
Other study ID # CoCO2
Secondary ID
Status Recruiting
Phase Phase 4
First received
Last updated
Start date January 15, 2024
Est. completion date July 2024

Study information

Verified date April 2024
Source University Children's Hospital, Zurich
Contact Rebeca Mozun, MD PhD
Phone +41 44 266 39 37
Email rebeca.mozuntorrico@kispi.uzh.ch
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study assesses the feasibility of digital data collection for a randomized controlled trial in a quaternary pediatric intensive care unit and the effect of two commonly used mechanical ventilation modes on gas exchange (CO2) in children over 2 days after randomization. This is a single-center, open-labelled, randomized controlled trial with two parallel 1:1 treatment arms: pressure controlled (PC) vs pressure-regulated volume controlled (PRVC) mechanical ventilation modes. Use to routine digital data is essential to enable health learning systems and to provide rapid clinical trials readiness, as the pandemic has demonstrated. Despite availability of data to perform digital trials in PICU settings, these are yet scarcely done.


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date July 2024
Est. primary completion date July 2024
Accepts healthy volunteers No
Gender All
Age group 0 Years to 18 Years
Eligibility Inclusion Criteria: - Informed consent provided by the participant or the participant's parents or legal guardians. In case of an emergency situation, a physician who is independent of the research project must be consulted prior to inclusion in order to safeguard the interests of the test subject. - Admission to PICU at the University Children's Hospital Zurich - Need for mechanical ventilation for >60 min during PICU hospitalization. Need for mechanical ventilation will be based on clinical decision of the treating physician. - Need for an arterial line during PICU hospitalization. Need for an arterial line will be based on clinical decision of the treating physician. - Age <18 years - Weight >2 Kg Exclusion Criteria: - Substantial air leaks around the endotracheal tube (>30%) - Cyanotic shunt lesions - Intracranial hypertension (i.e. traumatic brain injury or patients admitted after neurosurgery) - Pulmonary hypertension under treatment (i.e sildenafil or inhaled nitric oxide) - Time from start of invasive mechanical ventilation until time of screening is > 24 hours - Previous enrolment in the study in the past 30 days - Inability of the parents or legal guardians to understand the study due to linguistic or cognitive reasons

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Respiratory support a
Invasive mechanical ventilation mode
Respiratory support b
Invasive mechanical ventilation mode

Locations

Country Name City State
Switzerland University Children's Hospital Zurich Zürich

Sponsors (1)

Lead Sponsor Collaborator
University Children's Hospital, Zurich

Country where clinical trial is conducted

Switzerland, 

Outcome

Type Measure Description Time frame Safety issue
Other Oxygenation index measured using peripheral oxygen saturation index Other physiological outcome 4a (Peripheral oxygen saturation index = MAP * FiO2 *100 / SpO2; where MAP is mean airway pressure, FiO2 is fraction of inspired oxygen, SpO2 is peripheral oxygen saturation) From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Other Oxygenation index measured using arterial oxygenation index Other physiological outcome 4b (Arterial oxygenation index = MAP * FiO2 *100 / PaO2 ; where MAP is mean airway pressure, FiO2 is fraction of inspired oxygen, PaO2 is partial pressure of oxygen in arterial blood) From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Primary Adherence to the allocated ventilation mode among randomized/enrolled participants Main feasibility outcome From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Primary Proportion of time spent within the target range of carbon dioxide (normocarbia, defined as carbon dioxide = 35 mmHg or 4.5 kPa and = 45 mmHg or 6 kPa) measured using end-tidal carbon dioxide recorded every minute by the ventilation device Main physiological outcome From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Number of patients who were screened, were missed, gave consent and were randomized/enrolled per month Secondary feasibility outcome 1 From date of recruitment start until date of recruitment end (assessed when n=60, anticipated through 6 months of recruitment period)
Secondary Reasons for protocol violations Other feasibility outcome 2a From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours since randomization)
Secondary Time from randomization to protocol violation Other feasibility outcome 2b From time of randomization until time of protocol violation (assessed up to 48 hours)
Secondary Proportion of enrolled participants with complete primary and secondary outcome data extracted from the electronic patient records Other feasibility outcome 3 From date of recruitment start until date of study end (assessed when n=60 and data has been extracted for all participants, anticipated through 8 months)
Secondary Time from ventilation start until screening Other feasibility outcome 4a From time of ventilation start until time of screening (assessed up to 48 hours)
Secondary Time from ventilation start until randomization Other feasibility outcome 4b From time of ventilation start until time of randomization (assessed up to 48 hours)
Secondary Time from consent until randomization Other feasibility outcome 5 From time of consent signed until time of randomization (assessed up to 48 hours)
Secondary Time weighted average of hypocarbia (carbon dioxide < 35 mmHg or 4.5 kPa), measured using continuous end-tidal carbon dioxide Secondary physiological outcome 1a From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypocarbia (carbon dioxide < 35 mmHg or 4.5 kPa) measured using intermittent arterial blood measurements Other physiological outcome 1b From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypocarbia (carbon dioxide < 35 mmHg or 4.5 kPa) measured using continuous transcutaneous carbon dioxide measurements calibrated with results of arterial blood gas analysis Other physiological outcome 1c From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypercarbia (carbon dioxide > 45 mmHg or 6 kPa) measured using continuous end-tidal carbon dioxide Other physiological outcome 2a From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypercarbia (carbon dioxide >45 mmHg or 6 kPa) measured using intermittent arterial blood measurements Other physiological outcome 2b From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypercarbia (carbon dioxide > 45 mmHg or 6 kPa) measured using continuous transcutaneous carbon dioxide measurements calibrated with results of arterial blood gas analysis Other physiological outcome 2c From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypo- and hypercarbia (i.e. outside normocarbia, carbon dioxide < 35 mmHg or 4.5 kPa; or carbon dioxide >45 mmHg or 6 kPa) measured using continuous end-tidal carbon dioxide Other physiological outcome 3a From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypo- and hypercarbia (i.e. outside normocarbia, carbon dioxide < 35 mmHg or 4.5 kPa; or carbon dioxide >45 mmHg or 6 kPa) measured using intermittent arterial blood measurements Other physiological outcome 3b From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
Secondary Time weighted average of hypo- and hypercarbia (i.e. carbon dioxide < 35 mmHg or 4.5 kPa; or >45 mmHg or 6 kPa) measured using continuous transcutaneous carbon dioxide measurements calibrated with results of arterial blood gas analysis Other physiological outcome 3c From time of randomization until 48 hours, extubation, discharge or death, whichever comes first (assessed up to 48 hours)
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