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

NCT ID: NCT02107222

Last Updated: 2016-04-01

Basic Information

• Recruitment Status: WITHDRAWN
• Clinical Phase: NA
• Study Classification: INTERVENTIONAL

Brief 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

Detailed 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).

Conditions

COPD; Chronic Obstructive Pulmonary Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

mechanical ventilation (MV)

mechanical ventilation according to guidelines

Group Type: NO_INTERVENTION

No interventions assigned to this group

MV + ECCO2-R(PALP-Device/MaquetCP)

MV according to the guidelines plus CO2-Removal with PALP

Group Type: EXPERIMENTAL

CO2-Removal (PALP-Device/MaquetCP)

Intervention Type: DEVICE

extracorporeal circuit to remove CO2 out of the blood

Interventions

CO2-Removal (PALP-Device/MaquetCP)

extracorporeal circuit to remove CO2 out of the blood

Intervention Type: DEVICE

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Maquet Cardiopulmonary GmbH

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Marco V Ranieri, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Investigational institution

Locations

MAQUET Cardiopulmonary AG

Rastatt, , Germany

Countries

Germany

References

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. 2013 Aug;10(4):307-14. doi: 10.1513/AnnalsATS.201301-021OC.

Reference Type: RESULT

PMID: 23952848 (View on PubMed)

Other Identifiers

MAQ/COPD/PALP/2012

Identifier Type: -

Identifier Source: org_study_id