Effect of Extracorporeal CO2 Removal in Stable Hypercapnic COPD Patients

NCT ID: NCT02260583

Last Updated: 2017-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2018-12-31

Brief Summary

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Chronic hypercapnic respiratory failure is common in stable COPD patients in a terminal phase of their disease In an attempt to correct or slow down the rate of rise of PaCO2, long-term noninvasive mechanical ventilation (NIV) has been proposed.

Only very few studies demonstrated the clinical efficacy of NIV. Indeed this technique is not always well tolerated and therefore it may be effective only in a subset of patients The aim of this study is to assess the feasibility and safety of "one shot" extrcorporeal CO2 removal device, in reducing the PaCO2 level

Detailed Description

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Chronic hypercapnic respiratory failure is common in stable COPD patients in a terminal phase of their disease In an attempt to correct or slow down the rate of rise of PaCO2, long-term noninvasive mechanical ventilation (NIV) has been proposed.

Only very few studies demonstrated the clinical efficacy of NIV. Indeed this technique is not always well tolerated and therefore it may be effective only in a subset of patients Recently extracorporeal CO2 removal have been shown to avoid the need of endotracheal intubation in COPD patients with an episode of Acute Hypercapnic Respiratory Failure In this pilot physiological study we want to assess the safety and efficacy of this technique in reducing the PaCO2 level in those COPD patients with chronic hypercapnic respiratory failure non responding to chronic NIV.

Conditions

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Chronic Obstructive Pulmonary Disease Patients Chronic Respiratory Failure

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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extracorporeal CO2 removal device

the patients will be enroll to start a "one shot" session of extracorporeal CO2 removal. The patient will be connected to the device via a double lumen catheter inserted in the femoral vein An ECCO2R device based on a modified continuous venovenous hemofiltration system will be used. Blood flow is driven by a roller nonocclusive pump (0-450 mL/min) through a polypropylene oxygenator ; priming volume, 100 mL; contact surface area, 1.35 m2; maximum blood flow rate, 7 L/min) that is connected to a fresh gas flow source delivering 100% oxygen at a constant rate of 8 L/min. Exiting the oxygenator, blood is driven to a hemofilter.

Group Type EXPERIMENTAL

extracorporeal CO2 device

Intervention Type DEVICE

An ECCO2R device based on a modified continuous venovenous hemofiltration system will be used

Interventions

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extracorporeal CO2 device

An ECCO2R device based on a modified continuous venovenous hemofiltration system will be used

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* COPD ( FEV1/CVF \<0.70 post bronchodilation)
* stable PaCO2 \>55 mmHg non respondent to long-term NIV (at least one week). This means a decrease in PaCO2 during spontaneous breathing, at least 4 hrs after the termination of NIV, of\< 6%
* pH \> 7.35
* clinical stability

Exclusion Criteria

* Mean Arterial Pressure \< 60 mmHg
* contra-indication to heparin
* Body Mass Index (BMI) \> 30 kg/m2;
* presence of sleep apnea or overall syndrome
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Responsible Party

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dr. Stefano Nava

PRofessor of Respiratory Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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stefano nava

Role: PRINCIPAL_INVESTIGATOR

sant'orsola malpighi hospital

Locations

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san'Orsola Malpighi Hospital, Bologna ITALY

Bologna, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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stefano nava

Role: CONTACT

Phone: 051 6364017

Email: [email protected]

Facility Contacts

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stefano nava, md

Role: primary

lara pisani, md

Role: backup

Other Identifiers

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176/2013

Identifier Type: -

Identifier Source: org_study_id