Point-of-Care Bedside Lung Ultrasound Examination Advanced Trial Protocol

NCT ID: NCT02403791

Last Updated: 2015-03-31

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

COMPLETED

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2015-03-31

Brief Summary

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The purpose of this study was to evaluate the availability and diagnostic accuracy of point-of-care bedside lung ultrasound examination in management of mechanical ventilation in neonatal acute respiratory distress syndrome.

Detailed Description

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Neonatal acute respiratory distress syndrome (ARDS) is a critical condition requiring dynamic evaluation and interventions. Point-of-care bedside lung ultrasound examination (PoC-BLUE) is a noninvasive, readily available imaging modality that can complement physical and clinical evaluation.

At any time, most neonates and infants with ARDS in medical intensive care units (ICUs) require mechanical ventilation, making it one of the most frequently used critical care technologies. However, difficulties with regard to the accurate diagnosis of ARDS before administration of mechanical ventilation, dynamic monitoring of treatment effects during administration of mechanical ventilation, and decision-making of timing in weaning from mechanical ventilation, are often encountered in the majority neonates and infants who require mechanical ventilation.

Hence, techniques that expedite and advance the knowledge of the administration of mechanical ventilation should have an important clinical significance in the diagnosis, treatment and prognosis of ARDS.

Preliminary researches have suggested that BLUE has a high diagnostic accuracy in patients with acute respiratory failure, and has the potential to quantify the rate and degree of diaphragm thinning during mechanical ventilation, which may be useful to predict extubation success or failure during either spontaneous breathing (SB) or pressure support (PS) trials.

Unfortunately, few studies focus on the availability of PoC-BLUE in management of mechanical ventilation in neonatal acute respiratory distress syndrome. Also, they call into question the possible association of the demographic and clinical confounders with the diagnostic accuracy of PoC-BLUE for diagnosis, monitoring and prognosis of ARDS in the whole process of mechanical ventilation.

Given that a considerable need for a timely and dynamic diagnosis of severe condition and therapy evaluation during mechanical ventilation has been triggered to integrate the currently available bulk of knowledge and information, the objective of this study is to investigate the availability and diagnostic accuracy of PoC-BLUE Plus protocol in management of mechanical ventilation in ARDS.

Conditions

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Acute Respiratory Distress Syndrome

Keywords

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Acute Respiratory Distress Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Lung Ultrasound

In infants allocated to this arm Lung ultrasound for detection of ARDS will be performed before chest radiography.

Group Type EXPERIMENTAL

Linear Ultrasonic Sounder

Intervention Type DEVICE

Lung ultrasound evaluation is performed after clinical assessment and before chest radiography

Chest Radiography

In infants allocated to this arm chest radiography will be performed for the detection of indirect signs of ARDS without ultrasound evaluation.

Group Type ACTIVE_COMPARATOR

Bedside X-ray Machine

Intervention Type DEVICE

Chest Radiography is performed after clinical evaluation without using ultrasound assessment.

Interventions

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Linear Ultrasonic Sounder

Lung ultrasound evaluation is performed after clinical assessment and before chest radiography

Intervention Type DEVICE

Bedside X-ray Machine

Chest Radiography is performed after clinical evaluation without using ultrasound assessment.

Intervention Type DEVICE

Other Intervention Names

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Bedside Ultrasonography System Chest X-ray System

Eligibility Criteria

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Inclusion Criteria

* All infants who present to the ICU with respiratory symptoms suspicious for ARDS, according to Pediatric Acute Respiratory Distress Syndrome: Consensus Recommendations From the Pediatric Acute Lung Injury Consensus Conference, which is proposed by The Pediatric Acute Lung Injury Consensus Conference Group.
* In whom the treating Collaborative Review Groups of Poc-BLUE-Plus protocol believe would benefit from diagnostic imaging.

Exclusion Criteria

* Infants who arrive at the ICU with a previously performed chest radiography
* Unstable infants with life-threatening injuries who require ongoing resuscitation
Minimum Eligible Age

1 Day

Maximum Eligible Age

31 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The second affiliated hospital of Jinan University School of Medicine

UNKNOWN

Sponsor Role collaborator

First Affiliated Hospital of Chengdu Medical College

OTHER

Sponsor Role collaborator

The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role collaborator

Women and Children Health Hospital of Jiangsu Province

UNKNOWN

Sponsor Role collaborator

Affiliated Hospital of Sichuan Vocational College of Health and Rehabilitation

UNKNOWN

Sponsor Role collaborator

First Affiliated Hospital of Jinan University

OTHER

Sponsor Role collaborator

Yangzhou University

OTHER

Sponsor Role collaborator

The Third Affiliated Hospital of Southern Medical University

OTHER_GOV

Sponsor Role collaborator

The Sichuan Second Hospital of Guangxi Medical University

UNKNOWN

Sponsor Role collaborator

Guangzhou General Hospital

OTHER

Sponsor Role collaborator

Nankai University School of Medicine

OTHER

Sponsor Role collaborator

Guangdong Medical College

OTHER

Sponsor Role collaborator

Chongqing Medical University

OTHER

Sponsor Role collaborator

Tsinghua University

OTHER

Sponsor Role collaborator

Guiyang Medical University

OTHER

Sponsor Role collaborator

Shenzhen Institutes of Advanced Technology Chinese Academy of Science

UNKNOWN

Sponsor Role collaborator

Jiamusi University

UNKNOWN

Sponsor Role collaborator

The University of Science and Technology of China

OTHER

Sponsor Role collaborator

Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

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Hong Liu

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jie Zhou, MD

Role: STUDY_DIRECTOR

The First Affiliated Hospital with Nanjing Medical University

References

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Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015 Jun;16(5):428-39. doi: 10.1097/PCC.0000000000000350.

Reference Type RESULT
PMID: 25647235 (View on PubMed)

Muscedere J, Dodek P, Keenan S, Fowler R, Cook D, Heyland D; VAP Guidelines Committee and the Canadian Critical Care Trials Group. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: diagnosis and treatment. J Crit Care. 2008 Mar;23(1):138-47. doi: 10.1016/j.jcrc.2007.12.008.

Reference Type RESULT
PMID: 18359431 (View on PubMed)

ARDS Definition Task Force; Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.

Reference Type RESULT
PMID: 22797452 (View on PubMed)

MacIntyre NR, Cook DJ, Ely EW Jr, Epstein SK, Fink JB, Heffner JE, Hess D, Hubmayer RD, Scheinhorn DJ; American College of Chest Physicians; American Association for Respiratory Care; American College of Critical Care Medicine. Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001 Dec;120(6 Suppl):375S-95S. doi: 10.1378/chest.120.6_suppl.375s. No abstract available.

Reference Type RESULT
PMID: 11742959 (View on PubMed)

Other Identifiers

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PoC-BLUE-Plus One

Identifier Type: -

Identifier Source: org_study_id