Evaluation of the Effectiveness of Non-invasive Ventilation on the Reperfusion Pulmonary Edema Post Pulmonary Artery Angioplasty in the Post Embolic Pulmonary Hypertension

NCT ID: NCT02548091

Last Updated: 2017-10-13

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

236 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-01

Study Completion Date

2018-03-31

Brief Summary

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The purpose of this study is to determine whether Non Invasive Ventilation are effective in prevention of reperfusion pulmonary edema after pulmonary artery angioplasty. Our hypothesis is that administration of Non Invasive Ventilation during the procedure and systematically in post procedure period is a protective factor against the development and severity of reperfusion pulmonary edema.

Detailed Description

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Conditions

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Reperfusion Pulmonary Edema

Keywords

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non invasive ventilation reperfusion pulmonary edema chronic thrombolic pulmonary hypertension pulmonary artery angioplasty

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Preventive non invasive ventilation

Patients will receive the non invasive ventilation (NIV) systematically during the whole procedure of pulmonary angioplasty, and then systematically in post procedure period, 1 hour every 4 hours, during the whole hospitalization in post anesthesia care unit (PACU).

Group Type ACTIVE_COMPARATOR

Blood samples for assays of plasma inflammatory markers (cytokines InterLeukin-6, InterLeukin-8, InterLeukin-10)

Intervention Type OTHER

The same amount of blood sample is collected from both arms of study at the same time of the procedure.

In each patient, in the per procedure period, a total of 50 milliliters of blood sample is drawn from the pulmonary circulation downstream and upstream of obstructive lesion, the trunk of pulmonary artery, the superior vena cava and the femoral arterial line prior to angioplasty and at the end of procedure; in the post interventional care unit 10 milliliters of blood sample will be draw daily from the superior vena cava catheter line and femoral arterial line.

Non invasive ventilation

Intervention Type PROCEDURE

monitoring system Pulse-Induced Contour Cardiac Output (Picco)

Intervention Type PROCEDURE

Computed tomography (CT)

Intervention Type PROCEDURE

Non invasive ventilation on demand

Patients will not receive the NIV during the procedure of pulmonary angioplasty; in case of respiratory decompensation in post procedure period they will receive NIV during the whole hospitalization in PACU according to the following criteria: paradoxical breathing, respiratory rate above 25/minutes, a ratio of arterial oxygen pressure to fraction of inspired oxygen values (PaO2/FiO2) below 200.

Group Type OTHER

Blood samples for assays of plasma inflammatory markers (cytokines InterLeukin-6, InterLeukin-8, InterLeukin-10)

Intervention Type OTHER

The same amount of blood sample is collected from both arms of study at the same time of the procedure.

In each patient, in the per procedure period, a total of 50 milliliters of blood sample is drawn from the pulmonary circulation downstream and upstream of obstructive lesion, the trunk of pulmonary artery, the superior vena cava and the femoral arterial line prior to angioplasty and at the end of procedure; in the post interventional care unit 10 milliliters of blood sample will be draw daily from the superior vena cava catheter line and femoral arterial line.

Non invasive ventilation

Intervention Type PROCEDURE

monitoring system Pulse-Induced Contour Cardiac Output (Picco)

Intervention Type PROCEDURE

Computed tomography (CT)

Intervention Type PROCEDURE

Interventions

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Blood samples for assays of plasma inflammatory markers (cytokines InterLeukin-6, InterLeukin-8, InterLeukin-10)

The same amount of blood sample is collected from both arms of study at the same time of the procedure.

In each patient, in the per procedure period, a total of 50 milliliters of blood sample is drawn from the pulmonary circulation downstream and upstream of obstructive lesion, the trunk of pulmonary artery, the superior vena cava and the femoral arterial line prior to angioplasty and at the end of procedure; in the post interventional care unit 10 milliliters of blood sample will be draw daily from the superior vena cava catheter line and femoral arterial line.

Intervention Type OTHER

Non invasive ventilation

Intervention Type PROCEDURE

monitoring system Pulse-Induced Contour Cardiac Output (Picco)

Intervention Type PROCEDURE

Computed tomography (CT)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years
* First and /or second procedure of pulmonary artery angioplasty
* Mean pulmonary arterial pressure ≥ 40 mmHg and/or pulmonary vascular resistance ≥ 8 WU (Wood unit)
* Patient who signed informed consent
* Patients affiliated to a social security program

Exclusion Criteria

* severe neurological disease: Coma Glasgow Scale \< 8, severe cognitive decline, postural instability, loss of autonomy.
* psychiatric disease (illness)
* sepsis, severe sepsis and septic shock, according to definitions and diagnostic criteria for sepsis of 'Surviving Sepsis Campaign 2012'
* severe respiratory failure defined by a total lung capacity (TLC)\< 50% of the predicted value and/or expiratory volume in 1 second (FEV) \< 30% of predicted value
* obstructive sleep apnea syndrome with Continuous Positive Airway treatment
* preexisting hemorrhagic syndrome or coagulation factors deficiency
* severe renal insufficiency with glomerular filtration rate \< 30 ml/min
* severe hepatic failure with hepatic encephalopathy, hemodynamic disorder, decompensates cirrhosis, metabolic disorder( metabolic acidosis, hypoglycemia) hepatorenal syndrome, coagulation disorder (factor V\< 50%,disseminated intravascular coagulation)
* patient refusal of participation in the study program
* subjects not affiliated to social security program
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Chirurgical Marie Lannelongue

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Centre Chirurgical Marie Lannelongue

Le Plessis-Robinson, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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PATRASCU ALINA, MD

Role: CONTACT

Phone: 01 40 94 25 97

Email: [email protected]

Other Identifiers

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2015-A00399-40

Identifier Type: -

Identifier Source: org_study_id