Biphasic Ventilation Airway Management Clinical Trial

NCT ID: NCT03042598

Last Updated: 2017-02-03

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

2017-01-14

Study Completion Date

2017-04-30

Brief Summary

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Investigators intend to determine if the use of Biphasic Cuirass Ventilation (BCV) improves patient safety (avoiding hypoxia) during emergency rapid sequence intubation .

Detailed Description

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Methods/ Interventions:

Patients who are deemed to meet inclusion criteria and none of the exclusion criteria will be preoxygenated by any of the acceptable standard preoxygenation strategies (non-rebreather face mask, noninvasive positive pressure ventilation, etc.) . Patients will be placed and maintained on continuous 3-lead cardiac, automatic blood pressure, pulse oximeter, and waveform capnography monitoring for the duration of the procedure. Prior to induction, and during the pre oxygenation phase, subjects will be placed on the Biphasic Cuirass Ventilation (BCV) device per the manufacturer's guidelines. After adequate preoxygenation has been achieved (as determined by the treating emergency physician), the BCV assisted ventilations will be maintained and standard of care intubation procedures including apenic oxygenation if ordered by attending emergency physician will be utilized. BCV will be discontinued upon confirmation of proper tracheal intubation by waveform capnography.

Safety The BCV device covers the anterior chest wall, and therefore, it cannot be in place if CPR is needed. Therefore, all patients in cardiac arrest will be excluded. Investigators will be excluding patients with a pacemaker or central line which impairs the ability of the Curiass shell to secure on the anterior chest. Finally, patients with a history of valvular heart disease will be excluded. The protocol directs the device be applied during the normal preoxygenation period (\~within that 3-5 minute period of time prior to the administration of the induction and paralytic medications). There are no other known side effects of this device. There is a potential for the device application to delay the intubation attempt; however, it is not known whether delaying intubation ,while augmenting a patient's breathing with the BCV device, negatively impacts the patient's condition. The data collection form explicitly asks the intubating physician thinks that the device delayed the intubation attempt in any way. The data collection form also tracks all of the relevant time milestones. Both of these items will be reviewed periodically during the study as safety endpoints by the data monitoring committee and will be included in the manuscript results.

Conditions

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Intubation

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This is a single arm interventional feasibility trial to determine if the use of a Biphasic Cuirass Ventilator during the apneic period of intubation will decrease the prevalence of oxygen desaturation in patients undergoing RSI as compared to historical proportions of 20%.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Biphasic Cuirass Ventilation

Patients requiring emergent intubation in the Emergency Department will be provided ventilation during the apnic phase of intubation via the use of BCV.

Group Type EXPERIMENTAL

Biphasic Cuirass Ventilation

Intervention Type DEVICE

The RTX Respirator will be applied to the patient's chest to provide non-invasive ventilatory support using a Biphasic Cuirass Ventilation technology to increase the safe apnic period during intubation.

Interventions

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Biphasic Cuirass Ventilation

The RTX Respirator will be applied to the patient's chest to provide non-invasive ventilatory support using a Biphasic Cuirass Ventilation technology to increase the safe apnic period during intubation.

Intervention Type DEVICE

Other Intervention Names

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RTX Respirator, Hayek Medical

Eligibility Criteria

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Inclusion Criteria

* Patients who present to the adult emergency department and require emergency intubation.
* Patient's primary language is English.

Exclusion Criteria

* Cardiac arrest.
* Attending provider excludes patient as being at high risk for cardiac arrest or for any other reason.
* Patients who are known or reported to be pregnant pre-procedure.
* Patients in the custody of law enforcement.
* Inability to pre-oxygenate patient to an SPO2 equal to or greater than 95 percent prior to induction.
* Morbidly or Extremely obese patients defined by the NIH as BMI greater than 40.
* History of valvular heart disease.
* Presence of subclavian central line or pacemaker which impairs ability of shell to seal.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Medical Center of Southern Nevada

OTHER

Sponsor Role lead

Responsible Party

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David E Slattery

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David E Slattery, MD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center of Southern Nevada

Locations

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University Medical Center of Southern Nevada

Las Vegas, Nevada, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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David E Slattery, MD

Role: CONTACT

702-561-6260

Wesley J Forred, RN

Role: CONTACT

702-466-7801

Facility Contacts

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Wesley J Forred, RN

Role: primary

702-466-7801

Ronald Roemer, BS

Role: backup

702-207-8345

References

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Weingart SD, Levitan RM. Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med. 2012 Mar;59(3):165-75.e1. doi: 10.1016/j.annemergmed.2011.10.002. Epub 2011 Nov 3.

Reference Type BACKGROUND
PMID: 22050948 (View on PubMed)

Bodily JB, Webb HR, Weiss SJ, Braude DA. Incidence and Duration of Continuously Measured Oxygen Desaturation During Emergency Department Intubation. Ann Emerg Med. 2016 Mar;67(3):389-95. doi: 10.1016/j.annemergmed.2015.06.006. Epub 2015 Jul 9.

Reference Type BACKGROUND
PMID: 26164643 (View on PubMed)

Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013 Jan;20(1):71-8. doi: 10.1111/acem.12055.

Reference Type BACKGROUND
PMID: 23574475 (View on PubMed)

Brimacombe J, Keller C. Who is at increased risk of aspiration? Br J Anaesth. 2005 Feb;94(2):251; author reply 251-2. doi: 10.1093/bja/aei511. No abstract available.

Reference Type BACKGROUND
PMID: 15629910 (View on PubMed)

Kamine TH, Papavassiliou E, Schneider BE. Effect of abdominal insufflation for laparoscopy on intracranial pressure. JAMA Surg. 2014 Apr;149(4):380-2. doi: 10.1001/jamasurg.2013.3024.

Reference Type BACKGROUND
PMID: 24522521 (View on PubMed)

Li J, Murphy-Lavoie H, Bugas C, Martinez J, Preston C. Complications of emergency intubation with and without paralysis. Am J Emerg Med. 1999 Mar;17(2):141-3. doi: 10.1016/s0735-6757(99)90046-3.

Reference Type BACKGROUND
PMID: 10102312 (View on PubMed)

Benumof JL, Dagg R, Benumof R. Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinylcholine. Anesthesiology. 1997 Oct;87(4):979-82. doi: 10.1097/00000542-199710000-00034. No abstract available.

Reference Type BACKGROUND
PMID: 9357902 (View on PubMed)

Corrado A, Gorini M, Melej R, Baglioni S, Mollica C, Villella G, Consigli GF, Dottorini M, Bigioni D, Toschi M, Eslami A. Iron lung versus mask ventilation in acute exacerbation of COPD: a randomised crossover study. Intensive Care Med. 2009 Apr;35(4):648-55. doi: 10.1007/s00134-008-1352-9. Epub 2008 Nov 20.

Reference Type BACKGROUND
PMID: 19020859 (View on PubMed)

Other Identifiers

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EM 2016.05

Identifier Type: -

Identifier Source: org_study_id

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