Cardiorespiratory Performance and Pulmonary Microbiome in Patients After Repair of Esophageal Atresia

NCT ID: NCT03767673

Last Updated: 2018-12-06

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-08-10

Study Completion Date

2019-09-02

Brief Summary

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The majority of the clinical research on esophageal atresia focuses on the upper gastrointestinal tract. However, the trachea and the lung are also affected in many of these children, so that a lifelong pulmonary impairment may result. The importance of respiratory function in the context of follow-up of these patients has therefore been increasingly recognized in recent years. Scientific work has shown significantly, that patients following esophageal atresia repair develop respiratory symptoms more frequently than the normal population. Mild impairment of the pulmonary function in adolescence and adulthood was demonstrated in some studies, but to date, there is no exact idea about the relationship between early childhood disease progression and later pulmonary impairment. Only a few scientific papers have dealt with the effect of impaired pulmonary function on the physical capacity of these adolescents and adults. Most of these studies show small case numbers, inconclusive stress tests, and divergent results.

The aim of this prospective study is to investigate the cardiopulmonary performance capacity and the pulmonary microbiome of adolescent and adult patients with corrected esophageal atresia and to compare the results with a control group. Another focus of the investigators is on the composition of the pulmonary microbiome of the participants. Changes of the pulmonary microbiome and the influence on the cardio-pulmonary performance capacity have not yet been investigated. Furthermore, it should be investigated whether the treatment measures and a complicated disease course in the neonatal period have long-term effects on lung function, exercise capacity and composition of the microbiome in the lungs.

Detailed Description

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Conditions

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Esophageal Atresia

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Control group: Age and sex matched healthy volunteers.

Study Groups

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Patients after esophageal atresia

Patients older than 12 years following surgical repair of congenital esophageal atresia will be included after written informed consent. Patients will be subjected to spirometry to determine their age, weight (determined by Kilogram (kg) on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).

Group Type EXPERIMENTAL

Pulmonary microbiome (16S rDNA profiling)

Intervention Type DIAGNOSTIC_TEST

Harvesting of deep induced sputum and determination of the airway microbiome by 16S ribosomal RNA (rRNA) pyrosequencing. Evaluation of alpha and beta diversity and relative bacterial abundance at the genus level. Measurements will be performed in both groups (samples will be harvested within 30 minutes after spiroergometry).

Maximum oxygen uptake

Intervention Type DIAGNOSTIC_TEST

Determination of the maximum oxygen uptake (ml/kg/min) corrected for gender, age and body weight by bicycle spiroergometry. Measurements will be performed in both groups.

Maximum performance

Intervention Type DIAGNOSTIC_TEST

Determination of the maximum performance (W/kg) corrected for body weight by bicycle spiroergometry. Measurements will be performed in both groups.

weight

Intervention Type DIAGNOSTIC_TEST

Determined by Kilogram on a medical weight scale

age

Intervention Type OTHER

Determination of age by patient's Report and past medical history

Initial Spirometry

Intervention Type DIAGNOSTIC_TEST

Determination of Vital Capacity by spirometry before (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Final Spirometry

Intervention Type DIAGNOSTIC_TEST

Determination of Vital Capacity by spirometry after (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Control group

Age and sex matched adolescents will be recruited as control group and will be included after written informed consent. Adolescents will be subjected to spirometry to determine their age, weight (determined by Kilogram on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).

Group Type ACTIVE_COMPARATOR

Pulmonary microbiome (16S rDNA profiling)

Intervention Type DIAGNOSTIC_TEST

Harvesting of deep induced sputum and determination of the airway microbiome by 16S ribosomal RNA (rRNA) pyrosequencing. Evaluation of alpha and beta diversity and relative bacterial abundance at the genus level. Measurements will be performed in both groups (samples will be harvested within 30 minutes after spiroergometry).

Maximum oxygen uptake

Intervention Type DIAGNOSTIC_TEST

Determination of the maximum oxygen uptake (ml/kg/min) corrected for gender, age and body weight by bicycle spiroergometry. Measurements will be performed in both groups.

Maximum performance

Intervention Type DIAGNOSTIC_TEST

Determination of the maximum performance (W/kg) corrected for body weight by bicycle spiroergometry. Measurements will be performed in both groups.

weight

Intervention Type DIAGNOSTIC_TEST

Determined by Kilogram on a medical weight scale

age

Intervention Type OTHER

Determination of age by patient's Report and past medical history

Initial Spirometry

Intervention Type DIAGNOSTIC_TEST

Determination of Vital Capacity by spirometry before (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Final Spirometry

Intervention Type DIAGNOSTIC_TEST

Determination of Vital Capacity by spirometry after (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Interventions

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Pulmonary microbiome (16S rDNA profiling)

Harvesting of deep induced sputum and determination of the airway microbiome by 16S ribosomal RNA (rRNA) pyrosequencing. Evaluation of alpha and beta diversity and relative bacterial abundance at the genus level. Measurements will be performed in both groups (samples will be harvested within 30 minutes after spiroergometry).

Intervention Type DIAGNOSTIC_TEST

Maximum oxygen uptake

Determination of the maximum oxygen uptake (ml/kg/min) corrected for gender, age and body weight by bicycle spiroergometry. Measurements will be performed in both groups.

Intervention Type DIAGNOSTIC_TEST

Maximum performance

Determination of the maximum performance (W/kg) corrected for body weight by bicycle spiroergometry. Measurements will be performed in both groups.

Intervention Type DIAGNOSTIC_TEST

weight

Determined by Kilogram on a medical weight scale

Intervention Type DIAGNOSTIC_TEST

age

Determination of age by patient's Report and past medical history

Intervention Type OTHER

Initial Spirometry

Determination of Vital Capacity by spirometry before (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Intervention Type DIAGNOSTIC_TEST

Final Spirometry

Determination of Vital Capacity by spirometry after (within 30 minutes) spiroergometry. Measurements will be performed in both groups.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age from 12 years
* Status post surgical correction of esophageal atresia with and without fistula
* Granted consent

Exclusion Criteria

* Acute infections within the last 14 days
* Other associated serious malformations
* Acute, temporary respiratory complaints (cough, allergies etc.)
* Physical and mental illnesses or disabilities that do not allow the examination to be carried out
* non-granted consent
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Medical University of Graz

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jana Windhaber, MD

Role: STUDY_DIRECTOR

Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria

Holger Till, MD

Role: STUDY_CHAIR

Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria

Christoph Arneitz, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria

Locations

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Medical University of Graz

Graz, , Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Jana Windhaber, MD.

Role: CONTACT

01143316358 ext. 83770

Christoph Arneitz, MD.

Role: CONTACT

01143316358 ext. 80358

Facility Contacts

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Jana Windhaber, MD

Role: primary

01143316385 ext. 83770

Christoph Arneitz, MD

Role: backup

01143316385 ext. 80358

Other Identifiers

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1.1

Identifier Type: -

Identifier Source: org_study_id

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