Clinical Validation of Continuous and Non-invasive Monitoring of Effective Pulmonary Volume.

NCT ID: NCT04045262

Last Updated: 2022-10-12

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

Total Enrollment

85 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-06-04

Study Completion Date

2022-03-30

Brief Summary

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The aim of this study is to evaluate/validate a new non-invasive method to continuously monitor effective lung volume in critically ill patients.

Detailed Description

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The capnodinamyc method is a new monitoring method that provides continuous (breath by breath) measurements of effective pulmonary blood flow (EPBF) and effective end-expiratory l lung volume (EELVCO2). The former refers to the non-shunted fraction of cardiac output and the latter to the functional end-expiratory lung volume (EELV) that contains CO2.

The capnodynamic method is based on the advanced analysis of CO2 kinetics and the law of Conservation of mass. It states that lungs have to eliminate a similar amounts of CO2 as produced by aerobic metabolism and reaches the lung via pulmonary perfusion. For its calculation, two different measurements are needed:

1. Exhaled CO2 measured by infrared optic sensor technology placed in a mainstream configuration between the endotracheal tube and the "Y" piece of the ventilator respiratory circuit.
2. Flow, airway pressure and ventilatory volumes measured by the mechanical ventilator spirometer.

The method requires the generation of cyclic small changes in the alveolar concentration of CO2 which is achieved by introducing a slightly modified breathing pattern. It consists of adding a short expiratory hold in each 3 out of 9 consecutive breaths and requires the patient to be in passive breathing conditions under mechanical ventilation.

EPBF and EELVCO2 have been validated in experimental conditions and the first validations in patients in the setting of general anesthesia are under way.

Methods:

This study on EELVCO2 in critically ill patients involves 2 types of evaluations:

The validation of absolute values of EELV by comparing it with CTsan. The trending ability of EELVCO2 in critically ill patients by comparing it with EIT.

A calculated sample size of 30 patients is required for each objective.

Conditions

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Critical Illness

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* All patients on mechanical ventilation in passive breathing conditions in which a thoracic CTscan has been indicated for medical reasons and those with an EIT and a continuous cardiac monitoring
* Informed consent

Exclusion Criteria

* Hemodynamic instability
* Presence of barotrauma/ pneumothorax
* Presence of bronchopleural fistulas
* Thorax alterations that preclude the positioning of the EIT electrode belt (usually at the IV intercostal space).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fernando Suarez Sipmann

OTHER

Sponsor Role lead

Responsible Party

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Fernando Suarez Sipmann

MD PhD Intesive Care Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Fernando Suarez Sipmann, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Fundación de Investigación Biomédica - Hospital Universitario de La Princesa

Locations

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Hospital Universitario de la Princesa

Madrid, , Spain

Site Status

Countries

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Spain

References

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Sanchez Giralt JA, Tusman G, Wallin M, Hallback M, Perez Lucendo A, Sanchez Galindo M, Abad Santamaria B, Paz Calzada E, Garcia Garcia P, Rodriguez Huerta D, Canabal Berlanga A, Suarez-Sipmann F. Clinical validation of a capnodynamic method for measuring end-expiratory lung volume in critically ill patients. Crit Care. 2024 Apr 30;28(1):142. doi: 10.1186/s13054-024-04928-w.

Reference Type DERIVED
PMID: 38689313 (View on PubMed)

Other Identifiers

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EELVC02

Identifier Type: -

Identifier Source: org_study_id

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