Netosis in Determination of Respiratory Infection Severity

NCT ID: NCT04318691

Last Updated: 2023-03-16

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

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-06-07

Study Completion Date

2023-01-03

Brief Summary

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The study aims to evaluate the prognostic value of alveolar and blood NETosis in patients under mechanical ventilation and treated for an acute low-respiratory tract infection. The main outcome is the occurrence of an acute respiratory distress syndrome (ARDS) according to the Berlin definition.

Detailed Description

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Neutrophils are the first line of defense against infectious injury. Among the numerous mechanisms involving the immune system, neutrophil extracellular traps (NETs) have been recently described as an additional way neutrophils are able to use to fight against bacteria. NETs are made of DNA and antimicrobial proteins. In the other hand, NETs promote coagulation and may contribute to evolution of severe pneumonia into acute respiratory distress syndrome.

The secondary objectives of the study include the research of the relation between blood NETosis and alveolar NETosis with:

* the documentation of invasive pulmonary infection based on microbiological analysis criteria (which would be bacteria or viral) of LBA at admission to ICU;
* the diagnosis value of usually used biomarkers: procalcitonin and C-reactive protein;
* marbrure score at admission to ICU;
* arterial lactatemia;
* scores of gravity at admission IGSII and SOFA;
* all-cause mortality at day-28;
* duration of mechanical ventilation at day-28;
* duration of amines at day-28;
* developement of hemodynamic failure;
* developement of pulmonary circulatory failure.

The study will include 1) 60 patients under mechanical ventilation admitted to the intensive care unit for acute respiratory failure, 2) 10 control patients admitted to the ICU after a planned vascular surgery and 3) 10 healthy subjects.

Conditions

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Respiratory Infection

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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acute respiratory failure group

60 patients under mechanical ventilation admitted to the intensive care unit for acute respiratory failure

Blood sampling

Intervention Type BIOLOGICAL

Blood sampling at baseline and at day-3 (10 ml, EDTA tube), test of NETs.

Bronchoalveolar lavage

Intervention Type PROCEDURE

Bronchoalveolar lavage at admission to the ICU with analysis of cytological, bacteriological, viral and anatomopathological, and test of NETs.

vascular surgery control group

10 control patients admitted to the ICU after a planned vascular surgery

Blood sampling

Intervention Type BIOLOGICAL

Blood sampling at baseline and at day-3 (10 ml, EDTA tube), test of NETs.

Healthy volunteers group

10 healthy subjects.

Blood sampling

Intervention Type BIOLOGICAL

Blood sampling at baseline and at day-3 (10 ml, EDTA tube), test of NETs.

Interventions

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Blood sampling

Blood sampling at baseline and at day-3 (10 ml, EDTA tube), test of NETs.

Intervention Type BIOLOGICAL

Bronchoalveolar lavage

Bronchoalveolar lavage at admission to the ICU with analysis of cytological, bacteriological, viral and anatomopathological, and test of NETs.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

A/ For all subjets:

* Be \>/= 18 years of age on day of signing informed consent;
* Affiliated to the french social security - welfare system in France.


admitted to the ICU for acute respiratory failure requiring mechanical ventilation within the first 24 hours after admission and suspected to suffer from an infectious pneumonia, according to the following criteria:

* recent fever;
* acute respiratory failure signs (dyspnea, polypnea \> 30 cycles/min, hypoxemia PaO2\<65 mmHg);
* pulmonary focal signs of auscultation;
* evocative signs in chest radiography or chest TDM.


\- admitted to the ICU for post-operative management of vascular surgery.

Exclusion Criteria

A/ For all subjets:

* pregnancy,
* nosocomial pneumonia,
* no social health insurance,
* neutropenia of any cause;
* patient refusal.


\- no mechanical ventilation within the first 24 hours after admission to the ICU.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Edouard JULLIEN, MD

Role: PRINCIPAL_INVESTIGATOR

Service de médecine intensive réanimation, Hôpital Ambroise Paré, APHP

Guillaume Geri, MD, PhD

Role: STUDY_DIRECTOR

Service de médecine intensive réanimation, Hôpital Ambroise Paré, APHP

Locations

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Service de médecine intensive réanimation, Hôpital Ambroise Paré, APHP

Boulogne-Billancourt, , France

Site Status

Countries

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France

Other Identifiers

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2020-A00217-32

Identifier Type: -

Identifier Source: org_study_id

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