Prevalence AND Outcome of Acute Hypoxemic Respiratory fAilure in CHILDren (PANDORA-CHILD)

NCT ID: NCT04791501

Last Updated: 2021-03-10

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

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-01

Study Completion Date

2021-10-30

Brief Summary

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The present study is aimed to establish the epidemiological characteristics and clinical outcomes of mechanically ventilated children with acute hypoxemic respiratory failure (AHRF), defined as PaO2/FiO2 ≤300 mmHg on PEEP≥5 cmH2O and FiO2≥0.3, admitted in a network of pediatric hospitals in Spain.

Detailed Description

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Prospective, multicenter, observational study focused on the prevalence and outcomes of Acute Hypoxemic Respiratory Failure in children. From a total of 40 pediatric ICUs in Spain, 22 PICUs agreed to participate.

All consecutive patients from 7 days to 16 years old admitted in the PICU will have been enrolled if they fulfilled the following criteria: 1) acute episode (within 7 days of a clinical insult), 2) on invasive mechanical ventilatory support, 3) PaO2/FiO2 ≤ 300 mmHg (or SpO2/FiO2 ≤ 264), 4) Positive end-expiratory pressure (PEEP) ≥ 5 cmH2O and FiO2 ≥ 0.3.

This study is considered an audit, and informed consent is waived.

Period of study: 2 years (October 2019 to September 2021). Recruitment period: two consecutive months (i.e October-November followed by a period of no recruitment) until complete 12 months of recruitment (September 2021).

All investigators have received guidelines outlining the study design and the methods for data collection. All PICU admissions are screened daily for AHRF. Onset of AHRF was defined as the day on which the patient first met all inclusion criteria. All data are collected on standardized forms. Demographics, comorbidities, reason for initiation of IMV, arterial blood gases, laboratory, radiographic, hemodynamic and ventilator data were collected at study entry and during the first three days of AHRF diagnosis (T0 or time of inclusion in the study, 24 hours, days 2 and 3). Chest imaging (chest radiographs, lung ultrasound or computed tomography) were evaluated daily for the presence or absence of infiltrates, atelectasis, acute pulmonary edema, pleural effusion or pneumothorax. Tidal volume (VT) was calculated on the basis of the predicted body weight (PBW). Plateau pressure (Pplat) was determined after the application of a 0.5- to 1.0-sec end-inspiratory hold. Driving pressure was calculated as the difference between Pplat and PEEP. Patients meeting pediatric ARDS criteria were stratified into a mild, moderate, and severe according to PALICC definition and/or berlin definition. All patients are followed until PICU and hospital discharge.

Data are initially collected and stored at each center and then sent to study coordinators at the time of patient's hospital discharge.

Although patient care is not strictly protocolized, physicians are asked to follow the current standards of pediatric critical care management. For ventilatory management, it was recommended that all patients be ventilated with a VT of 6-8 mL/kg PBW, at a ventilatory rate to maintain PaCO2 at 35-50 mm Hg, a Pplat \<30 cm H2O, and PEEP and FiO2 combinations to maintain PaO2 \>60 mm Hg or SpO2 \>90%.

Statistical Analysis: for the main objective of the study, a descriptive analysis including clinical variables, mechanical ventilation data, respiratory settings and ancillary measures will be performed.

Conditions

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Acute Respiratory Insufficiency

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Hypoxemic Respiratory Failure

Consecutive intubated patients receiving invasive mechanical ventilation with a PaO2/FiO2 ≤300 mmHg under a PEEP of 5 cmH2O or more and FiO2 of 0.3 or more.

Mechanical ventilation

Intervention Type DEVICE

Ventilatory support

Interventions

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Mechanical ventilation

Ventilatory support

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients from 7 days to 16 years old admitted in the PICU.
* Acute episode (within 7 days of a clinical insult)
* On invasive mechanical ventilatory support
* PaO2/FiO2 ≤ 300 mmHg (or SpO2/FiO2 ≤ 264)
* Positive end-expiratory pressure (PEEP) ≥ 5 cmH2O and FiO2 ≥ 0.3.

Exclusion Criteria

* Non-invasive respiratory support \*Aged \>16 years or \< 7 days.
Minimum Eligible Age

7 Days

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Infantil Universitario Niño Jesús, Madrid, Spain

OTHER

Sponsor Role collaborator

Consorcio Centro de Investigación Biomédica en Red (CIBER)

OTHER_GOV

Sponsor Role collaborator

Dr. Negrin University Hospital

OTHER

Sponsor Role collaborator

Yolanda Lopez Fernandez

OTHER

Sponsor Role lead

Responsible Party

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Yolanda Lopez Fernandez

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jesús Villar Hernández, MD, PhD

Role: STUDY_DIRECTOR

Multidisciplinary Organ Dysfunction Evaluation Research Network (MODERN). Research Unit, hospital universitario dr. negrín, Las Palmas de gran Canaria, Spain.

Locations

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Cruces University Hospital

Barakaldo, Bizkaia, Spain

Site Status RECRUITING

Complejo Hospitalario Donosti

Donostia / San Sebastian, Gipuzkoa, Spain

Site Status RECRUITING

Hospital Universitario

Burgos, , Spain

Site Status RECRUITING

Hospital Universitario Puerta del Mar

Cadiz, , Spain

Site Status RECRUITING

Hospital Universitario Reina Sofia

Córdoba, , Spain

Site Status RECRUITING

Hospital Universitario

Las Palmas de Gran Canaria, , Spain

Site Status RECRUITING

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Gregorio Marañón

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario La Paz

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Virgen de la Arrixaca

Madrid, , Spain

Site Status RECRUITING

Niño Jesús University Hospital

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario

Málaga, , Spain

Site Status RECRUITING

Hospital Central de Asturias

Oviedo, , Spain

Site Status RECRUITING

Hospital Universitario Virgen del Camino

Pamplona, , Spain

Site Status RECRUITING

Hospital Universitario de Salamanca

Salamanca, , Spain

Site Status RECRUITING

Hospital Universitario Tenerife

Santa Cruz de Tenerife, , Spain

Site Status RECRUITING

Hospital Universitario Santiago de Compostela

Santiago de Compostela, , Spain

Site Status RECRUITING

Hospital Universitario Virgen del Rocio

Seville, , Spain

Site Status RECRUITING

Hospital Universitario Virgen de la Salud

Toledo, , Spain

Site Status RECRUITING

Hospital Universitario La fe

Valencia, , Spain

Site Status NOT_YET_RECRUITING

Hospital Clinico Universitario

Valladolid, , Spain

Site Status RECRUITING

Hospital Universitario Miguel Servet

Zaragoza, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Yolanda M López-Fernández, MD

Role: CONTACT

0034946006000 ext. 6582

Amelia Martinez de Azagra, MD

Role: CONTACT

0034630122450

Facility Contacts

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Yolanda M López-Fernández, MD

Role: primary

0034946000000 ext. 6582

Eider Oñate

Role: primary

María González, MD

Role: primary

Patricia Rodriguez

Role: primary

Ignacio Ibarra, MD

Role: primary

Rocio Nuñez, MD

Role: primary

Juan I Sanchez, MD

Role: primary

Laura Herrera, MD

Role: primary

Ana Gomez Zamora, MD

Role: primary

Ana Coca, MD

Role: primary

Susana B Reyes, MD, PhD

Role: primary

Amelia Martínez de Azagra, MD

Role: primary

Jose M Gonzalez

Role: primary

Alberto Medina, MD, PhD

Role: primary

Mikel Mendizabal, MD

Role: primary

Francisco Fernández, MD

Role: primary

Luis Perez

Role: primary

Antonio Rodriguez, MD

Role: primary

Julio Parrilla, MD

Role: primary

David Arjona, MD

Role: primary

Vicent Modesto

Role: primary

Marta Brezmes

Role: primary

Paula Madurga, MD

Role: primary

References

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Lopez-Fernandez Y, Azagra AM, de la Oliva P, Modesto V, Sanchez JI, Parrilla J, Arroyo MJ, Reyes SB, Pons-Odena M, Lopez-Herce J, Fernandez RL, Kacmarek RM, Villar J; Pediatric Acute Lung Injury Epidemiology and Natural History (PED-ALIEN) Network. Pediatric Acute Lung Injury Epidemiology and Natural History study: Incidence and outcome of the acute respiratory distress syndrome in children. Crit Care Med. 2012 Dec;40(12):3238-45. doi: 10.1097/CCM.0b013e318260caa3.

Reference Type BACKGROUND
PMID: 22990455 (View on PubMed)

Villar J, Blanco J, Anon JM, Santos-Bouza A, Blanch L, Ambros A, Gandia F, Carriedo D, Mosteiro F, Basaldua S, Fernandez RL, Kacmarek RM; ALIEN Network. The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med. 2011 Dec;37(12):1932-41. doi: 10.1007/s00134-011-2380-4. Epub 2011 Oct 14.

Reference Type BACKGROUND
PMID: 21997128 (View on PubMed)

Kopczynska M, Sharif B, Pugh R, Otahal I, Havalda P, Groblewski W, Lynch C, George D, Sutherland J, Pandey M, Jones P, Murdoch M, Hatalyak A, Jones R, Kacmarek RM, Villar J, Szakmany T, On Behalf Of The Pandora-Wales Investigators. Prevalence and Outcomes of Acute Hypoxaemic Respiratory Failure in Wales: The PANDORA-WALES Study. J Clin Med. 2020 Oct 31;9(11):3521. doi: 10.3390/jcm9113521.

Reference Type BACKGROUND
PMID: 33142837 (View on PubMed)

Lopez-Fernandez YM, Martinez-de-Azagra A, Reyes-Dominguez SB, Gomez-Zamora A, Herrera-Castillo L, Coca-Perez A, Parrilla-Parrilla J, Medina A, Garcia-Iniguez JP, Brezmes-Raposo M, Hernandez-Yuste A, Llorente de la Fuente AM, Ibarra de la Rosa I, Leon-Gonzalez JS, Trastoy-Quintela J, Arjona-Villanueva D, Gonzalez-Martin JM, Szakmany T, Villar J; Prevalence AND Outcome of acute hypoxemic Respiratory fAilure in children (PANDORA-CHILD) Network. The Prevalence and Outcome of Acute Hypoxemic Respiratory Failure (PANDORA) Study in Mechanically Ventilated Children: Prospective Multicenter Epidemiology in Spain, 2019-2021. Pediatr Crit Care Med. 2025 Jun 1;26(6):e759-e772. doi: 10.1097/PCC.0000000000003743. Epub 2025 Apr 25.

Reference Type DERIVED
PMID: 40277417 (View on PubMed)

Other Identifiers

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PI201935

Identifier Type: -

Identifier Source: org_study_id

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