Randomized Study of the pdSTIM™ System (Phrenic Nerve to Diaphragm STIMulation) in Failure to Wean Mechanically Ventilated Patients

NCT ID: NCT05998018

Last Updated: 2024-09-19

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

RECRUITING

Clinical Phase

NA

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-29

Study Completion Date

2026-02-28

Brief Summary

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This prospective, multi-center, randomized, controlled clinical trial is being conducted to evaluate the safety and efficacy of the pdSTIM System to facilitate weaning from mechanical ventilation through phrenic nerve stimulation. Potential subjects who are on mechanical ventilation for at least four days and have failed at least one weaning attempt will be considered for the study. Those enrolled will be randomized in a 1:1 manner between the treatment group that is standard of care with the pdSTIM System and a Control group, which is standard of care alone.

The primary endpoints focus on time to weaning and serious adverse event rates between the Treatment and Control groups.

Detailed Description

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The pdSTIM Pivotal Study (ReInvigorate Study) is a prospective, multicenter, randomized, controlled clinical study to evaluate the safety and efficacy of the pdSTIM System to facilitate weaning from mechanical ventilation through phrenic nerve stimulation. Potential subjects who are on mechanical ventilation for ≥ 96 hours (4 days) and have failed at least one weaning attempt will be considered for the study.

Those enrolled will be randomized in a 1:1 manner between a Treatment group that is standard of care with the pdSTIM System and a Control group that is standard of care only. For the Treatment group, stimulation therapy with pdSTIM will occur daily until the subject is successfully removed from mechanical ventilation or the 30-Day follow-up visit, whichever is sooner. All randomized subjects will be followed to 60 (± 7) days post randomization. Total subject participation will be no longer than 67 days.

Conditions

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Ventilator Induced Diaphragm Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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pdSTIM System Therapy

Group Type EXPERIMENTAL

pdSTIM System Therapy

Intervention Type DEVICE

Stimulate the phrenic nerves in synchrony with inspiratory cycles of the ventilator which exercises the diaphragm

Standard of Care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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pdSTIM System Therapy

Stimulate the phrenic nerves in synchrony with inspiratory cycles of the ventilator which exercises the diaphragm

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is 18 years or older.
2. Subject, or subject's Legally Authorized Representative, understands study requirements, study visits, and is willing and able to provide written informed consent prior to study specific procedures or testing.
3. Subject has been on mechanical ventilation for ≥ 96 hours prior to randomization (intubation or tracheostomy).
4. Subject has failed at least 1 weaning attempt (e.g., site directed spontaneous breathing trial(s) did not result in liberation).
5. At the time of enrollment, the subject is likely to be ventilated for an additional 48 hours, at minimum, in the opinion of the investigator.

Exclusion Criteria

1. Subject has been on invasive mechanical ventilation for \> 45 days.
2. Subject failed to wean due to pre-existing neurological or neuromuscular issues affecting the respiratory muscles (e.g., ALS, phrenic nerve paralysis, inflammatory muscle disease, underlying myopathy, myasthenia gravis, cervical spinal injury).
3. Subject's medical history, known anatomy or investigator's inability to visualize necessary anatomical landmarks that could prevent the safe placement of the pdSTIM leads.
5. Subject has an implant or external electrical device that may interact or interfere with the pdSTIM System (examples may include cardiac pacemaker, implantable defibrillator, vagal nerve stimulator, spinal cord stimulator, gastric stimulator, diaphragmatic stimulator).
6. Subject has been diagnosed and has been treated for neck cancer within the past 5 years or subject had any prior radiation treatment to the neck.
7. Subject currently has hemodynamic instability due to any cause (e.g., severe sepsis, hemorrhagic shock, or septic shock) with vasopressor support \> 0.1 mg/kg/min of norepinephrine or epinephrine, or equivalent, or is actively being titrated.
8. Subject has a local infection at or around the proposed pdSTIM Lead insertion site.
10. Subject has severe COPD as indicated by evidence of significant expiratory obstruction on the ventilator flow waveform or, where ventilator flow waveforms are not utilized, has a FEV1 ≤ 30%.
11. Subject has pre-existing severe chronic pulmonary fibrosis.
12. Subject has pleural effusion occupying greater than 1/3 of the pleural space on either side.
13. Subject is currently on or expected to begin neuromuscular blockades.
14. Subject is anticipating withdrawal of life support and/or shift to palliation as the goal of care with less than 6-months life expectancy.
15. Subject is known or suspected to be pregnant or lactating.
16. Subject is currently enrolled in or exited early from a) any investigational drug study or b) an investigational device study that may impact the ability to wean or is directly related to the lungs or diaphragm.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stimdia Medical Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Steven Conrad, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

LSU Health Sciences Shreveport

Locations

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University of South Alabama

Mobile, Alabama, United States

Site Status RECRUITING

Chandler Regional Medical Center

Chandler, Arizona, United States

Site Status RECRUITING

Abrazo West Health

Goodyear, Arizona, United States

Site Status RECRUITING

HonorHealth Research Institute

Scottsdale, Arizona, United States

Site Status RECRUITING

Northeast Georgia Medical Center

Gainesville, Georgia, United States

Site Status RECRUITING

University of Illinois Chicago

Chicago, Illinois, United States

Site Status RECRUITING

RML Specialty Hospital

Hinsdale, Illinois, United States

Site Status RECRUITING

University of Louisville

Louisville, Kentucky, United States

Site Status RECRUITING

Tulane University Medical Center

New Orleans, Louisiana, United States

Site Status RECRUITING

LSU Health Sciences Center at Shreveport

Shreveport, Louisiana, United States

Site Status RECRUITING

University of Michigan Health - West

Wyoming, Michigan, United States

Site Status RECRUITING

Bryan Medical Center

Lincoln, Nebraska, United States

Site Status WITHDRAWN

Northwell South Shore University Hospital

Bay Shore, New York, United States

Site Status RECRUITING

University at Buffalo

Buffalo, New York, United States

Site Status RECRUITING

Atrium Health

Charlotte, North Carolina, United States

Site Status RECRUITING

WakeMed Health

Raleigh, North Carolina, United States

Site Status RECRUITING

Forsyth Medical Center

Winston-Salem, North Carolina, United States

Site Status RECRUITING

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Baptist Clinical Research Institute, Inc.

Memphis, Tennessee, United States

Site Status RECRUITING

St. David's Healthcare

Georgetown, Texas, United States

Site Status RECRUITING

Houston Methodist

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Head of Clinical

Role: CONTACT

612-445-8252

References

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Schaaf K, Mullin CM, Cunningham KW, Eaton J, Conrad SA. The ReInvigorate Study-phrenic nerve-to-diaphragm stimulation for weaning from mechanical ventilation: a protocol for a randomized pivotal clinical trial. Trials. 2024 Aug 2;25(1):519. doi: 10.1186/s13063-024-08355-8.

Reference Type DERIVED
PMID: 39095923 (View on PubMed)

Related Links

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https://stimdia.com/

Company Website

Other Identifiers

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CIP0002

Identifier Type: -

Identifier Source: org_study_id

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