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Trial registered on ANZCTR
Registration number
ACTRN12612000108819
Ethics application status
Approved
Date submitted
14/01/2012
Date registered
23/01/2012
Date last updated
23/01/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
How to distinguish an active air leak from a pleural space effect by means of a digital chest drain system
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Scientific title
Differences between active air leak and pleural space effect detected by means a digital chest drain system on patients submitted to lung resections and plural biopsies
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Secondary ID [1]
279730
0
nil
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Universal Trial Number (UTN)
U1111-1127-1857
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Trial acronym
DBAALPSE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prolonged pulmonary air leakage
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Condition category
Condition code
Respiratory
285769
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0
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Normal development and function of the respiratory system
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
In this observational study we aimed to recognize a pleural space effect, distinguishing it from an active air leak, by means of a digital chest drain system providing a continuous air flow and pleural pressures check. Since March 2010 to October 2011, we employed 144 digital drains for 125 patients undergone 138 thoracic surgical procedures. We observed: 18 active air leaks (12.5%), among which 4 prolonged (2.8%), all characterized by high differential pleural pressure, especially due to an increased mean expiratory pressure (>1 cmH2O) (p <0.0001), and significantly related to upper lobe resections (p: 0.00017), a chest tube removal time later than the fifth post-operative day (p <0.0001), an increasing pneumothorax after a one day provocative clamping (p <0.0001); three late air leaks (2.1%), all long lasting (p <0.0001), predicted by pressure curves divergency before the air flow appearance. Moreover, we reported 25 pleural space effects (17.4%), equally characterized by a high differential pleural pressure, but mainly due to a lower mean inspiratory pressure (<20 cmH2O) (p <0.0001), and especially related to surgical pleurodesis procedures (p: 0.0003) and wide lung resections (p: 0.0002); none of these patients had an increasing pneumothorax after provocative clamping. A digital chest drain system ensuring a continuous air flow and pleural pressures measurement could clearly identify a pleural space effect, avoiding the frequent misinterpretation with an active air leak and allowing to safely remove a chest tube at the right time.
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Intervention code [1]
284029
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Not applicable
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Comparator / control treatment
No treatment
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To recognize a pleural space effect, distinguishing it from an active air leak, by means of a digital chest drain system: a pleural space effect is characterized by high pleural differential pressures and low trans-pleural air flows, while an active air leak is always characterized by high trans-pleural air flows. A digital chest drain system can detect both air flows and differential pleural pressures by means two MEMS (micro electronic mechanicakl systems) sensors, one for measuring flow and another for measuring pressures
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Assessment method [1]
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Timepoint [1]
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Since March 2010 to October 2011
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
Patients submitted to thoracic surgery interventions
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Minimum age
18
Years
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Maximum age
88
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Severe lung emphysema - re-do-surgery - no touch lung surgery
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
125
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4052
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Italy
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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I.R.C.C.S. - C.R.O.B. Basilicata Regional Cancer Institute
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Address [1]
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Via Padre Pio, 1 - 85028 - Rionero in Vulture, Potenza, Italy
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Country [1]
284511
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Italy
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Primary sponsor type
Hospital
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Name
I.R.C.C.S. - C.R.O.B. Basilicata Regional Cancer Institute
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Address
Via Padre Pio, 1 - Rionero in Vulture (PZ)
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Country
Italy
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
283441
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Comitato Etico I.R.C.C.S. - C.R.O.B.
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Ethics committee address [1]
286495
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Via Padre Pio, 1 - Rionero in Vulture - 85028 - Potenza, Italy
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Ethics committee country [1]
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Italy
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Date submitted for ethics approval [1]
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01/01/2010
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Approval date [1]
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02/02/2010
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Ethics approval number [1]
286495
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Nil
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Summary
Brief summary
Bachground: In this prospective study we aimed to recognize a pleural space effect, distinguishing it from an active air leak, by means of a digital chest drain system providing a continuous air flow and pleural pressures check. Methods: Since March 2010 to October 2011, we employed 144 digital drains for 125 patients undergone 138 thoracic surgical procedures. Results: We observed: 18 active air leaks (12.5%), among which 4 prolonged (2.8%), all characterized by high differential pleural pressure, especially due to an increased mean expiratory pressure (>1 cmH2O) (p <0.0001), and significantly related to upper lobe resections (p: 0.00017), a chest tube removal time later than the fifth post-operative day (p <0.0001), an increasing pneumothorax after a one day provocative clamping (p <0.0001); three late air leaks (2.1%), all long lasting (p <0.0001), predicted by pressure curves divergency before the air flow appearance. Moreover, we reported 25 pleural space effects (17.4%), equally characterized by a high differential pleural pressure, but mainly due to a lower mean inspiratory pressure (<20 cmH2O) (p <0.0001), and especially related to surgical pleurodesis procedures (p: 0.0003) and wide lung resections (p: 0.0002); none of these patients had an increasing pneumothorax after provocative clamping. Conclusions: A digital chest drain system ensuring a continuous air flow and pleural pressures measurement could clearly identify a pleural space effect, avoiding the frequent misinterpretation with an active air leak and allowing to safely remove a chest tube at the right time.
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Trial website
Nil
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Trial related presentations / publications
Nil
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Rita Daniela Marasco
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Address
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Via Grecia, 21/A, 71122, Foggia, Italy
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Country
16880
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Italy
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Phone
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+39.0881.633303
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Fax
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+39.0972.726214
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Email
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[email protected]
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Contact person for scientific queries
Name
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Rita Daniela Marasco
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Address
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Via Grecia, 21/A, 71122, Foggia, Italy
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Country
7808
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Italy
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Phone
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+39.320.6555275
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Fax
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+39.0972.726214
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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