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Trial registered on ANZCTR
Registration number
ACTRN12616000944437
Ethics application status
Approved
Date submitted
12/04/2016
Date registered
18/07/2016
Date last updated
18/07/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Pilot study investigating how Extracorporeal Membrane Oxygenation (ECMO) affects the major breathing muscles.
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Scientific title
Extracorporeal Membrane Oxygenation and Development Of Diaphragm Atrophy.
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Secondary ID [1]
288981
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Nil known
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Universal Trial Number (UTN)
U1111-1181-8511
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diaphragm atrophy
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ECMO
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Condition category
Condition code
Musculoskeletal
298479
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0
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Other muscular and skeletal disorders
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Respiratory
298480
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
Ultrasound of diaphragm, to identify onset and rate of diaphragm atrophy in ECMO patients. Initial ultrasound measurements will be taken as soon as possible after initiation of ECMO therapy. Repeat ultrasound measurements will be taken every 48 hours until cessation of ECMO therapy.
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Intervention code [1]
294467
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Diaphragm thickness as measured by diagnostic ultrasound
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Assessment method [1]
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Timepoint [1]
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Measured on cannulation of ECMO, and then every 48 hours until decannulation of ECMO.
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Secondary outcome [1]
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Mechanical ventilation time. Mechanical ventilation time is assesed by extracting data from MetaVision. The Prince Charles Hospital electronic medical record system in the ICU which is linked to both the mechanical ventilator and ECMO circuits
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Assessment method [1]
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Timepoint [1]
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Patients total mechanical ventilation time
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Secondary outcome [2]
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Duration of mechanical ventilation weaning process. Mechanical ventilation time is assesed by extracting data from MetaVision. The Prince Charles Hospital electronic medical record system in the ICU which is linked to both the mechanical ventilator and ECMO circuits
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Assessment method [2]
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Timepoint [2]
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Patients total mechanical ventilation weaning process time
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Secondary outcome [3]
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Re-intubation rate. Reintubation rate will be assesed by extracting data from MetaVision. The Prince Charles Hospital electronic medical record system in the ICU which is linked to both the mechanical ventilator and ECMO circuits
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Assessment method [3]
322782
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Timepoint [3]
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Number of times patient re-intubated post extubation. This will be assessed via extracting data from MetaVision. The Prince Charles Hospital electronic medical record system in the ICU. This will be from the first attempt at a patients exubation to successful discharge from the ICU in that episode of care. It will not seperate ICU admissions for that patient.
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Eligibility
Key inclusion criteria
All patients > 18 years old receiving ECMO therapy at The Prince Charles Hospital
Written informed consent by patient or legally authorised person.
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Minimum age
18
Years
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Maximum age
No limit
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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
Patients for whom consent was unable to be obtained
Male or female < 18 years old
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
This is a within subject design and repeated measures ANOVA will be used for statistical analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
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Date of last participant enrolment
Anticipated
1/08/2017
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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
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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The Prince Charles Hospital - Chermside
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Funding & Sponsors
Funding source category [1]
293337
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Other Collaborative groups
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Name [1]
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Extracorporeal Life Support Organisation
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Address [1]
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2800 Plymouth Rd
Building 300, Room 303
Ann Arbor, MI 48109-2800
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Country [1]
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United States of America
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Primary sponsor type
Individual
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Name
Trent Donnelly
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Address
Physiotherapy Department, The Prince Charles Hospital
Rode Road
Chermside, 4032
QLD
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Country
Australia
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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]
292155
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Prince Charles Hospital, Metro North Hospital and Health Service Human Research and Ethics Committee
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Ethics committee address [1]
294805
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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14/04/2016
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Approval date [1]
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18/05/2016
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Ethics approval number [1]
294805
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Summary
Brief summary
The diaphragm; the major breathing muscle, as a result of life supporting mechanical ventilation reduces in size, thickness and function (Umbrello, 2016). Diaphragm atrophy and dysfunction as a result of mechanical ventilation can lead to critically ill patients having a higher intensive care unit (ICU) mortality rate, increased ICU length of stay (LOS), increased mechanical ventilation duration and a higher rate of re-intubation (Demoule et al, 2013;). There is currently no body of evidence regarding the onset or extent of diaphragm atrophy in patients who receive Extracorporeal Membrane Oxygenation (ECMO) therapy; a patient cohort predisposed to atrophy and dysfunction of the diaphragm due to very low lung volumes delivered by the breathing machine, deep sedation and immobility. By using diagnostic ultrasound (US) in this study, we can accurately assess diaphragm thickness and determine the onset and rate of diaphragm atrophy in the ECMO cohort Aims: This pilot study aims to investigate if diaphragm atrophy occurs and the rate of diaphragm atrophy incurred whilst a patient is receiving ECMO therapy. The research questions are: 1. Does ECMO therapy lead to diaphragm atrophy as measured by diaphragm thickness on ultrasound? 2. What is the rate of diaphragm atrophy for patients receiving ECMO therapy? 3. Is there a difference in the rate of diaphragm atrophy between patients on VV versus patients on VA ECMO? Design: As this is a pilot study, we will recruit all patients that receive ECMO therapy after consent is obtained from the patient’s next of kin. Ultrasound data and other measurements will be collected at the onset of ECMO insertion and every second day until ECMO decannulation to identify the onset and rate of diaphragm atrophy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Trent Donnelly
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Address
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Physiotherapy Department
The Prince Charles Hospital, Rode Rd
Chermside, 4032
QLD
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Country
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Australia
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Phone
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+61 7 3139 4443
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Trent Donnelly
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Address
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Physiotherapy Department
The Prince Charles Hospital, Rode Rd
Chermside, 4032
QLD
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Country
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Australia
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Phone
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+61 7 3139 4443
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Fax
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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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Trent Donnelly
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Address
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Physiotherapy Department
The Prince Charles Hospital, Rode Rd
Chermside, 4032
QLD
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Country
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Australia
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Phone
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+61 7 3139 4443
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Fax
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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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