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Trial registered on ANZCTR
Registration number
ACTRN12616000688482
Ethics application status
Approved
Date submitted
17/05/2016
Date registered
26/05/2016
Date last updated
18/04/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Change of Respiratory Function during Extracorporeal Life Support (ECLS), a Pilot Study to identify Pulmonary Predictors of Outcome
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Scientific title
Change of Respiratory Function in Children during ECLS, a Pilot Study to identify Pulmonary Predictors of Outcome
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Secondary ID [1]
289237
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Nil Known
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Universal Trial Number (UTN)
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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:
Respiratory failure
298809
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Cardiac failure
298847
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Condition category
Condition code
Respiratory
298857
298857
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0
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Other respiratory disorders / diseases
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Cardiovascular
298858
298858
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0
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Other cardiovascular 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
Pulmonary function data will be collected, including measures of electrical impedance tomography (EIT) which, will be performed on a once daily base whilst the patient is on ECLS and the day after weaning off ECLS. The EIT will measure pulmonary function when the patient is on standard ventilation settings. An example of typical ventilation setting for a patient on ECLS are:
Mode:Pressure Controlled Ventilation (PC)
Positive End-Expiratory Pressure [mbar] (PEEP): 10
Peak Inspiratory Pressure [mbar] (PIP): 20
Tidal Volume (Vt)[mL/kg]: Not Applicable
Respiratory Rate [bpm] (RR): 10-15
Fraction of Inspired Oxygen (FiO2): 0.4
Inspiration Time [sec] (Ti):1
Pressure Support [mbar] (PS): Not applicable
Lung recruitment will can be undertaken on patients on ECLS for both respiratory and cardiac conditions, however remains at the discretion of the daily treating team. These function test maneuvers taken 30minutes. The pressure ramp is set according to the patient's age. Hysteresis, upper and lower inflection points, resistance and compliance values will be recorded, The maximal pressure ramp settings are as follows:
0-1 years- 30 mbar
2-5 years- 35 mbar
>5 years- 45 mbar
This pulmonary function data will be collected once daily for the duration of the ECLS run and one day following cessation of ECLS. There is no maximum follow-up period.
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Intervention code [1]
294774
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Early Detection / Screening
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Comparator / control treatment
Not applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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We intend to use our standard approach to explore all possible EIT parameters including respiratory mechanic data of the ventilator to identify predictors of successful ECLS treatment and recovery of the lung. A change of 20% from baseline is generally accepted as a clinical important change in pulmonary function tests. This will be determined through review of the collected data (see below).
The pulmonary function measures to be collected include:
Ventilation: tidal volume, tidal volume/kg, respiratory rate, FiO2, PEEP, PIP, PS, Ti, Compliance, Resistance, MAP, Amplitude, Frequency.
PV Curve: Max. Pressure Ramp, Compliance Stat, Volume recruitment, Slope.
EIT: End-expiratory level (EEL) Global, EEL Anterior, EEL Posterior, Amplitude Global, Amplitude Anterior, Amplitude Posterior, F-Index, GI Index, Profiles, Perfusion index.
This data will be collected on a data collection form, from the patient's medical records and directly from the ventilator.
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Assessment method [1]
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Timepoint [1]
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Data will be collected from the recruited patients once daily for the duration of ECLS and once daily one day following weaning off ECLS
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Secondary outcome [1]
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Not applicable
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Assessment method [1]
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Timepoint [1]
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Not applicable
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Eligibility
Key inclusion criteria
This study will include patients that require extracorporeal life support (ECLS) for both respiratory and/or cardiac failure. The plan for enrollment is to capture patients from day 1 of the ECLS run. This allows for greater data collection to determine if there is a trend in pulmonary function indicators.
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Minimum age
0
Years
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Maximum age
18
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
None
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Study design
Purpose
Natural history
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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
We will use an ANOVA with Bonferroni correction for repeated measurements and analyze data with a general mixed model, if one of the lung function parameters at any given point of ECLS treatment predicts outcome. The patients will be stratified into ECLS for cardiac and respiratory conditions.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
2/10/2017
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Actual
15/11/2017
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Date of last participant enrolment
Anticipated
1/10/2018
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Actual
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Date of last data collection
Anticipated
1/12/2018
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Actual
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Sample size
Target
50
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
5805
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Lady Cilento Children's Hospital - South Brisbane
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Recruitment postcode(s) [1]
13247
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Paediatric Critical Care Research Group
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Address [1]
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Level 7, Centre for Children's Health Research
Lady Cilento Children's Hospital Precinct
62 Graham Street, South Brisbane, QLD 4101
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Lady Cilento Children's Hospital
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Address
501 Stanley Street
South Brisbane
QLD, 4101
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Country
Australia
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Secondary sponsor category [1]
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Other
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Name [1]
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Paediatric Critical Care Research Group
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Address [1]
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Level 7, Centre for Children's Health Research
Lady Cilento Children's Hospital Precinct
62 Graham Street, South Brisbane, QLD 4101
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Country [1]
292433
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Children's Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Children's Health Queensland Human Research Ethics Committee, Level 7, Centre for Children's Health Research, Lady Cilento Children's Hospital Precinct, 62 Graham Street, South Brisbane QLD 4101
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Ethics committee country [1]
295055
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Australia
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Date submitted for ethics approval [1]
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06/06/2016
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Approval date [1]
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30/06/2016
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Ethics approval number [1]
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HREC/16/QRCH/213
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Summary
Brief summary
Pulmonary function tests including measures of electrical Impedance tomography (EIT) will be performed on a daily base whilst the patient is on Extracorporeal Life Support (ECLS) and preferentially one day after weaning off ECLS.The following proposed interventions and pulmonary function tests are part of our current standard treatment protocol and used for clinical assessment of patients on ECLS, except for the use of EIT. To facilitate easier use of the EIT system and measurement of pulmonary function tests, patients will be transitioned to a Hamilton G5 ventilator, which gives an easier access and download of pulmonary function data than our current fleet of ventilators (Evita XL, Servo I and Servo U). Mode and ventilation delivery of the Hamilton G5 ventilator is no different to our standard fleet. Based on the findings a potential interventional trial will be conducted investigating whether a different ventilation strategy on ECLS may improve outcome.
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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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A/Prof Andreas Schibler
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Address
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Lady Cilento Children's Hospital
501 Stanley Street South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61 7 3068 5733
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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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Andreas Schibler
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Address
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Lady Cilento Children's Hospital
501 Stanley Street South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61 7 3068 5733
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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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Andreas Schibler
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Address
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Lady Cilento Children's Hospital
501 Stanley Street South Brisbane QLD 4101
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Country
65920
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Australia
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Phone
65920
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+61 7 3068 5733
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Fax
65920
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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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