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Trial registered on ANZCTR
Registration number
ACTRN12618000468224
Ethics application status
Approved
Date submitted
1/12/2017
Date registered
29/03/2018
Date last updated
15/09/2021
Date data sharing statement initially provided
5/03/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessing patient-ventilator interaction for patients with respiratory failure
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Scientific title
Clinical Application of REspiratory models in monitoring patient-ventilator interaction (CARE Study)
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Secondary ID [1]
293488
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None
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Universal Trial Number (UTN)
U1111-1197-8785
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Trial acronym
CARE Trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
respiratory failure
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Condition category
Condition code
Respiratory
304896
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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
This trial is an observational trial to recruit 60 patients in two years (30 patients per year). All patients admitted to the intensive care unit (ICU) at the IIUM Medical Centre, Malaysia during the study period will be screened for inclusion into the study.
Approval from ethical committee will be obtained. New patients will be screened for inclusion to the study. Consent from legally-accepted representative will be obtained. All patients admitted to the ICU during the study period will be screened.
Data collection and clinical protocol
All patients enrolled are to be ventilated using Puritan Bennett PB980 ventilator (Covidien, Boulder, CO, USA). Data collection will be performed using a CURE soft system. This system records the mechanical ventilation data from the Puritan Bennet ventilator 980.
1. The mechanical ventilator settings were not set and will vary depending on attending clinicians.
2. For each patient, the data will be collected for 72 hours.
3. After 72 hours, the data collection is stopped.
The following data are collected from the patient recruited into the observational trial.
1. Patient gender, height, weight and ethnicity.
2. Patient APACHE III diagnostic code.
3. Primary patient diagnosis contributing to respiratory failure
4. Secondary patient diagnosis contributing to respiratory failure
5. Relevant past medical history e.g. smoking, medication, cardiovascular disease.
6. Chest X-ray score: Murray Index (Murray et al., 1988) if available.
7. Mechanical ventilation airway pressure and flow
8. Fraction of Inspired oxygen
9. Patient data sheet and arterial blood gases information
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Intervention code [1]
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Not applicable
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Asynchrony Index (AI).
*As this is is an observational trial, Aysnchrony index is calculated as from the airway pressure and flow waveform that are identified as asynchronous. Aysnchrony index is calculated as the number of identified asynchronous breath over the total breath being analysed X 100%
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Assessment method [1]
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Timepoint [1]
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Continuous recording from the ventilator/ airway pressure and flow during invasive mechanical ventilation, 72 hours from screening.
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Primary outcome [2]
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Magnitude of asynchronous breathing.
*As this is is an observational trial, The magnitude of Asynchrony is calculated as from the airway pressure and flow waveform when compared to none asychronous breath.
The formulation is new and one of the calculation method can be found in https://www.sciencedirect.com/science/article/pii/S0169260717309938
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Assessment method [2]
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Timepoint [2]
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Continuous recording from the ventilator/ airway pressure and flow during invasive mechanical ventilation, 72 hours from screening.
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Secondary outcome [1]
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Respiratory mechanics of the patient during mechanical ventilation. (This outcome is to be calculated from model, not collected from data).
*There are 2 respiratory mechanics that we are looking out on 1) respiratory system elastance (E) and 2) respiratory system resistance (R). These 2 respiratory mechancics can be calculated from model using airway pressure and flow waveform from the ventilator. Method of calculation can be found in https://www.ncbi.nlm.nih.gov/pubmed/28435689
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Assessment method [1]
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Timepoint [1]
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Continuous recording from the ventilator/ airway pressure and flow during invasive mechanical ventilation, 72 hours from screening.
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Eligibility
Key inclusion criteria
1. Patients requiring invasive mechanical ventilation (MV) (Intubation or tracheotomy).
2. Patients with PF [oxygen partial pressure to fraction of inspired oxygen] ratio < 300 mmHg) .
3. Arterial line in situ.
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Minimum age
16
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
1. Patients who are likely to be discontinued from MV within 24 hours.
2. Patients with age less or equal to 16.
3. Any medical condition associated with a clinical suspicion of raised intracranial pressure and/or a measured intracranial pressure more or equal to 20 cmH2O.
4. Patients who have a high spinal cord injury with loss of motor function and/ or have significant weakness from any neurological disease.
5. Patients who are moribund and/or not expected to survive for less than 72 hours.
6. Lack of clinical equipoise by intensive care unit (ICU) medical staff managing the patient.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
We have sufficient samples for this observational trial.
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Date of first participant enrolment
Anticipated
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Actual
29/08/2017
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Date of last participant enrolment
Anticipated
24/07/2019
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Actual
4/02/2020
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Date of last data collection
Anticipated
31/03/2020
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Actual
6/02/2020
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Sample size
Target
60
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Accrual to date
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Final
24
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Recruitment outside Australia
Country [1]
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Malaysia
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State/province [1]
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Pahang
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Ministry of Higher Education (MOHE) Malaysia
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Address [1]
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Kementerian Pendidikan Tinggi
No. 2, Menara 2,
Jalan P5/6, Presint 5,
62200 Putrajaya, Malaysia
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Country [1]
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Malaysia
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Primary sponsor type
University
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Name
Monash University Malaysia
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Address
Monash University Malaysia
Jalan Lagoon Selatan,
Bandar Sunway,
47500 Subang Jaya,
Selangor
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Country
Malaysia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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IIUM Medical Centre - International Islamic University Malaysia
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Address [1]
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IIUM Medical Centre
International Islamic University Malaysia
Jalan Sultan Haji Ahmad Shah, Bandar Indera Mahkota,
25200 Kuantan, Pahang Darul Makmu
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Country [1]
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Malaysia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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IIUM Research Ethics Commitee (IREC)
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Ethics committee address [1]
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IIUM Research Ethics Committee (IREC) Research Management Center (RMC), Kuantan Campus Level 1, Administrative Building (OCD), International Islamic University Malaysia Jalan Sultan Ahmad Shah, Indera Mahkota, 25200 Kuantan, Pahang
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Ethics committee country [1]
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Malaysia
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Date submitted for ethics approval [1]
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Approval date [1]
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12/01/2017
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Ethics approval number [1]
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IREC 666
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Summary
Brief summary
Asynchronous events (AE) occur when the breathing of a patient undergoing mechanical ventilation is not synchronised with the support from the ventilator. Frequent occurrence of AEs results in poor patient-ventilator interaction, leading to an increase in work of breathing and potentially, other adverse effects. Such adverse effects include patient discomfort, increased need for sedation, increased length of mechanical ventilation, and potentially higher mortality. AEs can occur anytime during partially or fully controlled ventilation. However, it is more frequent during partially assisted modes where the patient is breathing spontaneously and the ventilator support is triggered by patient respiratory effort. AE is currently assessed retrospectively and there is a need to detect AE in real time. This study aims to investigate the quality of patient-ventilator interaction in a local hospital. Using patient specific airway pressure and flow data, we aim to develop mathematical models that can be used to detect AEs automatically in real time.
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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 Mohd Basri Mat Nor
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Address
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Kulliyyah of Medicine,
International Islamic University Malaysia,
Bandar Indera Mahkota Campus,
Jalan Sultan Ahmad Shah,
25200 Kuantan,
Pahang Darul Makmur.
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Country
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Malaysia
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Phone
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+6095704672
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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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Mohd Basri Mat Nor
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Address
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Kulliyyah of Medicine,
International Islamic University Malaysia,
Bandar Indera Mahkota Campus,
Jalan Sultan Ahmad Shah,
25200 Kuantan,
Pahang Darul Makmur.
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Country
75687
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Malaysia
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Phone
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+6095704672
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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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Chiew Yeong Shiong
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Address
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Monash University Malaysia
Jalan Lagoon Selatan,
Bandar Sunway,
47500 Subang Jaya,
Selangor
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Country
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Malaysia
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Phone
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+60355144985
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
-
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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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