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Trial registered on ANZCTR
Registration number
ACTRN12622001392752p
Ethics application status
Submitted, not yet approved
Date submitted
19/10/2022
Date registered
31/10/2022
Date last updated
31/10/2022
Date data sharing statement initially provided
31/10/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of compression of front of chest on mechanically ventilated patients with breathing machine
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Scientific title
Effects of anterior chest wall compression on mechanically ventilated patients
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Secondary ID [1]
308215
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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:
Intubate and Mechanically ventilated adult patients
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PaO2/FiO2 >/ 300 with PEEP </5
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Condition category
Condition code
Respiratory
325029
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patient will have a 100 gm/kg weight placed on the anterior chest wall, while in supine position. The weight will be placed on the patients’ chest wall for 10 minutes and then removed. A number of measurements will be recorded before and after the procedure. Similar intervention repeated during CT chest.
Device: 100 gm/kg soft and smooth weight (saline bags) placed and secure around each hemithorax
Member of study team will be delivering the intervention.
The period between the first session of study and the CT session will be at least 1 hour.
The total amount of time involved per session for all measurements and procedure to be completed would be around 1 hour.
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Intervention code [1]
324676
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Prevention
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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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Difference in regional overdistention of lung before and after application of anterior chest wall compression. Overdistention will be assessed with the help of CT chest.
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Assessment method [1]
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Timepoint [1]
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Baseline (pre-intervention) and 10 minutes after application of anterior chest wall compression
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Secondary outcome [1]
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Difference in oxygenation before and after application of anterior chest wall compression
by measuring Pulse oximetry ( SPO2), Arterial blood gas oxygen saturation ( SaO2)
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Assessment method [1]
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Timepoint [1]
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Baseline (pre-intervention) and 10 minutes after application of anterior chest wall compression
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Secondary outcome [2]
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Difference in respiratory system compliance before and after application of anterior chest wall compression
By ventilator parameters e.g. PPeak, PPlateau,Driving pressure ( PPlateau -PEEP), Intrinsic PEEP, Flow
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Assessment method [2]
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Timepoint [2]
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Baseline (pre-intervention) and 10 minutes after application of anterior chest wall compression
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Secondary outcome [3]
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Difference in dead space before and after application of anterior chest wall compression.
By measuring PaCO2 ( ABG) and End tidal CO2 ( ETCO2), using Bohr equation
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Assessment method [3]
415046
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Timepoint [3]
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Baseline (pre-intervention) and 10 minutes after application of anterior chest wall compression
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Eligibility
Key inclusion criteria
Inclusion
Patients who are 18 years or older admitted to the ICU at Flinders Medical Centre who have been identified as either of the following
1. Intubated and ventilated
2. PaO2/FiO2 greater than or equal to 300 with PEEP less than or equal to 5
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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
1. History of chronic respiratory condition (COPD/Interstitial lung disease) or any suspected lung infection
2. Current lung collapse, pleural effusion, pneumothorax, pulmonary embolism, chest trauma
3. Chest drain
4. Unstable spine, femur or pelvic fractures
5. Cardiovascular unstable -MAP < 65 mmHg despite ongoing high vasopressor /inotropic support, arrhythmias
6. Recent cardiothoracic surgery ( 4 weeks)
7. Patients who are admitted to ICU with active palliation
8. Admitted consultant is not happy for the patient to be enrolled in this study
9. Intracranial pressure > 20 mmHg or Cerebral perfusion pressure < 60 mmHg
10. Pregnant women
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
All analyses will be performed using the SAS software version 9.4 (SAS Institute, Cary, NC, USA). Student t-test for normally distributed continuous variables, Wilcoxon rank-sum test for non-normally distributed continuous variables and chi-square or Fisher’s exact test as appropriate for categorical variables, with results presented as mean (standard error), median (interquartile range) and number (percentage) respectively. A two-sided p value of 0.05 will be used to indicate statistical significance.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
12/12/2022
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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
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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Flinders Medical Centre - Bedford Park
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Recruitment postcode(s) [1]
38787
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5042 - Bedford Park
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Recruitment postcode(s) [2]
38788
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5042 - Flinders University
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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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Flinders Medical Centre
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Address [1]
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1 Flinders Drive
Bedford Park
SA 5042
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Flinders Medical Centre
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Address
1 Flinders Drive
Bedford Park
SA 5042
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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]
314055
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Address [1]
314055
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Country [1]
314055
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
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Southern Adelaide Clinical Human Research Ethics Committee Level 2, Flinders Medical Centre 1 Flinders Drive Bedford Park SA 5042
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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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28/09/2022
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Approval date [1]
311816
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Ethics approval number [1]
311816
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Summary
Brief summary
Hypothesis of this study is application of anterior chest wall compression on mechanically ventilated patients will prevent ventral lung overdistention. We aim to examine changes in respiratory system compliance, oxygenation, ventilation and CT changes in lungs after applying anterior chest wall compression in mechanically ventilated patients We intend to enrol 10 patients in this single centre study. This trial will be conducted in the Southern Adelaide Local Health Network, Intensive and Critical Care Unit, Flinders Medical Centre. Screening and Recruitment Patients will be referred by treating ICU clinicians. Referral will be made as soon as possible after admission for patients who are intubated and ventilated Consent will be sought prior to enrolment Intervention Patient will have a 100 gm/kg weight placed on the anterior chest wall, while in supine position. The weight will be placed on the patients’ chest wall for 10 minutes and then removed. A number of measurements will be recorded before and after the procedure. Similar intervention repeated during CT chest. Device: weight on the anterior chest of the patient (soft and smooth weight (saline bags) placed and secure around each hemithorax) After enrolment, each patient will be treated as follows: Patients will be sedated and paralysed while mechanical ventilation settings will be kept unchanged over the course of the entire study. Initial baseline in the lying on the back ( Supine) position (T0) 10-minute period in supine position with 100 gm/kg soft and smooth weight (saline bags) placed and secure around each hemithorax (T1) In case of drop of oxygen level ( SPO2) , increase in delivered oxygen ( FiO2) will be allowed to achieve the previously described oxygen target. During the study, each patient will undergo standard ICU monitoring:
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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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Dr Mitul Purushottam Chavda
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Address
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ICU Fellow
ICU, Level 3 ,Flinders Medical Centre,
1 Flinders Drive,
Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 449026671
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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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Mitul Purushottam Chavda
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Address
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ICU Fellow
ICU, SALHN
ICU, Level 3 ,Flinders Medical Centre,
1 Flinders Drive ,
Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 449026671
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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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Mitul Purushottam Chavda
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Address
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ICU Fellow
ICU, SALHN
ICU, Level 3 Flinders Medical Centre,
1 Flinders Drive ,
Bedford Park, SA 5042
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Country
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Australia
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Phone
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+61 449026671
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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)?
Yes
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What data in particular will be shared?
all of the individual participant data collected during the trial, after de-identification
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When will data be available (start and end dates)?
Following publication with no end date.
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Available to whom?
only researchers who provide a methodologically sound proposal, case-by-case basis
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Available for what types of analyses?
any purpose
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How or where can data be obtained?
access subject to approvals by Principal Investigator (provide email or other contact details) through email. (
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
17403
Study protocol
384852-(Uploaded-19-10-2022-12-21-04)-Study-related document.docx
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.
Download to PDF