Lung and Systemic Inflammation in the Critically Ill Patient
Acute Pulmonary and Systemic Inflammation in Mechanically Ventilated Intensive Care Patients
Acute respiratory distress syndrome (ARDS) is a devastating form of acute lung inflammation, that may be caused by a variety of insults with pulmonary and systemic infectious disease being the most common predisposing factor. Sepsis, on the other hand, represents the systemic inflammatory response to an invading pathogen, which may inflict damage upon the host through organ dysfunction. ARDS and sepsis are heterogenous clinical conditions that have a high mortality, and both diseases involve a complex interplay of different inflammatory mediators and cell types. It has been suggested that locally released inflammatory mediators pass from the lungs into the bloodstream following ARDS, triggering systemic inflammation. Conversely, it is possible that severe systemic inflammation may lead to ARDS by an influx of inflammatory mediators from the bloodstream to the lungs. However, the time course and the possible pathways for this transmission of disease have yet to be established.
Investigators hypothesize that:
- Primary systemic inflammation is followed by a secondary pulmonary inflammatory response
- Primary pulmonary inflammation is followed by a secondary systemic inflammatory response
- Both primary and secondary inflammatory responses are characterized by the appearance of pro-inflammatory cytokines, inflammatory cells and production of collagen-like proteins (termed 'lectins')
- The inflammatory response is most pronounced in the primary afflicted compartment.
Study Overview
Status
Status
Conditions
Conditions
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Copenhagen Ø, Denmark, 2100
- Intensive Care Unit, 4131, Rigshospitalet
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
General:
- Age >18 years
- Mechanically ventilated
- < 48 hours after admission to the Intensive Care Unit
Specific:
-ARDS: acute (< 1 week) respiratory failure, characterized by hypoxemia (PaO2/FiO2 < 300 mmHg/40kPa), and bilateral infiltrates on x-ray or CT of thorax, that can not be explained by heart failure og overhydration.
OR
- SIRS (two of the following): Temperature > 38°C or < 36°C, heart rate > 90/min, respiratory frequency > 20 or PaCO2 < 4.2 kPa, leukocytosis (> 12x10^9/L) or leukopenia (< 4x10^9/L)
OR
ARDS + SIRS
Exclusion Criteria:
One lung ventilation; Tube size < 8.0 mm; INR > 1.5 or thrombocytes < 40x10^9/L; Intracranial hypertension; Malignant arrythmias
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
Acute respiratory distress syndrome (ARDS)
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|
Systemic inflammatory response syndrome (SIRS)
|
|
ARDS+SIRS
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Tumor necrosis factor alpha (TNF-a) bioactivity
Time Frame: Day one
|
Day one
|
|
Tumor necrosis factor alpha (TNF-a) bioactivity
Time Frame: Day three
|
Day three
|
|
Tumor necrosis factor alpha (TNF-a) bioactivity
Time Frame: Day seven
|
Day seven
|
|
Tumor necrosis factor alpha (TNF-a) bioactivity
Time Frame: Day fourteen
|
Day fourteen
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Interleukin (IL)-6
Time Frame: Day one
|
Day one
|
|
Mannose binding lectin (MBL)
Time Frame: Day one
|
Day one
|
|
Ficolin-1,2,3
Time Frame: Day one
|
Day one
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Respiratory Tract Diseases
- Respiration Disorders
- Lung Diseases
- Disease
- Infant, Newborn, Diseases
- Shock
- Lung Injury
- Infant, Premature, Diseases
- Syndrome
- Inflammation
- Respiratory Distress Syndrome
- Respiratory Distress Syndrome, Newborn
- Acute Lung Injury
- Systemic Inflammatory Response Syndrome
Other Study ID Numbers
Other Study ID Numbers
- 959521891
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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