- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01589926
Bi-Level Positive Airway Ventilation for Acute Chest Syndrome
Early Bi-Level Positive Airway Pressure (BiPAP) Ventilation for Acute Chest Syndrome (ACS) - a Double-Blind Randomized Controlled Pilot Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Acute chest syndrome (ACS) is a frequent complication of sickle cell disease and is diagnosed by a new infiltrate on chest x-ray and one of the following: chest pain, fever, or respiratory signs or symptoms (tachypnea, cough, new onset hypoxemia, or increased work of breathing.)The treatment for acute chest syndrome is focused on supportive care with hydration, antibiotics, blood transfusions and respiratory support. Unfortunately, despite these treatments many patients fail to have improvements in their respiratory status, or have respiratory decompensation. These patients require more aggressive treatments, which frequently include exchange transfusions, pediatric intensive care unit (PCCU) management, and respiratory support.
The study objective is to perform a prospective double blind randomized control trial to investigate if early initiation of effective BiPAP in addition to providing standard clinical care for ACS alters the clinical course of these patients vs. sham BiPAP and standard clinical care. Investigators hypothesize that participants receiving effective BiPAP will have milder clinical courses resulting in shorter hospital stays and fewer transfers to PCCU and exchange transfusions.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
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Bronx, New York, United States, 10467
- Children's Hospital @ Montefiore
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- patients diagnosed with Hemoglobin SS (HB SS), the most common type of sickle cell disease
- patients diagnosed with Hemoglobin SC (HB SC), the second most common type of sickle cell disease.
- patients diagnosed with Hemoglobin sickle beta-zero thalassemia ( HB SB0thal) or Hemoglobin sickle thalassemia (HB SBthal)
Must meet clinical criteria for ACS- an infiltrate on Chest X-ray and one of the following:
- Respiratory symptoms/signs (patients pulse oximetry < 92% or oxygen saturation < 2% below their baseline, tachypnea, cough, and increased work of breathing)
- Fever
- Chest pain AND
Patients' eligible for a simple transfusion based on one of the following criteria:
- Hypoxemia (patients pulse oximetry < 92% or oxygen saturation < 2% below their baseline)
- Hemoglobin < 5 gm/dl
- Increased work of breathing
Exclusion Criteria:
- Patient requires exchange transfusion within first 24 hours of admission
- Patient requires PCCU transfer within first 24 hours of admission
- Hemoglobin > 9gm/dl secondary to these patients requiring an exchange transfusion
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Bi-level Positive Airway Pressure Device
BiPAP initiated for at least 16 hours per day for a minimum of 48hrs.
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BiPAP initiated for at least 16 hours per day for a minimum of 48hrs.
|
Sham Comparator: Sham CPAP
Physiologic continuous positive airway pressure (CPAP) initiated for at least 16 hours per day for a minimum of 48hrs.
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Sham CPAP initiated for at least 16 hours per day for a minimum of 48hrs.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Length of Stay as Measured by the Time From Initial Diagnosis of ACS Until Meeting Discharge Criteria.
Time Frame: From diagnosis of ACS until meeting discharge criteria- Average 7 days.
|
Length of stay as measured by the time from initial diagnosis of ACS until meeting discharge criteria.
It is anticipated length of stay will correlate to efficacy of treatment: shorter stay is theorized to indicate more efficient treatment.
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From diagnosis of ACS until meeting discharge criteria- Average 7 days.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of Exchange Transfusions.
Time Frame: Diagnosis until discharge. Average 7 days.
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Diagnosis until discharge. Average 7 days.
|
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Determine Parent and Patient Acceptability of BLPAP Administration in the Setting of ACS.
Time Frame: Upon completion of intervention at 48hrs.
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Upon completion of intervention at 48hrs.
|
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Rate of PCCU Transfers.
Time Frame: Diagnosis until discharge. Average 7 days.
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Diagnosis until discharge. Average 7 days.
|
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Difference in Respiratory Rate.
Time Frame: 48hrs after initiation of treatment
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48hrs after initiation of treatment
|
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Difference in Pulmonary Function Tests.
Time Frame: 48hrs after initiation of treatment
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48hrs after initiation of treatment
|
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Difference in Mean SpO2 Recording During Sleep.
Time Frame: 48hrs after initiation of treatment
|
Peripheral capillary oxygen saturation (SpO2) is an estimate of the amount of oxygen in the blood.
It is the percentage of haemoglobin containing oxygen compared to the total amount of haemoglobin in the blood (i.e.
oxygenated haemoglobin vs oxygenated and non-oxygenated haemoglobin).
|
48hrs after initiation of treatment
|
Collaborators and Investigators
Investigators
- Principal Investigator: Deepa Manwani, MD, Albert Einstein College Of Medicine
- Principal Investigator: Michael E Roth, MD, Albert Einstein College Of Medicine
- Study Director: Kerry Morrone, MD, Albert Einstein College Of Medicine
- Principal Investigator: Hiren Muzumdar, MD, Albert Einstein College Of Medicine
- Principal Investigator: Ranaan Arens, MD, Albert Einstein College Of Medicine
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 12-04-139
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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