- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02047877
Airway Inflammatory Response During Illness in Children With Respiratory Failure
Investigation of Airway Inflammatory Response During an Acute Respiratory Illness in Pediatric Patients With Respiratory Failure
Study Overview
Status
Detailed Description
This study is designed to measure the concentration and describe the distribution of cytokine IL-10 and IL-12p70 in a previously healthy pediatric population suffering direct lung injury by an infectious etiology, not yet described in the literature.
In addition, this study seeks to determine whether tracheal aspirates (TA) obtained in early acute respiratory failure can be substituted for distal airway aspirates, obtained by non-bronchoscopic broncho-alevolar lavage (nb-BAL), for the purposes of investigating markers of inflammation. We will compare the ratio of IL-10 to IL-12p70 at each time point measured in tracheal secretion, bronchial secretion, and blood to assess for sample equivalence.
Finally, this study will affirm the safety profile for repeated nb-BAL, establish a protocol for respiratory sample collection and storage for future larger scale studies, and generate feasibility data regarding consent rate, estimates of data completion, and fraction of missing data for us to determine whether a future study involving the ratio of IL-10 to IL-12p70 can be used as a predictor of acute respiratory distress syndrome (ARDS) in this population.
The data generated by this study regarding safety, comparison of nb-BAL and TA, and cytokine concentrations will be used as preliminary data informing the design of a larger multicenter study testing the hypothesis that IL-10 and IL-12p70 levels in airway secretions can predict risk for ARDS in this population. This may be approached via application to the Pediatric Acute Lung Injury and Sepsis (PALISI) clinical research network group.
Study Type
Contacts and Locations
Study Locations
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North Carolina
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Chapel Hill, North Carolina, United States, 27514
- University of North Carolina Hospital at Chapel Hill
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Previously healthy
- Age 37 weeks gestation through 17 years
- Presumed respiratory infection
- Intubated <48 hours
Exclusion Criteria:
- Trauma, Drowning, Pancreatitis, or Sepsis not originating from a pulmonary infection.
- Pre-existing chronic disease including:
- congenital heart disease or acquired cardiomyopathy
- pulmonary hypertension
- restrictive lung disease
- cystic fibrosis
- asthma controlled with chronically inhaled steroids
- Tracheostomy
- Immunocompromised including chronic steroid use within last month
- Oncological condition except conditions in active remission not requiring maintenance chemotherapy.
- Intubated patient with an endotracheal tube <3.5 mm
- Patients with persistent SpO2 <90% despite adequate ventilator support, or patients deemed too unstable to undergo mini-BAL by the clinical care team
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Respiratory Illness
Previously healthy patients admitted with acute respiratory illness who are then intubated requiring mechanical ventilator support.
Endotracheally intubated patients of age 37 weeks gestation through 17 years with an acute respiratory illness in the absence of existing cardiopulmonary disease, tracheostomy, or immunocompromised condition.
Tracheal aspirates (TA), bronchial fluid (nb-BALF), and blood are collected within 48-hours following endotracheal intubation.
All three samples are collected again at two additional time points following intubation: between days 3-4 and between days 5-7, so long as the patient remains endotracheally intubated.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean log transformed IL-10:IL-12p70 ratio in tracheal secretion, bronchial secretion, and serum within 48-hours of mechanical ventilation
Time Frame: Within 48 hours of mechanical ventilation
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Tracheal aspirates (TA), bronchial fluid (nb-BALF), and blood are collected within 48-hours following endotracheal intubation.
All three samples are collected again at two additional time points following intubation: between days 3-4 and between days 5-7, so long as the patient remains endotracheally intubated.
Three time points were chosen to show consistency in ratio of IL-10 to IL-12p70 between TA and nb-BALF throughout the first week of endotracheal intubation.
If a patient is extubated before day 7 all sample collection will stop.
No samples will be obtained after 7 days of intubation as we are focusing on the acute phase of lung injury only.
An ELISA assay is performed to measure the concentration of IL-10 and IL-12p70 for ratio comparison.
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Within 48 hours of mechanical ventilation
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood oxygenation saturation and hemodynamic changes following non-bronchoscopic BAL
Time Frame: Baseline through 1-hour post procedure
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Pulse Oxygen Saturation (SpO2), heart rate (HR), blood pressure (BP), and cardiac rhythm are continuously monitored per clinical routine in intubated patients. These parameters will be recorded pre-procedure then monitored over the 1 hour post-procedure. Transient and inconsequential changes in these parameters are expected. The following changes will be considered adverse events and reported to data safety monitor (DSM):
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Baseline through 1-hour post procedure
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Mean log transformed IL-10:IL-12p70 ratio in tracheal secretion, bronchial secretion, and serum between days 3-4
Time Frame: Days 3 to 4 of mechanical ventilation
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Tracheal aspirates (TA), bronchial fluid (nb-BALF), and blood are collected within 48-hours following endotracheal intubation.
All three samples are collected again at two additional time points following intubation: between days 3-4 and between days 5-7, so long as the patient remains endotracheally intubated.
Three time points were chosen to show consistency in ratio of IL-10 to IL-12p70 between TA and nb-BALF throughout the first week of endotracheal intubation.
If a patient is extubated before day 7 all sample collection will stop.
No samples will be obtained after 7 days of intubation as we are focusing on the acute phase of lung injury only.
An ELISA assay is performed to measure the concentration of IL-10 and IL-12p70 for ratio comparison.
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Days 3 to 4 of mechanical ventilation
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Mean log transformed IL-10:IL-12p70 ratio in tracheal secretion, bronchial secretion, and serum between days 5-7
Time Frame: Days 5 to 7 of mechanical ventilation
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Tracheal aspirates (TA), bronchial fluid (nb-BALF), and blood are collected within 48-hours following endotracheal intubation.
All three samples are collected again at two additional time points following intubation: between days 3-4 and between days 5-7, so long as the patient remains endotracheally intubated.
Three time points were chosen to show consistency in ratio of IL-10 to IL-12p70 between TA and nb-BALF throughout the first week of endotracheal intubation.
If a patient is extubated before day 7 all sample collection will stop.
No samples will be obtained after 7 days of intubation as we are focusing on the acute phase of lung injury only.
An ELISA assay is performed to measure the concentration of IL-10 and IL-12p70 for ratio comparison.
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Days 5 to 7 of mechanical ventilation
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fraction of screened patients enrolled, fraction of patients with complete sample collection, and fraction of patients with complete clinical data
Time Frame: 1-Year from Initial Enrollment
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Estimate the feasibility of enrolling ARDS patient for a future larger trial designed to examine IL-10:IL-12p70 as a predictor of ARDS in pediatric patients.
This study will generate pilot data regarding consent rate, estimates of data completion, and fraction of missing clinical data necessary for us to determine whether a future study involving the ratio of IL-10 to IL-12p70 can be used as a predictor of ARDS in this population.
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1-Year from Initial Enrollment
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Collaborators and Investigators
Investigators
- Principal Investigator: Daniel Lercher, MD, University of North Carolina Hospital at Chapel Hill
- Study Director: Benny Joyner, MD, MPH, University of North Carolina, Chapel Hill
- Study Chair: Benny L Joyner, Jr., MD, MPH, University of North Carolina, Chapel Hill
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 13-2784
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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