- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03026777
Preventing Cardiovascular collaPse With Administration of Fluid Resuscitation Before Endotracheal Intubation (PrePARE)
Preventing Cardiovascular collaPse With Administration of Fluid Resuscitation Before Endotracheal Intubation: The PrePARE Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The investigators propose a randomized, parallel-group trial evaluating the impact of fluid loading to decrease cardiovascular collapse during and after endotracheal intubation in critically ill adults. Patients admitted to the study sites who are deemed by their clinical team to require intubation and fulfill inclusion criteria without meeting exclusion criteria will be enrolled and randomly assigned to intravenous fluid loading versus none. All other decisions regarding airway management will remain at the discretion of the treating provider. Data will be collected at the time of intubation and prospectively from the medical record in order to determine the effect of the assigned intervention on short- and long-term outcomes. All data are collected non-invasively and are already a part of clinical data obtained in usual ICU care at the bedside or in the medical record. No additional data will be collected that is not observed at the bedside or obtained from the medical record.
Study Population: The study population will be all critically ill adults for whom the clinical team has decided to perform endotracheal intubation using sedation with or without neuromuscular blockade. Patients will be excluded only if the operator feels: 1. Additional intravenous fluids in the form of fluid loading is absolutely indicated or contraindicated, or 2. The urgency of the intubation would make performing the study procedures unsafe. Patients will be included regardless of gender, race, weight or body mass index, initial oxygen saturation, anticipated grade of view, and other clinical factors.
Study Interventions:
Fluid Loading - (1) 500 milliliters of an intravenous crystalloid solution of the operator's choosing will be (2) infused at any time after randomization and prior to the administration of procedural medications from (3) above the level of the central or peripheral intravenous or intraosseus access used and allowed to infuse by gravity and (4) stopped after 500 mL have infused. All intravenous infusions preceding the decision to perform endotracheal intubation will not be altered.
No Fluid Loading - No intravenous fluids are started after the decision is made to perform endotracheal intubation. All intravenous infusions preceding the decision to perform endotracheal intubation will not be altered.
Primary Endpoint:
Cardiovascular collapse - a composite endpoint defined as one or more of the following:
- Death within 1 hour of intubation
- Cardiac arrest within 1 hour of intubation
- New systolic blood pressure < 65 mmHg between induction and 2 minutes after completion of intubation
- New or increased vasopressor receipt between induction and 2 minutes after completion of intubation
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Alabama
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Birmingham, Alabama, United States
- University of Alabama Birmingham
-
-
Louisiana
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Jefferson, Louisiana, United States, 70121
- Ochsner Medical Center
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New Orleans, Louisiana, United States, 70112
- LSUHSC and University Medical Center
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-
Massachusetts
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Burlington, Massachusetts, United States, 01805
- Lahey Medical Center
-
-
New York
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Bronx, New York, United States, 10451
- Lincoln Medical Center
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
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-
Washington
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Seattle, Washington, United States, 98104
- University of Washington
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient is admitted to participating study unit
- Planned procedure is endotracheal intubation and planned operator is a provider expected to routinely perform endotracheal intubation in the participating unit
- Administration of sedation with or without neuromuscular blockade is planned
- Age ≥ 18 years old
Exclusion Criteria:
- Operator believes fluid loading to be absolutely indicated or contraindicated for the safe care of the patient
- Urgency of intubation precludes safe performance of study procedures
- Pregnancy
- Prisoners
- Age < 18 years old
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fluid Loading
(1) 500 milliliters of an intravenous crystalloid solution of the operator's choosing will be (2) infused at any time after randomization and prior to the administration of procedural medications from (3) above the level of the central or peripheral intravenous or intraosseus access used and allowed to infuse by gravity and (4) stopped after 500 mL have infused.
All intravenous infusions preceding the decision to perform endotracheal intubation will not be altered.
|
|
No Intervention: Usual Care
No intravenous fluids are started after the decision is made to perform endotracheal intubation.
All intravenous infusions preceding the decision to perform endotracheal intubation will not be altered.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Cardiovascular Collapse
Time Frame: 1 hour
|
a composite endpoint defined as one or more of the following:
|
1 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
In-hospital Mortality
Time Frame: from date of randomization through study completion, an average of 28 days
|
What was the patient's vital status at the time of hospital discharge
|
from date of randomization through study completion, an average of 28 days
|
Ventilator-free Days
Time Frame: from date of randomization through study completion, an average of 28 days
|
Number of days alive and free of invasive ventilation in a 28-day period
|
from date of randomization through study completion, an average of 28 days
|
ICU-free Days
Time Frame: from date of randomization through study completion, an average of 28 days
|
Number of days alive and outside of an ICU in a 28 day period
|
from date of randomization through study completion, an average of 28 days
|
Lowest Arterial Oxygen Saturation
Time Frame: between induction and 2 minutes following procedure
|
Lowest arterial oxygen saturation between induction and 2 min after intubation
|
between induction and 2 minutes following procedure
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Number of Laryngoscopy Attempts
Time Frame: during procedure
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Number of laryngoscopy attempts to achieve successful tracheal intubation
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during procedure
|
Lowest Systolic Blood Pressure
Time Frame: between induction and 2 minutes following procedure
|
Lowest systolic blood pressure between induction and 2 min after intubation
|
between induction and 2 minutes following procedure
|
Collaborators and Investigators
Investigators
- Study Chair: David Janz, MD, MSc, LSU School of Medicine New Orleans
Publications and helpful links
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
- PREPARE
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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