- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03997630
Management of Moderately Hypoxemic Thoracic Trauma (TrOMaTho)
Post Traumatic Early Use of High Flow Oxygenation Versus Standard Oxygen for Management of Moderately Hypoxemic Thoracic Trauma: TrOMaTho Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
TrOMaTho study is an investigator-initiated, randomized, unblinded, controlled trial. The aim of this study is to compare a prophylactic use of high-flow nasal cannula oxygenation (experimental group) to low-flow oxygenation (control group) after thoracic trauma. 770 patients will be included. Randomization will be conducted with random block and patients will be randomized in 1:1 ratio in one of the two groups. Randomization process will be stratified on: age (more or less 65 years old), use of peridural analgesia and existence of extra thoracic trauma. Only the oxygenation technique is studied, all other aspects of management will be handle by the attending physician.
All patients will be followed from enrollment to hospital discharge. To ensure the same data collection in all centers, six visits are planned: day (D) 1 (inclusion), D7, D14, D28.
Classical blinded methods cannot be used for the evaluation of these kinds of devices. To ensure the same evaluation for all patients and in all centers, all relevant outcomes will be evaluated by an independent clinical event committee. Statistical analysis will be performed by an independent statistician.
Primary endpoint will be analyzed according to intention to treat. Secondary outcomes will be analyzed as exploratory analysis.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Véronique Vermeersch, Dr
- Phone Number: +33298347288
- Email: veronique.vermeersch@chu-brest.fr
Study Contact Backup
- Name: Olivier Huet, Pr
- Phone Number: +33298347288
- Email: olivier.huet@chu-brest.fr
Study Locations
-
-
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Angers, France
- Recruiting
- Angers University Hospital
-
Principal Investigator:
- Sigismond Lasocki, MD, PhD
-
Contact:
- Sigismond Lasocki, MD, PhD
- Phone Number: +33241353635
- Email: silasocki@chu-angers.fr
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Brest, France
- Recruiting
- Brest University Hospital
-
Contact:
- Olivier HUET, MD,PhD
- Phone Number: +33298347288
- Email: olivier.huet@chu-brest.fr
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Principal Investigator:
- Olivier Huet, MD,PhD
-
Sub-Investigator:
- Véronique Vermeersch, MD
-
Chartres, France, 28000
- Recruiting
- Chartres Hospital
-
Principal Investigator:
- Pierre Kalfon, MD
-
Contact:
- Juliette AUDIBERT, MD
- Phone Number: +33237303239
- Email: jaudibert@ch-chartres.fr
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Clamart, France, 92141
- Recruiting
- HIA Percy
-
Contact:
- Pierre PASQUIER, MD, PhD
- Phone Number: +33141466726
- Email: pasquier9606@me.com
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Principal Investigator:
- Pierre PASQUIER, MD, PhD
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Dreux, France
- Recruiting
- Dreux hospital
-
Contact:
- Aude GARIN, MD, PhD
- Phone Number: +33237517633
- Email: agarin@ch-dreux.fr
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Principal Investigator:
- GARIN Aude, MD, PhD
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Le Mans, France
- Recruiting
- Le Mans hospital
-
Contact:
- Mickael Landais, MD
- Phone Number: +33243432458
- Email: mlandais@ch-lemans.fr
-
Contact:
- Charlène LE MOAL, MD
- Email: clemoal@ch-lemans.fr
-
Principal Investigator:
- Charlène LE MOAL, MD
-
Sub-Investigator:
- Mickael Landais, MD
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Lorient, France, 56100
- Recruiting
- Centre Hospitalier de Bretagne Sud
-
Contact:
- Pierre Bouju, MD
- Email: p.bouju@ch-bretagne-sud.fr
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Principal Investigator:
- Pierre Bouju, MD
-
MArseille, France, 13005
- Not yet recruiting
- La Timone Hospital (AP-HM)
-
Contact:
- Jeremy BOURENNE, MD
- Phone Number: +334 13 42 95 31
- Email: jeremy.bourenne@aphm.fr
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Principal Investigator:
- Jeremy BOURENNE, MD
-
Marseille, France
- Recruiting
- Marseille university horpital
-
Contact:
- Gary DUCLOS, MD, PhD
- Email: gary.duclos@ap-hm.fr
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Principal Investigator:
- Gary DUCLOS, MD
-
Sub-Investigator:
- Marc LEONE, MD, PhD
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Montpellier, France, 34295
- Recruiting
- CHRU de Montpellier
-
Contact:
- Jonathan Charbit, MD
- Phone Number: +33467338256
- Email: j-charbit@chu-montpellier.fr
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Principal Investigator:
- Jonathan CHARBIT, MD
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Morlaix, France
- Recruiting
- Morlaix hospital
-
Contact:
- Pierre-Yves Egreteau, MD
- Phone Number: +33298626095
- Email: PEgreteau@ch-morlaix.fr
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Principal Investigator:
- Pierre-Yves Egreteau, MD
-
Nantes, France
- Recruiting
- Nantes university hospital
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Contact:
- Karim Asehnoune, MD, PhD
- Phone Number: +33240083005
- Email: karim.asehnoune@chu-nantes.fr
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Principal Investigator:
- Karim Asehnoune, MD, PhD
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Paris, France
- Recruiting
- Kremlin Bicêtre university hospital (APHP)
-
Contact:
- Jacques Duranteau, MD, PhD
- Phone Number: +33145213936
- Email: jacques.duranteau@aphp.fr
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Principal Investigator:
- Jacques Duranteau, MD, PhD
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Paris, France, 75651
- Recruiting
- CHRU de la Pitié-Salpétrière
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Contact:
- Mathieu RAUX, MD,PhD
- Email: mathieu.raux@aphp.fr
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Contact:
- Arthur JAMES, MD,PhD
- Email: arthur.james@aphp.fr
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Principal Investigator:
- Mathieu Raux, MD,PhD
-
Sub-Investigator:
- Arthur JAMES, MD
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Rennes, France, 35000
- Recruiting
- Rennes, University hospital
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Contact:
- Thomas LEBOUVIER, MD
- Email: thomas.lebouvier@chu-rennes.fr
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Contact:
- Philippe SEGUIN, MD,PhD
- Email: philippe.seguin@chu-rennes.fr
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Principal Investigator:
- Thomas LEBOUVIER, MD
-
Sub-Investigator:
- Philippe SEGUIN, MD,PhD
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Tours, France
- Recruiting
- Tours university Hospital
-
Contact:
- Martine Ferrandiere, MD, PhD
- Phone Number: +33247475997
- Email: m.ferrandiere@chu-tours.fr
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Principal Investigator:
- Martine Ferrandiere, MD, PhD
-
Vannes, France, 56017
- Recruiting
- CHBA de Vannes
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Contact:
- Angélique GOEPP, MD
- Phone Number: +33297014306
- Email: angelique.goepp@ch-bretagne-atlantique.fr
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Principal Investigator:
- Angélique GOEPP, MD
-
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Bretagne
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Quimper, Bretagne, France, 29000
- Recruiting
- Centre Hospitalier de Cornouaille
-
Contact:
- Mikaël Moriconi, MD
- Phone Number: +33298526515
- Email: m.moriconi@chcormouaille.fr
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Principal Investigator:
- Mikaël Moriconi
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Major patient (age ≥ 18 years),
- Admitted to intensive care unit for less than 48 hours for the management of chest trauma.
- Closed chest trauma, non-penetrating, with a TTSS score> or equal to 4.
- Need for conventional oxygen therapy to maintain SpO2 greater than or equal to 95%.
- Patient affiliated or beneficiary of a social security scheme
- Patient having signed a consent
Exclusion Criteria:
- Severe hypoxemia defined as a PaO2/FiO2 ratio < 200 noted before randomization
- Recommended indication for NIV: cardiogenic pulmonary oedema, decompensated COPD.
Indication to immediate oro-tracheal intubation. (will not be excluded patients requiring general anaesthesia for a surgical procedure for a peripheral surgical procedure or embolization)
- Patient with acute respiratory distress, whatever the cause.
- Hemodynamic instability marked by a fall of the PAS> 30% or a PAS <110 mmHg despite the initial resuscitation measures
- Neurological degradation with Glasgow score less than 12
- Pregnant or lactating woman
- Patient under guardianship or curatorship
- Contraindication to the use of one or both devices studied (decaying facial trauma)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Interventional group
Interventional group: All patients included in this group will receive a continuous heated and humidified high-flow (30 to 60 l/min) oxygenation with a nasal cannula for 48 hours.
Initially, flow rate will be started at 50 l/min with a FiO2 at 50%.
According to the protocol, flow rate and FiO2 will be titrated on SpO2 and respiratory tolerance.
Weaning and failure of high-flow oxygenation are described in detail in the study protocol.
|
Interventional group: All patients included in this group will receive a continuous heated and humidified high-flow (30 to 60 l/min) oxygenation with a nasal cannula for 48 hours.
Initially, flow rate will be started at 50 l/min with a FiO2 at 50%.
According to the protocol, flow rate and FiO2 will be titrated on SpO2 and respiratory tolerance.
Weaning and failure of high-flow oxygenation are described in detail in the study protocol.
|
ACTIVE_COMPARATOR: Control group
Control group: All patients included in this group will receive a low flow oxygenation (flow rate < 15 l/min) with nasal cannula (flow rate ≤ 6 l/min) or non-rebreathing mask (flow rate ≥ 7 l/min).
|
Control group: All patients included in this group will receive a low flow oxygenation (flow rate < 15 l/min) with nasal cannula (flow rate ≤ 6 l/min) or non-rebreathing mask (flow rate ≥ 7 l/min).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
safety event
Time Frame: Day 28
|
The primary endpoint is a composite endpoint defined by:
|
Day 28
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Severe hypoxemia
Time Frame: day 7
|
Severe hypoxemia before day 7: SpO2 < 92% or PaO2/FiO2 < 200 without oxygenation
|
day 7
|
Severe hypoxemia
Time Frame: day 14
|
Severe hypoxemia before day 14: SpO2 < 92% or PaO2/FiO2 < 200 without oxygenation
|
day 14
|
Respiratory tract infection
Time Frame: day 7
|
Respiratory tract infection before day 7 defined according to international recommendations on health-associated pneumonia or trachea-bronchitis.
|
day 7
|
Respiratory tract infection
Time Frame: day 14
|
Respiratory tract infection before day 14 defined according to international recommendations on health-associated pneumonia or trachea-bronchitis.
|
day 14
|
Mechanical ventilation
Time Frame: day 7
|
Need for mechanical ventilation before day 7. Criteria used to define the need of mechanical ventilation is an acute respiratory distress defined as: the inability to clear tracheal secretion, a deterioration of neurological status (decrease in GCS of 2 points), a respiratory acidosis (pH < 7,25 and PaCO2 > 45 mmHg), signs of persisting or worsening respiratory failure (respiratory rate > 35/min, high respiratory-muscle workload) with a poor response to another oxygenation device.
|
day 7
|
Mechanical ventilation
Time Frame: day 14
|
Need for mechanical ventilation before day 14.
Criteria used to define the need of mechanical ventilation is an acute respiratory distress defined as: the inability to clear tracheal secretion, a deterioration of neurological status (decrease in GCS of 2 points), a respiratory acidosis (pH < 7,25 and PaCO2 > 45 mmHg), signs of persisting or worsening respiratory failure (respiratory rate > 35/min, high respiratory-muscle workload) with a poor response to another oxygenation device.
|
day 14
|
oxygen free days
Time Frame: day 14
|
number of day without oxygen
|
day 14
|
ventilator free days
Time Frame: day 14
|
number of day without ventilation
|
day 14
|
ICU length of stay
Time Frame: day 90
|
number of day in ICU
|
day 90
|
Hospital length of stay
Time Frame: day 90
|
number of day of the total stay in hospital
|
day 90
|
All cause of mortality
Time Frame: day 28 or day 90
|
Mortality (yes/no)
|
day 28 or day 90
|
quality of life 3 months after High flow oxgenation with the The Short Form (36) Health Survey score
Time Frame: day 90
|
SF 36 questionnary total score
|
day 90
|
Severity of dyspnea using a Saint Georges respiratory questionnaire
Time Frame: day 90
|
Saint Georges questionnary total score
|
day 90
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 29BRC18.0159 ( TrOMaTho)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
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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