Comparison of Early Pleural Irrigation Strategy With Saline to the Standard of Care for the Management of Complicated Pleural Infections. (EPISSOC)
Randomized Controlled Trial Comparing an Early Pleural Irrigation Strategy With Saline to the Standard of Care for the Management of Complicated Pleural Infections.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Damien BASILLE, Pr
- Telefonnummer: 33+3 22 45 59 10
- E-mail: basille.damien@chu-amiens.fr
Studiesteder
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Picardie
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Amiens, Picardie, Frankrig, 80054
- Rekruttering
- CHU Amiens Picardie
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Ledende efterforsker:
- Christophe GUT-GOBERT, MD
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Ledende efterforsker:
- Hugues MOREL, MD
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Ledende efterforsker:
- Frédéric GAGNADOUX, MD
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Kontakt:
- Damien BASILLE, Dr
- E-mail: basille.damien@chu-amiens.fr
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Ledende efterforsker:
- Elise NOELSAVINA, MD
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Ledende efterforsker:
- Camille PIRIOU-GAROUTE, MD
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Ledende efterforsker:
- Gilles MANGIAPAN, MD
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Ledende efterforsker:
- Thomas FLAMENT, MD
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Ledende efterforsker:
- Vincent DUCROCQ, MD
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Ledende efterforsker:
- Laure SEYER, MD
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Ledende efterforsker:
- Elise ARTAUD-MACARI, MD
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Ledende efterforsker:
- Ibrantina LUCENA, MD
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Ledende efterforsker:
- Marine GOSSET-WOIMANT, MD
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Ledende efterforsker:
- Cherifa GOUNANE, MD
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Ledende efterforsker:
- Marion DESQUIENS, MD
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Ledende efterforsker:
- Charles- Hugo MARQUETTE, MD
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Ledende efterforsker:
- Laure GOUBERT, MD
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Ledende efterforsker:
- Nina DE MONTMOLLIN, MD
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Ledende efterforsker:
- Xavier DEMANT, MD
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Ledende efterforsker:
- Vincent IOOS, MD
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Ledende efterforsker:
- Maxime FURSTENBERGER, MD
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Ledende efterforsker:
- Jean MORIN, MD
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Ledende efterforsker:
- Asaël BERGER, MD
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Ledende efterforsker:
- Antoine DUMAZET, MD
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Ledende efterforsker:
- Lidia PETIT, MD
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Ledende efterforsker:
- Jean STAENTZEL, MD
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Adults (≥18 years old) capable of fully understanding the study;
- Complicated pleural infection (macroscopically purulent fluid, positive for bacteria on Gram's staining, positive on culture for bacterial infection, loculated effusion, pH <7.2, great abundance) leading to thoracic drainage;
- Initial ultrasound evaluation to estimate pleural fluid abundance and detect fibrinous septation;
- Social security affiliation
- Written informed consent
- Highly effective contraceptive methods for women of childbearing age include: Combined hormonal contraception (estrogen and progestogen) associated with inhibition of ovulation (oral, intravaginal, transdermal); progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable); intrauterine device; hormone- releasing intrauterine system; bilateral occlusion of the Fallopian tubes; vasectomized partner; sexual abstinence
Exclusion Criteria:
- Tuberculous pleural effusions;
- Previous treatment with intrapleural fibrinolytic agents (urokinase, streptokinase, alteplase, or DNase) or intrapleural saline lavage;
- Previous thoracic surgery for pleural infection;
- Contraindications to auxiliary treatments, to fibrinolysis or surgery as well as to procedures such as drainage and lavage;
- Pregnancy or lactation;
- Expected survival of less than 3 months;
- Thoracic drainage since more than 24h;
- Patient deprived of liberty by administrative or judicial decision or placed under judicial protection (guardianship or supervision);
- Inability to give informed written consent;
- Participation in another clinical trial;
- Patient being a relative of the investigator or any member of the team directly involved in the study, including assistant physicians, pharmacists, nurses, and coordinators
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: intrapleural irrigation
Experimental group: 500 mL bags of 0.9% sodium chloride will be administered into the thoracic cavity via the chest tube using a three way tap and gravity (no infusion pump or pressure).
The infusion is followed by free drainage with thoracic suction (up to -20 cmH2O).
This process will occur twices daily for a total of 6 irrigations.
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500 mL bags of 0.9% sodium chloride will be administered into the thoracic cavity via the chest tube using a three way tap and gravity (no infusion pump or pressure).
The infusion is followed by free drainage with thoracic suction (up to -20 cmH2O).
This process will occur two times daily for a total of 6 irrigations.
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|
Aktiv komparator: standard care
Control group: Standard care includes pleural drainage with 20 mL 0.9% sodium chloride flushes administered twice daily for 3 days to maintain tube patency.
Thoracic suction (up to -20 cmH2O) will be applied to chest tubes.
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Standard care includes pleural drainage with 20 mL 0.9% sodium chloride flushes administered two times daily for 3 days to maintain tube patency.
Thoracic suction (up to -20 cmH2O) will be applied to chest tubes.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of treatment failure
Tidsramme: at 30 days
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Treatment failure, defined as a composite outcome that includes death, the need for thoracic surgery, or additional intrapleural enzyme therapy.
This criterion will be assessed at 30 days.
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at 30 days
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Volume of pleural fluid drained from randomization
Tidsramme: at day 3
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Volume of pleural fluid drained from randomization to day 3
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at day 3
|
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Incidence of adverse events
Tidsramme: at 90 days
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Incidence of serious and non-serious adverse events, including fever, allergic reactions, bleeding, and chest tube obstruction
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at 90 days
|
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Intra-hospital mortality
Tidsramme: at 30 days
|
at 30 days
|
|
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Intra-hospital mortality
Tidsramme: at 90 days
|
at 90 days
|
|
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Rate of thoracic surgery
Tidsramme: at 30 days
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Rate of thoracic surgery
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at 30 days
|
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Rate of additional intrapleural enzyme therapy
Tidsramme: at 30 days
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Rate of additional intrapleural enzyme therapy
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at 30 days
|
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Length of hospital stay
Tidsramme: at 90 days
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Length of hospital stay
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at 90 days
|
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Change in the area of pleural opacity
Tidsramme: at day 3
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Change in the area of pleural opacity, measured as the percentage of the ipsilateral hemithorax occupied by effusion on chest radiography from randomization to day 3;
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at day 3
|
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Presence of a restrictive ventilatory defect
Tidsramme: at day 90
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Presence of a restrictive ventilatory defect, defined as total lung capacity < 80% of predicted values
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at day 90
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Assessment of pain using a numeric pain scale
Tidsramme: at 90 days
|
Assessment of pain using a numeric pain scale
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at 90 days
|
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valuation of the prognostic performance of the RAPID score
Tidsramme: at day 0
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valuation of the prognostic performance of the RAPID score
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at day 0
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PI2025_843_0088
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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