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Standard vs. gezielte Sauerstofftherapie vor dem Krankenhaus bei chronisch obstruktiver Lungenerkrankung (STOP-COPD)

30. September 2026 aktualisiert von: Central Denmark Region

The STOP-COPD trial is a randomized, patient-blinded, prehospital clinical trial designed to evaluate the effect of titrated oxygen therapy compared to standard oxygen treatment in patients with suspected acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated with inhaled bronchodilators. The primary objective is to determine whether a titrated oxygen strategy targeting SpO₂ 88-92% can reduce 30-day mortality compared to the current standard practice using 100% compressed oxygen as a nebulizer driver.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally. In the prehospital setting, patients with suspected acute exacerbation of COPD (AECOPD) are frequently treated with inhaled bronchodilators driven by 100% oxygen, despite concerns that high-concentration oxygen therapy may worsen hypercapnia and acidosis, leading to increased mortality.

The STOP-COPD trial is a prospective, randomized, parallel-group, superiority trial conducted in the Prehospital Emergency Medical Services, Central Denmark Region. Patients aged 40 years or older with suspected AECOPD requiring inhaled bronchodilators are randomized 1:1 to receive either:

Titrated oxygen therapy: Inhaled bronchodilators driven by compressed air with supplemental oxygen titrated to maintain SpO₂ 88-92%.

Standard treatment: Inhaled bronchodilators driven by 100% compressed oxygen according to standard protocols.

The primary outcome is 30-day all-cause mortality. Secondary outcomes include 24-hour and 7-day mortality, need for invasive or non-invasive ventilation, development of respiratory acidosis upon hospital arrival, ICU admission rate, length of hospital and ICU stay, patient-experienced dyspnoea, and readmission rates. A total of 1,888 patients will be enrolled.

The study is conducted under emergency research regulations allowing enrolment before informed consent, with consent obtained as soon as feasible after hospital admission. This trial seeks to evaluate whether titrating oxygen delivery in the prehospital phase can improve survival and clinical outcomes for patients with AECOPD.

Studientyp

Interventionell

Einschreibung (Geschätzt)

1888

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

  • Name: Martin F Gude, PhD
  • Telefonnummer: 0045 25343621
  • E-Mail: martgude@rm.dk

Studieren Sie die Kontaktsicherung

  • Name: Arne Sylvester R Jensen
  • Telefonnummer: 22396968
  • E-Mail: arjens@rm.dk

Studienorte

      • Aarhus N, Dänemark, 8200
        • Rekrutierung
        • Prehospital Emergency Medical Servises, Central Denmark Region

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

40 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Patients over the age of 40
  • EMT or Paramedic suspected AECOPD
  • Confirmed suspicion of COPD

Exclusion Criteria:

  • Bronchospasm due to asthma, allergic reaction or non-COPD conditions
  • Known or suspected pregnancy
  • Prehospital Non-invasive, invasive or assisted bag mask ventilation
  • Allergy to inhaled bronchodilators (Salbutamol)
  • Inter-hospital transfer
  • More than 2 doses (5 mg salbutamol) inhalation drug, acute treatment by EMS (emergency medical service) personnel, before allocated treatment is initiated
  • Suspicion of acute coronary syndrome

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Titrated Oxygen

If the treating EMT or paramedic finds indications for inhaled bronchodilators, this will be done with compressed air 6-8 l/min. as the driver for the nebulizer. The patient will have a Bi-nasal EtCO2 (end-tidal carbon dioxide) meter placed under the nebulizer. This will measure the EtCO2 during the treatment and at the same time oxygen can be titrated through this to a target SpO2 of 88-92%. Repeated treatment will be at the discretion of the treating EMT or paramedic according to SOP (standard operating procedures).

Following scenarios regarding SpO2 can occur during treatment:

SpO2 <88%: Supplemental oxygen via the EtCO2-meter up to 10 l/min, if higher oxygen levels are needed oxygen will be used as driver for the nebulizer. If the SpO2 remains under 88% additional oxygen can be added via the EtCO2-meter.

SpO2 88-92%: No intervention.

SpO2 >92%: No intervention.

If repeated treatment is not indicated the patient receives oxygen to SpO2 88-92% according SOP.

Titrated oxygen strategy - a mix of supplemental oxygen and compressed atmospheric air as driver for inhaled bronchodilators to target SpO2 88-92%

Andere Namen:
  • Sauerstofftitration zu Spo₂ 88-92% und komprimierte atmosphärische Luft als Nebelschütze-Treiber
Aktiver Komparator: Standard Oxygen

If the treating EMT or paramedic finds indication for inhaled bronchodilators, this will be done with oxygen 6-8 l/min. as the driver for the nebulizer. The patient will have a Bi-nasal EtCO2 meter placed under the nebulizer. This will measure the EtCO2 during the treatment and at the same time mask the patient for group allocation. Repeated treatment will be at the discretion of the treating EMT or paramedic according to SOP.

Following scenarios regarding SpO2 can occur during treatment:

SpO2 <88%: Supplemental oxygen via the EtCO2 -meter up to 10 l/min.

SpO2 88-92%: No intervention.

SpO2 >92%: No intervention.

If repeated treatment is not indicated the patient receives oxygen to SpO2 88-92% according SOP.

Standard care using compressed oxygen (100%) as driver for inhaled bronchodilators

Andere Namen:
  • Keine SPO₂ -Zielbeschränkung und 100% komprimierter Sauerstoff als Nebelrisiko -Treiber

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Mortality, 30-day
Zeitfenster: Day 30 from randomization

Vital status assessed 30 days after randomization using hospital electronic medical records

Day 30 from randomization

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Mortality, 24-hour
Zeitfenster: 24 hours from randomization

Vital status assessed 24 hours after randomization using hospital electronic medical records

24 hours from randomization
Mortality, 7-day
Zeitfenster: Day 7 from randomization

Vital status assessed 7 days after randomization using hospital electronic medical records

Day 7 from randomization
Length of hospital stay
Zeitfenster: Day 30 from randomization

Number of days from hospital admission to hospital discharge, collected from hospital electronic medical records

Day 30 from randomization
ICU admission rate
Zeitfenster: Day 30 from randomization

Proportion of patients admitted to an intensive care unit during the index hospitalization, collected from the electronic hospital medical record

Day 30 from randomization
Length of ICU stay
Zeitfenster: Day 30 from randomization

Number of days spent in the intensive care unit during the index hospitalization, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for NIV (non-invasive ventilation) within 24 hours
Zeitfenster: Day 30 from randomization

Use of non-invasive ventilation recorded within 24 hours of hospital admission, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for NIV within 7 days
Zeitfenster: Day 30 from randomization

Use of non-invasive ventilation recorded within 7 days of hospital admission, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for NIV within 30 days
Zeitfenster: Day 30 from randomization

Use of non-invasive ventilation recorded within 30 days of randomization, collected from the patient's electronic hospital medical record

Day 30 from randomization
Time to NIV
Zeitfenster: Day 30 from randomization

Time from hospital admission to initiation of non-invasive ventilation, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for invasive mechanical ventilation within 24 hours
Zeitfenster: Day 30 from randomization

Initiation of invasive mechanical ventilation within 24 hours of hospital admission, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for invasive mechanical ventilation within 7 days
Zeitfenster: Day 30 from randomization

Initiation of invasive mechanical ventilation within 7 days of hospital admission, collected from the patient's electronic hospital medical record

Day 30 from randomization
In-hospital need for invasive mechanical ventilation within 30 days
Zeitfenster: Day 30 from randomization

Initiation of invasive mechanical ventilation within 30 days of randomization, collected from the patient's electronic hospital medical record

Day 30 from randomization
Time to invasive ventilation
Zeitfenster: Day 30 from randomization

Time from hospital admission to initiation of invasive mechanical ventilation, collected from the patient's electronic hospital medical record

Day 30 from randomization
Proportion of patients with respiratory acidosis on arrival to hospital
Zeitfenster: Day 30 from randomization

Presence of respiratory acidosis (PaCO₂ >6.3 kPa and pH <7.35) assessed via arterial blood gas analysis within 30 minutes after arrival, collected from the patient's electronic hospital medical record

Day 30 from randomization
The degree of acidosis based on the pH (potential of hydrogen) value
Zeitfenster: Day 30 from randomization

Lowest pH value measured from arterial blood gas within 30 minutes of hospital arrival, collected from the patient's electronic hospital medical record

Day 30 from randomization
Patient experienced dyspnoea on a verbal rating scale 0-10
Zeitfenster: Day 30 from randomization

Patient-reported dyspnoea score at hospital arrival on a scale from 0 (no dyspnoea) to 10 (worst imaginable dyspnoea), collected from the prehospital patient record and hospital medical record

Day 30 from randomization
Readmission rate
Zeitfenster: Day 30 after discharge

Proportion of patients readmitted to hospital within 30 days after discharge from index hospitalization, collected from the patient's electronic hospital medical record

Day 30 after discharge
Time to readmission
Zeitfenster: Day 30 after discharge

Number of days from hospital discharge to first hospital readmission within 30 days, collected from the patient's electronic hospital medical record

Day 30 after discharge

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Martin F Gude, PhD, Central Denmark Region

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

2. Juni 2025

Primärer Abschluss (Geschätzt)

29. Februar 2028

Studienabschluss (Geschätzt)

31. Mai 2028

Studienanmeldedaten

Zuerst eingereicht

10. Januar 2023

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

19. Januar 2023

Zuerst gepostet (Tatsächlich)

30. Januar 2023

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

2. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

30. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 5925
  • 2022-502003-30-00 (Andere Kennung: https://euclinicaltrials.eu)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

De-identified individual participant data (IPD) will be made available to researchers whose proposed use of the data has been approved by the local administration. Data will be shared starting 9 months after publication of the primary results and will be accessible until data are no longer stored, according to current ICMJE recommendations and EU data protection regulations.

All trial-related documents (e.g., protocol, statistical analysis plan) will be made publicly available on the trial website. Patient-related data will not be accessible on the website.

IPD-Sharing-Zeitrahmen

9 months after primary results publication; data will remain available until de-identified data are no longer stored according to ICMJE recommendations and EU regulations.

IPD-Sharing-Zugriffskriterien

Researchers must submit a methodologically sound proposal for use of the data. Access will be granted following review and approval by the local trial administration. A data-sharing agreement will be required.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF
  • ANALYTIC_CODE
  • CSR

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .