Key Diagnostic & Therapeutic Technologies for Severe Acute High Altitude Disease (SAHAD): Integration and Application (SAHAD)
Integration and Application Demonstration of Key Diagnosis and Treatment Technologies for Severe Acute High Altitude Disease
Aperçu de l'étude
Statut
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Gesang Luobu, MD
- Numéro de téléphone: 8618108912487
- E-mail: kelsangnorbu@hotmail.com
Lieux d'étude
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Tibet
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Lhasa, Tibet, Chine, 850000
- Xizang Autonomous Region People's Hospital
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Contact:
- li hui Yang
- Numéro de téléphone: 13638992795
- E-mail: 1640794768@qq.com
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Meeting the diagnostic criteria for severe acute mountain sickness (including high-altitude pulmonary edema [HAPE] and high-altitude cerebral edema [HACE]).
- Aged 18 to 75 years.
- Rapid ascent to an altitude above 2500 m within 72 hours prior to onset.
Exclusion Criteria:
- History of severe cardiopulmonary diseases.
- Pregnant women, patients with psychiatric disorders, inability to cooperate with treatment or follow-up, and patients with an expected survival of less than 6 months.
- Patients with malignant tumors, severe hepatic or renal insufficiency, or immune system diseases requiring immunosuppressive therapy.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Aucune intervention: HAPE： Calcium Channel Blocker (CCB) Group
Calcium Channel Blocker (CCB) Group: Nifedipine sustained-release tablets: 30-60 mg/day, orally in 2-3 divided doses;
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Aucune intervention: HAPE：Glucocorticoid Group
Dexamethasone: 8-16 mg/day, intravenous injection, tapering off after 3-5 days; Methylprednisolone: 40-80 mg/day, intravenous injection; Prednisone: 40-60 mg/day, oral administration;
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Aucune intervention: HAPE：Diuretic Group
Furosemide: 40-80 mg/day, administered intravenously or orally; Spironolactone: 40-80 mg/day, administered orally; Note: Strictly monitor electrolytes and renal function.
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Aucune intervention: HAPE：Theophylline Drugs Group
Aminophylline: 0.25-0.5g,
intravenous drip, 1-2 times a day; Doxofylline: 200mg, intravenous drip, 2 times a day;
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Aucune intervention: HAPE：Combined Treatment Group
CCB + Glucocorticoid: Nifedipine + Dexamethasone; Glucocorticoid + Diuretic: Dexamethasone + Furosemide; Triple Therapy: CCB + Glucocorticoid + Diuretic.
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Aucune intervention: HACE：Osmotic Diuretic Group
0.5-1.0
g/kg, rapid intravenous infusion, once every 6-8 hours; Hypertonic saline: 3% sodium chloride solution, 250 ml intravenous infusion.
Monitoring indicators: intracranial pressure, blood osmotic pressure, renal function.
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Aucune intervention: HACE：Intensive Glucocorticoid Treatment Group
High-dose dexamethasone: 16-32 mg/day, intravenously; Methylprednisolone pulse therapy: 500-1000 mg/day for 3 days, followed by dosage tapering.
Treatment course: 7-10 days with gradual dose reduction.
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Aucune intervention: HACE：Combined Intracranial Pressure-Reducing Treatment Group
Mannitol + Glucocorticoid: Mannitol 0.5 g/kg + Dexamethasone 16 mg/day; Hypertonic saline + Glucocorticoid: 3% NaCl + Methylprednisolone; Triple therapy: Mannitol + Glucocorticoid + Diuretic.
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Aucune intervention: HACE：Other Adjuvant Drug Group
Furosemide: 20-40 mg/day to reduce cerebral edema; Albumin: 25% albumin 50 ml to increase plasma colloid osmotic pressure; Sodium aescinate: 20-40 mg/day to improve vascular permeability.
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Expérimental: Multicenter Study of HAPE：Traditional Classic Treatment Group
Oxygen inhalation plus CCB or aminophylline
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Traditional treatment plus CPAP or BiPAP
Traditional treatment plus inhaled nitric oxide therapy (20-40 ppm, continuous administration for 12-24 hours)
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Expérimental: Protocol for Proteomics and Peptidomics Study of HAPE：Control Group
40 healthy individuals who are either migrant residents or indigenous residents at high altitude.
Age, gender, and residential altitude were strictly matched.
Peripheral venous blood samples were collected during the same period.
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40 patients clinically diagnosed with HAPE.
Peripheral venous blood samples were collected during the acute onset stage and prior to any effective intervention.
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Aucune intervention: HAPE Database
To establish a High-Altitude Pulmonary Edema (HAPE) Database (≥1000 cases) through a multicenter retrospective study.
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Aucune intervention: HACE Database
To establish a High-Altitude Pulmonary Edema (HACE) Database (≥400 cases) through a multicenter retrospective study.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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HAPE：Recovery
Délai: From date of disease onset to achievement of recovery criteria ,assessed up to 36 months
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Patients are defined as recovered only when all of the following criteria are met simultaneously: Resolution of clinical symptoms: complete relief of dyspnea (no shortness of breath at rest), disappearance of cough and expectoration, and resolution of chest tightness or chest pain. Restoration of normal physical signs: complete disappearance of lung crackles, resolution of cyanosis, and heart rate < 100 beats per minute at rest. Normalization of physiological parameters: blood oxygen saturation (SpO₂) ≥ 90% above 3500 m altitude (≥ 88% above 4000 m altitude) and normal arterial blood gas analysis (if performed). Improvement on imaging studies: clear bilateral lung fields on chest X-ray, and resolution of alveolar exudation without significant effusion on chest CT. Meeting hospital discharge criteria: stable condition for more than 48 hours, recovery of self-care ability, and no requirement for continuous oxygen therapy. |
From date of disease onset to achievement of recovery criteria ,assessed up to 36 months
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HACE ：recovery
Délai: From date of disease onset to achievement of recovery criteria ,assessed up to 36 months
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Patients are defined as recovered only when all of the following criteria are met simultaneously: Recovery of consciousness: Glasgow Coma Score (GCS) of 15, full restoration of orientation, and no signs of impaired consciousness. Resolution of neurological symptoms: complete relief of headache, and disappearance of ataxia, nausea, vomiting, blurred vision, and other related symptoms. Normal neurological signs: disappearance of pathological reflexes, negative meningeal irritation signs, and normal cranial nerve function. Improvement on imaging: resolution of cerebral edema, no mass effect, and normal ventricular system on head CT or MRI. Meeting hospital discharge criteria: stable condition for more than 72 hours, recovery of activities of daily living, and no requirement for special monitoring. |
From date of disease onset to achievement of recovery criteria ,assessed up to 36 months
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Death
Délai: From admission to discharge, or all-cause mortality within 30 days and 90 days after discharge.
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Death is defined as all-cause mortality occurring during hospitalization, or all-cause mortality within 30 days and 90 days after discharge.
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From admission to discharge, or all-cause mortality within 30 days and 90 days after discharge.
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Length of hospital stay
Délai: The total duration from the first day of hospitalization to recovery and discharge, assessed up to 36 months
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From the first day of admission to the day of discharge
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The total duration from the first day of hospitalization to recovery and discharge, assessed up to 36 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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HAPE：Improvement
Délai: At discharge(assessed up to 5 days)
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Clinical symptoms improved by ≥50%, manifested as significant relief of dyspnea (no shortness of breath during mild activity), marked reduction in cough and expectoration, and alleviation of chest discomfort. Physiological indicators improved, including a decrease in heart rate by ≥20 beats per minute from baseline, an increase in blood oxygen saturation by ≥5% compared with admission, and a respiratory rate < 24 breaths per minute. Imaging examinations showed a ≥50% reduction in pulmonary exudation on chest radiograph compared with admission, or a significant reduction in lesion extent on chest CT. |
At discharge(assessed up to 5 days)
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Length of ICU/CCU stay
Délai: From date of the first day admimion in the ICU until the last day in the ICU, up to 48 weeks.
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From the first day of admission to the day of discharge
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From date of the first day admimion in the ICU until the last day in the ICU, up to 48 weeks.
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Duration of mechanical ventilation
Délai: From the date of the first day of mechanical ventilation until the last day of mechanical ventilation,up to 48 weeks.
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Duration of mechanical ventilation, calculated in hours
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From the date of the first day of mechanical ventilation until the last day of mechanical ventilation,up to 48 weeks.
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Total hospitalization cost (CNY)
Délai: At discharge(assessed up to 5 days)
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total expenses incurred during hospitalization
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At discharge(assessed up to 5 days)
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Time to independence from oxygen therapy (days)
Délai: At discharge(assessed up to 5 days)
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Duration of oxygen therapy during hospitalization (days)
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At discharge(assessed up to 5 days)
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HAPE：incidence of complications
Délai: From date of admission until the date of discharge, and within 30 days and 90 days after discharge,up to 48 weeks.
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such as pulmonary embolism, pneumothorax, infection, etc
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From date of admission until the date of discharge, and within 30 days and 90 days after discharge,up to 48 weeks.
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HACE：improved
Délai: At discharge(assessed up to 5 days)
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A patient is defined as having "improved" if meeting the following core criteria: Improved consciousness: Glasgow Coma Scale (GCS) score increased by ≥3 points from admission, partial recovery of orientation, and improved response to stimuli. Improved neurological symptoms: ≥50% reduction in headache severity (VAS score), significant improvement in ataxia, and decreased nausea and vomiting. Improved physiological indicators: heart rate decreased by ≥15 beats per minute from baseline, blood oxygen saturation increased by ≥5% compared with admission, and blood pressure controlled within the normal range. |
At discharge(assessed up to 5 days)
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HACE：Incidence of complications
Délai: From date of admission until the date of discharge, and within 30 days and 90 days after discharge,up to 48 weeks.
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such as seizures, intracranial infection, brain herniation, permanent neurological deficit
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From date of admission until the date of discharge, and within 30 days and 90 days after discharge,up to 48 weeks.
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HACE：Modified Rankin Scale (mRS) score at 90 days
Délai: From the first day of admission to 90 days thereafter
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specifically categorized as: 0 (no symptoms),
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From the first day of admission to 90 days thereafter
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Collaborateurs et enquêteurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- ME-TBHP-25-090
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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