- ICH GCP
- USA klinikai vizsgálatok nyilvántartása
- Klinikai vizsgálat NCT02312869
Local Assessment of Management of Burn Patients (LAMiNAR)
Local Assessment of Management of Burn Patients (LAMiNAR) - a Prospective Observational International Multicenter Cohort Study
In the general intensive care unit (ICU) population, there is strong evidence for benefit from lung-protective mechanical ventilation, including the use of low tidal volumes and adequate levels of positive end-expiratory pressure (PEEP). In burn patients it is highly uncertain whether these settings are beneficial and there are even concerns over safety of, in particular use of low tidal volumes. There is lack of international guidelines and consequently ventilation practice in burn patients may widely vary.
The primary objective is to determine ventilation practice in burn ICUs worldwide, focusing on the size of tidal volumes and the levels of PEEP used for burn patients. In addition, data on other strategies considered important in patients who receive ventilation are also collected, including data on neuromuscular blocking agents, sedatives and analgesics, and type and amount of intravenous fluids used in the period of ventilation. The secondary objective is to determine the association between tidal volume size and levels of PEEP, and duration of ventilation in burn patients.
A tanulmány áttekintése
Állapot
Körülmények
Beavatkozás / kezelés
Részletes leírás
Patient population: Consecutive burn patients admitted to participating burn ICUs who receive invasive ventilation, irrespective of severity of burn injury and/or presence of inhalation trauma are eligible for participation.
Data collection: includes burn patients admitted within a period of three months. Demographic and baseline data are collected from the clinical files on the day of admission. If available, standard of care and clinical outcome parameters are collected daily until day 14, death or discharge from ICU, whatever comes first.
Sample size: The primary objective is to determine (variations in) ventilation practice in burn patients in burn ICUs. Therefore, the sample size is based on the main secondary objective, which is to determine the association between the following ventilator settings: tidal volume, PEEP, FiO2 and mode; and outcome of burn patients. The investigators calculated the sample size for a multiple regression model: a sample size of at least 300 patients is required to have a power of 0.80, a significance level of 0.05, using an estimated effect size of 0.04, while using 4 independent variables in the model.
Ethics Approval: National coordinators will be responsible for clarifying the need for ethics approval and applying for this where appropriate according to local policy. Centres will not be permitted to record data unless ethics approval or an equivalent waiver is in place. The investigators expect that in most, if not every participating country, a patient informed consent is not be required.
Monitoring: Due to the observational nature of the study, a DSMB is not necessary.
Organization: National co-ordinators will lead the project within individual nations and identify participating hospitals, translate study paperwork, distribute study paperwork and ensure necessary regulatory approvals are in place. They provide assistance to the participating clinical sites in trial management, record keeping and data management. Local coordinators in each site will supervise data collection and ensure adherence to Good Clinical Practice during the trial.
Tanulmány típusa
Beiratkozás (Tényleges)
Kapcsolatok és helyek
Tanulmányi helyek
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Zuid Holland
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Amsterdam, Zuid Holland, Hollandia, 1105AZ
- Academic Medical Center
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Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
Egészséges önkénteseket fogad
Tanulmányozható nemek
Mintavételi módszer
Tanulmányi populáció
Leírás
Inclusion Criteria:
- Burns
- Admission to a participating burn ICU Need for invasive ventilation
- Informed consent (only if applicable in the country where data are collected)
Exclusion Criteria:
- None
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
---|---|---|
Ventilation parameters
Időkeret: Up to 14 days during mechanical ventilation
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Tidal volume size; milliliters per kilogram of predicted body weight
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Up to 14 days during mechanical ventilation
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Ventilation parameters
Időkeret: Up to 14 days during mechanical ventilation
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Level of positive end-expiratory pressure (PEEP); cm H2O
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Up to 14 days during mechanical ventilation
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Ventilation parameters
Időkeret: Up to 14 days during mechanical ventilation
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Fraction of oxygen in inspired air (FiO2), %
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Up to 14 days during mechanical ventilation
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Ventilation parameters
Időkeret: Up to 14 days during mechanical ventilation
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Mode of ventilation; assist-control or spontaneous modes of ventilation
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Up to 14 days during mechanical ventilation
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
---|---|---|
Az intenzív osztályon való tartózkodás időtartama a 90. napon
Időkeret: A 90. napig
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A felvétel és az elbocsátás vagy a halál között eltelt idő
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A 90. napig
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A kórházi tartózkodás időtartama a 90. napon
Időkeret: A 90. napig
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A felvétel és az elbocsátás vagy a halál között eltelt idő
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A 90. napig
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Minden ok miatti intenzív osztályos halálozás
Időkeret: A 90. napig
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Bármilyen haláleset az intenzív osztályon való tartózkodás alatt
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A 90. napig
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Minden okú kórházi halálozás
Időkeret: A 90. napig
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Bármilyen haláleset a kórházi tartózkodás alatt
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A 90. napig
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Number of ventilator-free days and alive at day 28
Időkeret: From day 1 to day 28
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Defined as the number of days, from day 1 to day 28, the patient is alive and breathes without assistance of a mechanical ventilator, if the period of unassisted breathing lasted at least 24 consecutive hours.
Notably, if after successful withdrawal of mechanical ventilation the patient requires ventilation for a surgical procedure, this will not count as a 'ventilator day'.
If ventilation is prolonged after surgery due to respiratory insufficiency, the day(s) ventilation is required counts as a 'ventilator day'
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From day 1 to day 28
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Other Ventilation Parameters
Időkeret: Up to 14 days during mechanical ventilation
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Peak and plateau pressures or maximum airway pressure
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Up to 14 days during mechanical ventilation
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Other Ventilation Parameters
Időkeret: Up to 14 days during mechanical ventilation
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Respiratory rate
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Up to 14 days during mechanical ventilation
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Other Ventilation Parameters
Időkeret: Up to 14 days during mechanical ventilation
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Inspiration to expiration ratio
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Up to 14 days during mechanical ventilation
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Other Ventilation Parameters
Időkeret: Up to 14 days during mechanical ventilation
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Peripheral oxygen saturation
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Up to 14 days during mechanical ventilation
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Other Ventilation Parameters
Időkeret: Up to 14 days during mechanical ventilation
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Arterial blood gas parameters
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Up to 14 days during mechanical ventilation
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Need for Tracheostomy
Időkeret: daily up to 14 days from inclusion
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Need for tracheostomy, first tracheostomy will be assessed up to 14 days from inclusion
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daily up to 14 days from inclusion
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Daily Lung Injury Scores
Időkeret: Up to 14 days during mechanical ventilation
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Score based on chest X-ray findings (if obtained), PaO2/FiO2, PEEP level and respiratory compliance.
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Up to 14 days during mechanical ventilation
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Daily Sequential Organ Failure Assessment (SOFA)-scores
Időkeret: Daily up to 14 days from inclusion
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six-organ dysfunction/failure score measuring multiple organ failure daily
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: Skin and soft tissue infections
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: (Ventilator associated) Pneumonia
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: Sepsis
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: Acute respiratory distress syndrome according to Berlin criteria
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: Acute renal failure
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Daily up to 14 days from inclusion
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Complications
Időkeret: Daily up to 14 days from inclusion
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Complications will include: Abdominal compartment syndrome
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Daily up to 14 days from inclusion
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Egyéb eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
---|---|---|
Standard care strategies
Időkeret: Daily up to 14 days from inclusion
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Strategies considered to be important in patients who receive ventilation, including: Fluid balance, types and dose of fluids used
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Daily up to 14 days from inclusion
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Standard care strategies
Időkeret: Daily up to 14 days from inclusion
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Strategies considered to be important in patients who receive ventilation, including: use of sedative and analgesic drugs
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Daily up to 14 days from inclusion
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Standard care strategies
Időkeret: Daily up to 14 days from inclusion
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Strategies considered to be important in patients who receive ventilation, including: use of sedation and delirium scores
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Daily up to 14 days from inclusion
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Standard care strategies
Időkeret: Daily up to 14 days from inclusion
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Strategies considered to be important in patients who receive ventilation, including: use of neuromuscular blocking agents
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Daily up to 14 days from inclusion
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Standard care strategies
Időkeret: Daily up to 14 days from inclusion
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Strategies considered to be important in patients who receive ventilation, including: use of antibiotic prophylaxis
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Daily up to 14 days from inclusion
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Együttműködők és nyomozók
Nyomozók
- Kutatásvezető: Marcus J. Schultz, MD, PhD, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Publikációk és hasznos linkek
Hasznos linkek
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete
Elsődleges befejezés (Tényleges)
A tanulmány befejezése (Tényleges)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Becslés)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- LAMiNAR
Ezt az információt közvetlenül a clinicaltrials.gov webhelyről szereztük be, változtatás nélkül. Ha bármilyen kérése van vizsgálati adatainak módosítására, eltávolítására vagy frissítésére, kérjük, írjon a következő címre: register@clinicaltrials.gov. Amint a változás bevezetésre kerül a clinicaltrials.gov oldalon, ez a webhelyünkön is automatikusan frissül. .
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