Detection of Exhaled Methane Levels in Hemorrhagic Shock
Detection of Exhaled Methane Levels for the Recognition and Monitoring of Hemorrhagic Shock - Study Protocol for a Prospective Observational Study
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Contatto studio
Contatto studio
- Nome: Péter Dr. Jávor, M.D.
- Numero di telefono: +36703193420
- Email: peter.javor.md.@gmail.com
Backup dei contatti dello studio
- Nome: Petra Dr. Hartmann, MD, Ph.D.
- Numero di telefono: +36304388695 +3662545531
- Email: hatmann.petra@med.u-szeged.hu
Luoghi di studio
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Szeged, Ungheria, 6720
- Department of Traumatology, University of Szeged
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Contatto:
- Eszter Bucsuház
- Numero di telefono: +3662545531
- Email: office.trauma@med.u-szeged.hu
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Investigatore principale:
- Petra Dr. Hartmann, MD, Ph.D.
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Criteri di partecipazione
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Descrizione
Inclusion Criteria:
- injury severity score (ISS)≥16
- intubated on scene or upon arrival
- transported directly from scene to the Emergency Department of the University of Szeged
- hemorrhage confirmed with eFAST or CT
- consent signed by patient surrogate
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Numero di gruppi/coorti
Coorti e interventi
Gruppo / CoorteGruppo / Coorte |
Intervento / TrattamentoIntervento / Trattamento |
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Hemorrhagic group
Patients with bleeding confirmed with eFAST or CT.
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To measure methane concentrations, a near-infrared laser technique-based photoacoustic apparatus will be attached to the exhalation outlet of the ventilator upon arrival of severely injured patients.
Exhaled methane levels will be monitored continuously during the first 72 in-hospital hours and will be recorded at pre-determined time points (directly upon arrival, 6 hours post-admission, 12 hours post-admission, 24 hours post-admission, 48 hours post-admission and 72 hours post-admission).
Orthogonal polarization spectral imaging technique (Cytoscan A/R, Cytometrics) will be used to visualize the microcirculation of the sublingual mucosa of the patients.
The OPS technique utilizes reflected, polarized light at the wavelength of the isobestic point of oxyhemoglobin and deoxyhemoglobin (548 nm).
The diminution of sublingual microcirculation can refer to circulatory redistribution due to hemorrhage.
Sublingual microcirculation of the patients will be visualized and evaluated at pre-determined time points (directly upon arrival, 6 hours post-admission, 12 hours post-admission, 24 hours post-admission, 48 hours post-admission and 72 hours post-admission) during the first 72 in-hospital hours.
Altri nomi:
Arterial blood gas analysis and laboratory testing of venous blood are routine examinations in clinical practice.
Base deficit and lactate are considered as global markers of blood loss and shock, and can be obtained rapidly with blood gas analysis.
Hemoglobin and hematocrit values can correspond to the severity of blood loss, and are measured routinely both from arterial and venous blood.
Sampling of arterial and venous blood for blood gas and laboratory analyses will be performed at pre-determined time points (directly upon arrival, 24 hours post-admission, 48 hours post-admission and 72 hours post-admission) during the first 72 in-hospital hours.
Hemodynamic monitoring is an essential part of emergency trauma care.
Non-invasive monitoring of blood pressure, heart rate and respiratory rate of patients will be started immediately upon arrival.
After patients are stabilized, invasive arterial blood pressure (IABP) monitoring can be started.
IABP is considered as the gold standard of blood pressure measurement in critical care as it reflects the fluctuations of blood pressure in real time.
Blood pressure and heart rate values will be recorded at pre-determined time points (directly upon arrival, 6 hours post-admission, 12 hours post-admission, 24 hours post-admission, 48 hours post-admission and 72 hours post-admission) during the first 72 in-hospital hours.
Altri nomi:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Association between exhaled methane levels and vital signs
Lasso di tempo: First 72 in-hospital hours
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We intend to investigate the relation between exhaled methane levels and systolic blood pressure and heart rate.
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First 72 in-hospital hours
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Association between exhaled methane levels and blood gas and laboratory markers
Lasso di tempo: First 72 in-hospital hours
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We intend to investigate the relation between exhaled methane levels and blood gas and laboratory markers (base deficit, lactate, hemoglobin, hematocrit).
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First 72 in-hospital hours
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Association between exhaled methane levels and sublingual microcirculation
Lasso di tempo: First 72 in-hospital hours
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We intend to investigate the relation between exhaled methane concentrations and sublingual microcirculation.
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First 72 in-hospital hours
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Association between exhaled methane levels and mortality
Lasso di tempo: First 72 in-hospital hours
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The relation between exhaled methane levels and mortality will be assessed.
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First 72 in-hospital hours
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Association between exhaled methane levels and number of packed red blood cells required for transfusion/massive transfusion
Lasso di tempo: First 72 in-hospital hours
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The relation between exhaled methane levels and the number of packed red blood cells required for transfusion/massive transfusion will be assessed.
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First 72 in-hospital hours
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Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Pubblicazioni generali
- Barsony A, Vida N, Gajda A, Rutai A, Mohacsi A, Szabo A, Boros M, Varga G, Erces D. Methane Exhalation Can Monitor the Microcirculatory Changes of the Intestinal Mucosa in a Large Animal Model of Hemorrhage and Fluid Resuscitation. Front Med (Lausanne). 2020 Oct 22;7:567260. doi: 10.3389/fmed.2020.567260. eCollection 2020.
- Szucs S, Bari G, Ugocsai M, Lashkarivand RA, Lajko N, Mohacsi A, Szabo A, Kaszaki J, Boros M, Erces D, Varga G. Detection of Intestinal Tissue Perfusion by Real-Time Breath Methane Analysis in Rat and Pig Models of Mesenteric Circulatory Distress. Crit Care Med. 2019 May;47(5):e403-e411. doi: 10.1097/CCM.0000000000003659.
- Szabo A, Unterkofler K, Mochalski P, Jandacka M, Ruzsanyi V, Szabo G, Mohacsi A, Teschl S, Teschl G, King J. Modeling of breath methane concentration profiles during exercise on an ergometer. J Breath Res. 2016 Feb 1;10(1):017105. doi: 10.1088/1752-7155/10/1/017105.
- Javor P, Rarosi F, Horvath T, Torok L, Varga E, Hartmann P. Detection of exhaled methane levels for monitoring trauma-related haemorrhage following blunt trauma: study protocol for a prospective observational study. BMJ Open. 2022 Jul 6;12(7):e057872. doi: 10.1136/bmjopen-2021-057872.
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- 5400/2021-SZTE
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