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VENtilation Modalities During Transport of PostoperatIve CRITically Ill Patients to the ICU (VENTICRIT)

VENtilation Modalities During Transport of PostoperatIve CRITically Ill Patients to the ICU - A Multicenter Observational Study

Patients undergoing major non-cardiac surgery may require postoperative mechanical ventilation and transfer from the operating room to the intensive care unit (ICU). This intra-hospital transport phase is critical, as patients may experience changes in respiratory and hemodynamic status, including alterations in oxygenation, ventilation, blood pressure, and heart rate.

During transport, ventilatory support may be provided using different strategies, including manual ventilation with a bag-valve device or mechanical ventilation with a portable ventilator. Although both approaches are commonly used in clinical practice, there is limited evidence comparing their effects on respiratory function, gas exchange, and overall physiological stability during and after transport.

This multicenter, prospective observational study aims to describe current clinical practices in ventilatory support during intra-hospital transport in adult patients undergoing non-cardiac surgery who require ICU admission. The study will also evaluate changes in vital signs, arterial blood gas parameters, and respiratory mechanics, as well as the occurrence of adverse events during transport and postoperative pulmonary complications within the first five days after surgery.

No additional interventions or procedures beyond standard clinical care will be performed. All data will be collected as part of routine clinical practice. The results of this study are expected to improve the understanding of ventilation management during transport and to identify safer and more effective strategies for critically ill postoperative patients.

Panoramica dello studio

Descrizione dettagliata

Intra-hospital transport from the operating room to the intensive care unit (ICU) represents a vulnerable phase for critically ill postoperative patients, particularly for those who remain intubated and require ongoing invasive mechanical ventilation. During this period, patients may develop respiratory and hemodynamic instability, including hypoxemia, ventilation impairment, and adverse cardiovascular events.

In current clinical practice, ventilatory support during transport may be provided either manually, using a bag-valve device, or mechanically, using portable ventilators. Manual ventilation is widely used but may result in variability in tidal volume, airway pressures, respiratory rate, and minute ventilation. In contrast, mechanical ventilation may allow more controlled and protective respiratory support during transport. However, there is limited evidence describing the real-world use of these strategies and their associated physiological effects in patients undergoing non-cardiac surgery.

The VENTICIRT study is a multicenter, prospective observational study designed to describe ventilation practices during intra-hospital transport from the operating room to the ICU in adult patients undergoing non-cardiac surgery under general anesthesia who require postoperative ICU admission for continuation or weaning of invasive mechanical ventilation.

Data will be collected as part of routine clinical care without any modification of standard practice. The study will record patient demographics, surgical and anesthetic characteristics, ventilatory support modality during transport (manual versus mechanical), transport duration, and ventilator settings when applicable. Physiological variables, including vital signs, arterial blood gas values, and respiratory mechanics, will be assessed before and after transport according to routine clinical timing.

Adverse events occurring during transport and postoperative pulmonary complications within five days after surgery will also be documented.

By providing a comprehensive description of current ventilation strategies, their physiological impact, and associated clinical outcomes, this study aims to improve understanding of intra-hospital transport management and to generate evidence that may support safer and more effective care of critically ill postoperative patients.

Tipo di studio

Osservativo

Iscrizione (Stimato)

800

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: RICERCA SIAARTI Ufficio Ricerca Clinica, Clinical Trial Office
  • Numero di telefono: 0039 06 4452816
  • Email: ricerca@siaarti.it

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Metodo di campionamento

Campione non probabilistico

Popolazione di studio

Intubated adult patients (≥18 years) undergoing general anesthesia (intravenous or mixed) for non-cardiac surgery, requiring transport from the operating room to the ICU for continuation/weaning from IMV in the postoperative period.

Descrizione

Inclusion criteria

  • Intubated patients undergoing general anesthesia for non-cardiac surgery
  • Requirement for postoperative IMV
  • Age ≥18 years
  • Obtained informed consent Exclusion criteria
  • Patients undergoing cardiac surgery
  • Patients receiving preoperative mechanical ventilation prior to surgery.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Ventilation strategies applied during transport
Lasso di tempo: Periprocedural period
Describe the ventilation strategies applied during transport from the operating room to ICU of the intubated patients subjected to general anesthesia for non-cardiac surgery requiring continuation of IMV in the postoperative period.
Periprocedural period

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before- 30 minutes after
assess changes in vital signs (SpO2 in %) in the peritransport period .
30 minutes before- 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before- 30 minutes after
assess changes in vital signs (EtCO2 mmHg) in the peritransport period .
30 minutes before- 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before- 30 minutes after
assess changes in vital signs (Blood pressure in mmHg), in the peri-transport period
30 minutes before- 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before- 30 minutes after
assess changes in vital signs (heart rate in beats per minute) , in the peri-transport period.
30 minutes before- 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in vital signs ( ECG ST interval modifications) in the peri-transport period.
30 minutes before - 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (pH) in the peri-transport period .
30 minutes before - 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (PaO2 in mmHg) in the peri-transport period .
30 minutes before - 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (lactate concentration) in the peri-transport period .
30 minutes before - 30 minutes after
assess changes in respiratory mechanics parameters before and after transport
Lasso di tempo: 30 minutes before transport - 30 minutes after transport
assess changes in respiratory mechanics parameters (respiratory system compliance in ml/cmH2O), before and after transport (30 minutes before transport - 30 minutes after transport)
30 minutes before transport - 30 minutes after transport
assess changes in respiratory mechanics parameters before and after transport
Lasso di tempo: 30 minutes before transport - 30 minutes after transport
assess changes in respiratory mechanics parameters (optional calculation of airway resistance cmH2O/(l/s)), before and after transport (30 minutes before transport - 30 minutes after transport)
30 minutes before transport - 30 minutes after transport
assess modification of mechanical ventilation setup
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
possible application of corrective measures (application or not of protective ventilation defined according to driving pressure in cmH2O and/or tidal volume in ml/kg of predeicted body weigth - descriptive outcome).
30 minutes before transport - 30 minutes after transport (whole transport period)
incidence of adverse events
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
report the incidence of adverse events such as number of desaturation (descriptive outcome) during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
sedation plan and any curarization applied
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
Describe the sedation plan and any curarization applied during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
Inotropic/vasopressor medications applied and/or modified
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
Report the number of any inotropic/vasopressor medications application (descriptive outcome) 30 minutes before, during, and 30 minutes after transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
Incidence of PPCs
Lasso di tempo: within 5 postoperative days
Report the incidence of PPCs within 5 postoperative days.
within 5 postoperative days
assess modification of mechanical ventilation setup
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
possible application of corrective measures (application and/or modification of positive end-expiratory pressure - descriptive outcome)
30 minutes before transport - 30 minutes after transport (whole transport period)
assess modification of mechanical ventilation setup
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
possible application of corrective measures (application of recruitment maneuvers- descriptive outcome).
30 minutes before transport - 30 minutes after transport (whole transport period)
incidence of adverse events
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
report the incidence of adverse events such as number of episodes of hemodynamic instability (descritptive outcome) during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
incidence of adverse events
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
report the incidence of adverse events such as episodes of cardiocirculatory arrest (descriptive outcome) during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
incidence of adverse events
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
report the incidence of adverse events such as arrhythmia events (descriptive outcome), during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
incidence of adverse events
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
report the incidence of adverse events such as accidental extubation (descriptive outcome) during transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
Inotropic/vasopressor medications applied and/or modified
Lasso di tempo: 30 minutes before transport - 30 minutes after transport (whole transport period)
Report the number of modifications in inotropic/vasopressor medications (descriptive outcome) 30 minutes before, during, and 30 minutes after transport.
30 minutes before transport - 30 minutes after transport (whole transport period)
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (bicarbonate concentration) in the peri-transport period .
30 minutes before - 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (PaCO2 in mmHg) in the peri-transport period .
30 minutes before - 30 minutes after
assess changes in vital signs and blood gas analysis in the peri-transport period
Lasso di tempo: 30 minutes before - 30 minutes after
assess changes in blood gas analysis (PaO2/FiO2 in mmHg) in the peri-transport period .
30 minutes before - 30 minutes after

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

  • Morita Y. et al. Comparison of Manual and Mechanical Ventilation During Intensive Care Unit Transport Following Cardiac Surgery: Impact on Oxygenation, Ventilation, and Hemodynamic Stability. J Cardiothorac Vasc Anesth. 2025 Mar;39(3):644-652.LAS VEGAS investigators, Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - an observational study in 29 countries. Eur J Anaesthesiol. 2017 Aug;34(8):492-507 Matthay et al. A New Global Definition of Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2024 Jan 1;209(1):37-47

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 luglio 2026

Completamento primario (Stimato)

1 ottobre 2027

Completamento dello studio (Stimato)

1 ottobre 2027

Date di iscrizione allo studio

Primo inviato

4 marzo 2026

Primo inviato che soddisfa i criteri di controllo qualità

9 giugno 2026

Primo Inserito (Effettivo)

12 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

12 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

9 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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