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Detection of Exhaled Methane Levels in Hemorrhagic Shock
27 september 2021 bijgewerkt door: Petra Hartmann MD Ph.D., Szeged University
Detection of Exhaled Methane Levels for the Recognition and Monitoring of Hemorrhagic Shock - Study Protocol for a Prospective Observational Study
This prospective observational study aims to test the efficacy of the continuous measurement of exhaled methane levels in monitoring the hemodynamic state of severely injured, bleeding trauma patients.
Studie Overzicht
Toestand
Nog niet aan het werven
Conditie
Gedetailleerde beschrijving
This prospective observational study aims to test the efficacy of the continuous measurement of exhaled methane levels in monitoring the hemodynamic state of severely injured, bleeding trauma patients.
Our inclusion criteria require an age of 18 years or greater, an Injury Severity Score (ISS) of 16 or greater, transport directly from scene, intubation on scene or upon arrival, hemorrhage confirmed with eFAST or CT, and signed consent from patient surrogates.
Exhaled methane concentrations and indicators of blood loss and shock (vital signs: systolic blood pressure, heart rate; blood gas and laboratory markers: base deficit, lactate, hemoglobin, hematocrit; videomicroscopic image of sublingual microcirculation) will be recorded in pre-determined time points during the first 72 in-hospital hours.
The relation between exhaled methane levels and indicators of shock will constitute our primary outcome measures.
The association of methane concentrations with clinical outcomes (transfusion need, mortality) will serve as secondary outcomes.
Studietype
Observationeel
Inschrijving (Verwacht)
40
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Péter Dr. Jávor, M.D.
- Telefoonnummer: +36703193420
- E-mail: peter.javor.md.@gmail.com
Studie Contact Back-up
- Naam: Petra Dr. Hartmann, MD, Ph.D.
- Telefoonnummer: +36304388695 +3662545531
- E-mail: hatmann.petra@med.u-szeged.hu
Studie Locaties
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Szeged, Hongarije, 6720
- Department of Traumatology, University of Szeged
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Contact:
- Eszter Bucsuház
- Telefoonnummer: +3662545531
- E-mail: office.trauma@med.u-szeged.hu
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Hoofdonderzoeker:
- Petra Dr. Hartmann, MD, Ph.D.
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
NVT
Geslachten die in aanmerking komen voor studie
Allemaal
Bemonsteringsmethode
Niet-waarschijnlijkheidssteekproef
Studie Bevolking
Severely injured (ISS)≥16, intubated trauma patients with active bleeding.
Beschrijving
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
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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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.
Andere namen:
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.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Association between exhaled methane levels and vital signs
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Association between exhaled methane levels and mortality
Tijdsspanne: 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
Tijdsspanne: 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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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- 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.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Verwacht)
1 november 2021
Primaire voltooiing (Verwacht)
1 november 2022
Studie voltooiing (Verwacht)
31 januari 2023
Studieregistratiedata
Eerst ingediend
27 juli 2021
Eerst ingediend dat voldeed aan de QC-criteria
27 juli 2021
Eerst geplaatst (Werkelijk)
3 augustus 2021
Updates van studierecords
Laatste update geplaatst (Werkelijk)
28 september 2021
Laatste update ingediend die voldeed aan QC-criteria
27 september 2021
Laatst geverifieerd
1 september 2021
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 5400/2021-SZTE
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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