Internal Jugular Vein Respiratory Variability as a Marker of Disease Severity in Infant Bronchiolitis (IJV-BRONCH)
Respiratory Variation of Internal Jugular Vein Diameter as a Novel Ultrasonographic Marker of Disease Severity in Infants With Acute Bronchiolitis: A Prospective Observational Cohort Study
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Szczegółowy opis
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Emre Güngör, Medical Doctor
- Numer telefonu: 5214 +90 222 239 2979
- E-mail: emre.gungor@ogu.edu.tr
Lokalizacje studiów
-
-
Eskişehir
-
Eskişehir, Eskişehir, Turcja (Türkiye), 26480
- Eskisehir Osmangazi University Faculty of Medicine, Pediatric Emergency Department
-
Kontakt:
- Emre Güngör, Medical Doctor
- Numer telefonu: 5214 +90 222 239 2979
- E-mail: emre.gungor@ogu.edu.tr
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dziecko
Akceptuje zdrowych ochotników
Metoda próbkowania
Badana populacja
Opis
Inclusion Criteria:
- Infants aged 1-23 months
- Clinical diagnosis of acute bronchiolitis per AAP (2014) criteria (first wheezing episode following an upper respiratory infection prodrome, with tachypnea, retractions, and/or crackles)
- Written informed consent obtained from parent/legal guardian
- Evaluable within the first 6 hours of emergency department presentation
Exclusion Criteria:
- Underlying congenital heart disease
- Chronic lung disease (bronchopulmonary dysplasia, cystic fibrosis)
- Prior history of recurrent wheezing/suspected asthma
- Anatomical abnormality of the neck or prior history of central venous catheterization or jugular vein thrombosis
- Hemodynamic instability/shock
- Immediate need for intubation/mechanical ventilation precluding ultrasound assessment
- Parent/legal guardian declines consent
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
Liczba grup / kohort
Kohorty i interwencje
Grupa / KohortaGrupa / Kohorta |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
|
Acute Bronchiolitis Cohort
Infants aged 1-23 months diagnosed with acute bronchiolitis per AAP (2014) clinical practice guideline criteria, undergoing a standardized point-of-care ultrasound assessment (internal jugular vein, lung, and diaphragm) in addition to standard clinical evaluation and treatment.
No intervention is assigned as part of this study; the cohort will be stratified post hoc by clinical severity scores for descriptive and exploratory subgroup analyses.
|
A standardized point-of-care ultrasonography assessment will be performed in addition to routine clinical evaluation.
The protocol includes M-mode assessment of the right internal jugular vein (IJV) to measure maximal and minimal respiratory-cycle diameters and calculate the IJV Variability Index ([IJVmax-IJVmin]/IJVmax × 100).
Concurrent lung ultrasonography and diaphragm ultrasonography, including diaphragm excursion and thickening fraction, will also be performed.
Ultrasonographic assessments are performed for research measurements only and do not determine or modify clinical treatment decisions.
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Correlation Between Internal Jugular Vein Respiratory Variability Index and Wang Bronchiolitis Severity Score
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation between the Internal Jugular Vein (IJV) Variability Index and the Wang Bronchiolitis Severity Score.
The IJV Variability Index will be calculated as ([IJVmax - IJVmin] / IJVmax) × 100, where IJVmax and IJVmin represent the maximum and minimum IJV diameters measured during the respiratory cycle.
The Wang Bronchiolitis Severity Score ranges from 0 to 12, with higher scores indicating greater disease severity.
The association will be quantified using Pearson or Spearman correlation coefficients, as appropriate.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Correlation Between IJV Variability Index and Oxygen Saturation, Respiratory Rate, and Retraction Severity
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation between the IJV Variability Index and oxygen saturation (SpO2, %), respiratory rate (breaths/minute), and the retraction component of the Wang Bronchiolitis Severity Score.
The retraction component ranges from 0 to 3, with higher scores indicating more severe retractions.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
|
Association Between IJV Variability Index and Need for High-Flow Nasal Cannula or Supplemental Oxygen Therapy
Ramy czasowe: From enrollment through hospital discharge, assessed up to approximately 7 days
|
Comparison of baseline IJV Variability Index between infants who require and do not require high-flow nasal cannula (HFNC) or supplemental oxygen therapy during hospitalization.
|
From enrollment through hospital discharge, assessed up to approximately 7 days
|
|
Association Between IJV Variability Index and Pediatric Intensive Care Unit Admission
Ramy czasowe: From enrollment through hospital discharge, assessed up to approximately 7 days
|
Comparison of baseline IJV Variability Index between infants admitted and not admitted to the pediatric intensive care unit (PICU) during hospitalization.
|
From enrollment through hospital discharge, assessed up to approximately 7 days
|
|
Correlation Between Diaphragm Ultrasound Parameters and IJV Variability Index and Clinical Severity Scores
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation of diaphragm excursion, diaphragm thickening fraction, and inspiratory/expiratory ratio with the IJV Variability Index and clinical severity scores.
Clinical severity measures will include the Wang Bronchiolitis Severity Score (range 0-12), Modified Tal Score (range 0-12), Respiratory Distress Assessment Instrument (range 0-17), and Kristjansson Respiratory Score (range 0-10).
For all four clinical severity scores, higher scores indicate greater disease or respiratory distress severity.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
|
Correlation Between IJV Variability Index and Modified Tal Score
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation between the IJV Variability Index and the Modified Tal Score.
The Modified Tal Score ranges from 0 to 12, with higher scores indicating greater bronchiolitis severity.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
|
Correlation Between IJV Variability Index and Respiratory Distress Assessment Instrument
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation between the IJV Variability Index and the Respiratory Distress Assessment Instrument (RDAI).
The RDAI assesses wheezing and retractions and ranges from 0 to 17, with higher scores indicating greater respiratory distress.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
|
Association Between IJV Variability Index and Respiratory Assessment Change Score
Ramy czasowe: Baseline and 2-4 hours after enrollment
|
Association between the baseline IJV Variability Index and the Respiratory Assessment Change Score (RACS).
RACS quantifies change in respiratory status using the change in the Respiratory Distress Assessment Instrument together with a standardized change in respiratory rate between baseline and follow-up assessment.
RACS is a change measure rather than a bounded scale and therefore does not have a fixed theoretical minimum or maximum.
|
Baseline and 2-4 hours after enrollment
|
|
Correlation Between IJV Variability Index and Kristjansson Respiratory Score
Ramy czasowe: At enrollment (baseline, within 6 hours of emergency department presentation)
|
Correlation between the IJV Variability Index and the Kristjansson Respiratory Score.
The Kristjansson Respiratory Score ranges from 0 to 10, with higher scores indicating greater respiratory disease severity.
|
At enrollment (baseline, within 6 hours of emergency department presentation)
|
Inne miary wyników
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Discriminative Performance of a Multimodal Point-of-Care Ultrasound Model Versus Wang Bronchiolitis Severity Score for Predicting Escalated Respiratory Support
Ramy czasowe: From enrollment through 24 hours after enrollment
|
Area under the receiver operating characteristic curve (AUC, 95% confidence interval) for a multimodal model combining baseline IJV Variability Index, lung ultrasound score, and diaphragm ultrasound parameters, compared with the Wang Bronchiolitis Severity Score alone using the DeLong test.
The lung ultrasound score ranges from 0 to 36, with higher scores indicating greater pulmonary aeration abnormality.
The Wang Bronchiolitis Severity Score ranges from 0 to 12, with higher scores indicating greater bronchiolitis severity.
|
From enrollment through 24 hours after enrollment
|
Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Emre Güngör, Medical Doctor, Eskisehir Osmangazi University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency Medicine
Publikacje i pomocne linki
Publikacje ogólne
- McCallum GB, Morris PS, Wilson CC, Versteegh LA, Ward LM, Chatfield MD, Chang AB. Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis? Pediatr Pulmonol. 2013 Aug;48(8):797-803. doi: 10.1002/ppul.22627. Epub 2012 Sep 4.
- Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S 3rd, Hernandez-Cancio S; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502. doi: 10.1542/peds.2014-2742.
- Right Internal Jugular Ultrasound Measurements during the Respiratory Cycle in Children Journal Authors: AM IsacoffDJ McLarioKP CrossAR O'HaganBJ HollandDJ LorenzMD Stevenson DOI: 10.7727/wimj.2016.540 ABSTRACT Background: Point of care ultrasound could be useful as a non-invasive objective measure of throughout the respiratory cycle. Objective: To determine the reliability of measurements of the right internal jugular vein (RIJV). Methods: We performed a prospective observation study of children aged 6-17 years. Using M-mode ultrasonography one centimeter cephalad from the clavicle, triplicate measurements were recorded during inhalation and exhalation with the head straight ahead and 45 degrees leftward. Results: Among the 40 enrolled subjects, mean diameters ± standard deviations of the RIJV (cm) were: maximum inhalation with head straight ahead (0.53 ± 0.18), leftward (0.78 ± 0.22); maximum exhalation with head straight ahead (0.54 ± 0.19), leftward (0.79 ± 0.22). Intraclass correlation coefficients were all significant (p<0.001). Conclusion: The RIJV diameter can be reliably measured during the respiratory cycle; measures are larger with head turned 45 degrees leftward. Received: 28 Oct, 2016 Accepted: 03 Jan, 2017
- Giorno EPC, Foronda FK, De Paulis M, Bou Ghosn DSN, Couto TB, Sa FVM, Fraga AMA, Farhat SCL, Preto-Zamperlini M, Schvartsman C. Point-of-care lung ultrasound score for predicting escalated care in children with respiratory distress. Am J Emerg Med. 2023 Jun;68:112-118. doi: 10.1016/j.ajem.2023.02.035. Epub 2023 Mar 1.
- Bilgili B, Haliloglu M, Tugtepe H, Umuroglu T. The Assessment of Intravascular Volume with Inferior Vena Cava and Internal Jugular Vein Distensibility Indexes in Children Undergoing Urologic Surgery. J Invest Surg. 2018 Dec;31(6):523-528. doi: 10.1080/08941939.2017.1364806. Epub 2017 Sep 27.
- Jayasimha K, Liu W, Hanna W. Use of Internal Jugular Vein POCUS to Assess Intravascular Volume Status: A Study in Critically Ill Pediatric Post-Operative Cardiac Patients. POCUS J. 2025 Nov 17;10(2):109-114. doi: 10.24908/pocusj.v10i02.18249. eCollection 2025 Nov.
- Fernandes RM, Plint AC, Terwee CB, Sampaio C, Klassen TP, Offringa M, van der Lee JH. Validity of bronchiolitis outcome measures. Pediatrics. 2015 Jun;135(6):e1399-408. doi: 10.1542/peds.2014-3557. Epub 2015 May 18.
- Sik N, Citlenbik H, Ozturk A, Yilmaz D, Duman M. Point of care diaphragm ultrasound in acute bronchiolitis: A measurable tool to predict the clinical, sonographic severity of the disease, and outcomes. Pediatr Pulmonol. 2021 May;56(5):1053-1059. doi: 10.1002/ppul.25268. Epub 2021 Jan 26.
- Curinha F, Fernandes A, Pinto C, Dionisio MT. Thoracic Ultrasound in Pediatric Intensive Care: A Valuable Tool for Children with Acute Bronchiolitis. Acta Med Port. 2026 Apr 1;39(4):271-280. doi: 10.20344/amp.24309. Epub 2026 Apr 1.
- Drum B, La Course B, Kelly M, York A, Worrall E, Martins J, Johnson S, Liles EA Jr. Does This Patient Have Volume Overload?: The Rational Clinical Examination. JAMA. 2026 Apr 7;335(13):1159-1168. doi: 10.1001/jama.2026.0446.
- Wang EE, Milner R, Allen U, Maj H. Bronchodilators for treatment of mild bronchiolitis: a factorial randomised trial. Arch Dis Child. 1992 Mar;67(3):289-93. doi: 10.1136/adc.67.3.289.
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Infekcje dróg oddechowych
- Infekcje
- Zakażenia wirusem RNA
- Choroby wirusowe
- Choroby Układu Oddechowego
- Choroby płuc
- Choroby oskrzeli
- Choroby płuc, obturacyjne
- Zapalenie oskrzeli
- Infekcje pneumowirusowe
- Infekcje Paramyxoviridae
- Zakażenia Mononegavirales
- Zakażenia syncytialnym wirusem oddechowym
- Zapalenie oskrzelików
- Zapalenie oskrzelików, wirusowe
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- IJVBRONCH-2026-01
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .