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Can Respiratory Rate Predict the Risk of Deterioration of Septic Patients

2018年11月21日 更新者:PMD Solutions

The primary objective is to determine if the trend in Respiratory Rate measurements provided by the device under investigation can be used to predict an increase in Sequential/Sepsis-related Organ Failure Assessment (SOFA) score.

The RR trend will be measured as the difference between the RR recorded by the device at a point 15 minutes after commencement of treatment, as per the standard of care for patients suspected of being septic, and a point 3 hours following this.

研究概览

地位

完全的

条件

详细说明

The primary objective is to determine if the trend in Respiratory Rate measurements provided by the device under investigation can be used to predict an increase in Sequential/Sepsis-related Organ Failure Assessment (SOFA) score.

The RR trend will be measured as the difference between the RR recorded by the device at a point 15 minutes after commencement of treatment, as per the standard of care for patients suspected of being septic, and a point 3 hours following this.

Secondary objective The secondary objective is to test if Respiratory Rate can help identify patients at increased risk of 30 day mortality.

The null Hypotheses of the planned comparison is that there is no difference in the RR trend in the 3 hours following commencement of treatment for sepsis in subjects who have an increase in SOFA score by 2 or more points and those who have a change in SOFA score of +1 or less.

The change in SOFA score will be measured at point of commencement of treatment and at 6 hours following commencement of treatment, or nearest available SOFA score determination.

Respiratory Rate captured during admission could have a predictive course for cohort of interest

The time points for reviewing the RR will be as follows:

(i) The last measurement (ii) The trend over 3 hours following commencement of treatment as per the standard of care for patients suspected of being septic.

(iii) The trend over the entire duration of admission

研究类型

观察性的

注册 (实际的)

132

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • South West Jutland
      • Esbjerg、South West Jutland、丹麦、DK-6700
        • Hospital of South West Jutland, Department of Emergency Medicine

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不适用

有资格学习的性别

全部

取样方法

非概率样本

研究人群

For this investigation, the population of interest are patients admitted to the Acute Medical Unit (AMU) with sepsis or that develop sepsis during their admission.

描述

Inclusion criteria

  • ≥ 18 Years
  • Admitted for a minimum of 12 hours
  • Have been diagnosed with sepsis

Sepsis diagnosis confirmed by documented or suspected infection (ordering of blood culture or other microbiological investigation by the clinician) and ≥1 of the following presenting within the first 4 hours of admission:

  • Fever or hypothermia, Core temperature > 38.3 or < 36 °C
  • Heart rate > 90/min
  • Respiratory rate > 20/min
  • Altered consciousness/mental state, defined as GCS < 15
  • Hyperglycemia, (BS > 6.7 mmol/L non-diabetic)
  • LKC > 12 *10^9 or < 4*10^9,
  • Normal LKC with > 10 % immature cells,
  • CRP > highest normal local lab. Interval
  • Hypotension: Systolic BP <90 mmHg, or drop in systolic BP > 40
  • Hypoxemia: PaO2 < 8.5 Kpa or PaO2/FiO2 < 40 or tissue perfusion: P-lactate > 1.6
  • Creatinine . 177 µmol/L
  • Acute oliguria (Diuresis per hour ,0.5 ml/kg/t or 45 ml/t in 2 hours)
  • Coagulopathy: Spontaneous INR > 1.5, or apt > 60 sec, thrombocytopenia
  • Paralytic ileus (absence of bowel sounds)
  • Hyperbilirubinemia > 34µmol/L
  • Are willing to voluntarily sign a statement of informed consent to participate in this investigation

Exclusion criteria

  • Allergic to medical grade skin adhesive
  • Pregnant women during second and third trimester
  • Continuous long term steroid use. Defined as not using steroids in the 4 weeks previous to enrolment
  • Patients under the influence of substance abuse (drug or alcohol) that may interfere with their ability to cooperate and comply with the investigation procedures
  • Any disorder, including cognitive dysfunction, which would affect the ability to accurately complete questionnaires and freely give full informed consent. This will be determined by the Abbreviated Mental Test Score (AMT) Cannot be followed a second time if admitted again at a later date during the study period

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

队列和干预

团体/队列
Suspicion of Sepsis
Patients who are admitted and are diagnosed with sepsis will be recruited for this investigation.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
RespiraSense triggered escalation in SOFA score
大体时间:15 minutes after commencement of treatment, as per the standard of care for patients suspected of being septic, and a point 3 hours following this.
Escalation of SOFA score by 2 or more points. The primary endpoint will be evaluated with an ANCOVA with escalation of SOFA score by 2 or more points as a factor and mean RR in the first hour of treatment as a covariate.
15 minutes after commencement of treatment, as per the standard of care for patients suspected of being septic, and a point 3 hours following this.

次要结果测量

结果测量
措施说明
大体时间
Upward trend in Respiratory Rate as a predictor of 30 day mortality
大体时间:30 days after discharge
The secondary endpoint is the 30 day mortality rate after discharge.
30 days after discharge

其他结果措施

结果测量
措施说明
大体时间
Upward trend in Respiratory Rate as a predictor of 30 day readmission.
大体时间:30 days after discharge
The secondary endpoint is the 30 day readmission rate after discharge.
30 days after discharge

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2017年3月23日

初级完成 (实际的)

2017年9月9日

研究完成 (实际的)

2017年11月21日

研究注册日期

首次提交

2018年11月20日

首先提交符合 QC 标准的

2018年11月21日

首次发布 (实际的)

2018年11月23日

研究记录更新

最后更新发布 (实际的)

2018年11月23日

上次提交的符合 QC 标准的更新

2018年11月21日

最后验证

2018年11月1日

更多信息

与本研究相关的术语

其他研究编号

  • PMD-CS-006ii

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

未定

IPD 计划说明

Data can be shared upon request.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

研究美国 FDA 监管的设备产品

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