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Cardiorespiratory Performance and Pulmonary Microbiome in Patients After Repair of Esophageal Atresia

Primary Purpose

Esophageal Atresia

Status
Unknown status
Phase
Not Applicable
Locations
Austria
Study Type
Interventional
Intervention
Initial Spirometry
Final Spirometry
Pulmonary microbiome (16S rDNA profiling)
Maximum oxygen uptake
Maximum performance
weight
age
Sponsored by
Medical University of Graz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Esophageal Atresia

Eligibility Criteria

12 Years - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Age from 12 years
  • Status post surgical correction of esophageal atresia with and without fistula
  • Granted consent

Exclusion Criteria:

  • Acute infections within the last 14 days
  • Other associated serious malformations
  • Acute, temporary respiratory complaints (cough, allergies etc.)
  • Physical and mental illnesses or disabilities that do not allow the examination to be carried out
  • non-granted consent

Sites / Locations

  • Medical University of GrazRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Patients after esophageal atresia

Control group

Arm Description

Patients older than 12 years following surgical repair of congenital esophageal atresia will be included after written informed consent. Patients will be subjected to spirometry to determine their age, weight (determined by Kilogram (kg) on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).

Age and sex matched adolescents will be recruited as control group and will be included after written informed consent. Adolescents will be subjected to spirometry to determine their age, weight (determined by Kilogram on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).

Outcomes

Primary Outcome Measures

Pulmonary microbiome (16S rDNA profiling) - Alpha diversity
Determination of alpha diversity (Chao1 Test) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of Alpha diversity (Chao1 Analysis) between patients after repair of esophageal atresia and age and sex matched healthy controls.
Pulmonary microbiome (16S rDNA profiling) - Beta diversity
Determination of beta diversity (unweighted UniFrac test) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of beta-diversity (Unweighted UniFrac Analysis) between patients after repair of esophageal atresia and age and sex matched healthy controls.
Pulmonary microbiome (16S rDNA profiling) - relative bacterial abundance
Determination of relative bacterial abundance (in per Cent) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of relative bacterial abundance (Mann-Whitney-U-Test) between patients after repair of esophageal atresia and age and sex matched healthy controls.

Secondary Outcome Measures

Maximum oxygen uptake (ergospirometer)
Maximum oxygen uptake (corrected for age, gender and body weight ) as determined by bicycle ergospirometer. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.
Maximum Performance (ergospirometer)
Maximum performance as determined by bicycle ergospirometer. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.
Vital capacity (spirometry)
Vital capacity as determined by spirometry. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.

Full Information

First Posted
July 19, 2018
Last Updated
December 5, 2018
Sponsor
Medical University of Graz
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1. Study Identification

Unique Protocol Identification Number
NCT03767673
Brief Title
Cardiorespiratory Performance and Pulmonary Microbiome in Patients After Repair of Esophageal Atresia
Official Title
Examination of the Cardiorespiratory Performance Capacity and Pulmonary Microbiome in Patients Following Surgical Repair of Esophageal Atresia
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Unknown status
Study Start Date
August 10, 2017 (Actual)
Primary Completion Date
April 6, 2019 (Anticipated)
Study Completion Date
September 2, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medical University of Graz

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The majority of the clinical research on esophageal atresia focuses on the upper gastrointestinal tract. However, the trachea and the lung are also affected in many of these children, so that a lifelong pulmonary impairment may result. The importance of respiratory function in the context of follow-up of these patients has therefore been increasingly recognized in recent years. Scientific work has shown significantly, that patients following esophageal atresia repair develop respiratory symptoms more frequently than the normal population. Mild impairment of the pulmonary function in adolescence and adulthood was demonstrated in some studies, but to date, there is no exact idea about the relationship between early childhood disease progression and later pulmonary impairment. Only a few scientific papers have dealt with the effect of impaired pulmonary function on the physical capacity of these adolescents and adults. Most of these studies show small case numbers, inconclusive stress tests, and divergent results. The aim of this prospective study is to investigate the cardiopulmonary performance capacity and the pulmonary microbiome of adolescent and adult patients with corrected esophageal atresia and to compare the results with a control group. Another focus of the investigators is on the composition of the pulmonary microbiome of the participants. Changes of the pulmonary microbiome and the influence on the cardio-pulmonary performance capacity have not yet been investigated. Furthermore, it should be investigated whether the treatment measures and a complicated disease course in the neonatal period have long-term effects on lung function, exercise capacity and composition of the microbiome in the lungs.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophageal Atresia

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Masking Description
Control group: Age and sex matched healthy volunteers.
Allocation
Non-Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patients after esophageal atresia
Arm Type
Experimental
Arm Description
Patients older than 12 years following surgical repair of congenital esophageal atresia will be included after written informed consent. Patients will be subjected to spirometry to determine their age, weight (determined by Kilogram (kg) on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).
Arm Title
Control group
Arm Type
Active Comparator
Arm Description
Age and sex matched adolescents will be recruited as control group and will be included after written informed consent. Adolescents will be subjected to spirometry to determine their age, weight (determined by Kilogram on a medical weight scale) and Vital Capacity before (initial Spirometry) and after (final Spirometry) exercise performance testing. Bicycle ergospirometer will be applied to determine the Maximum Oxygen Uptake and the Maximum Performance. Thereafter deep induced sputum will be harvested for measurements of the pulmonary microbiome (Pulmonary Microbiome 16S rDNA profiling).
Intervention Type
Diagnostic Test
Intervention Name(s)
Initial Spirometry
Intervention Description
Determination of Vital Capacity by spirometry before (within 30 minutes) spiroergometry. Measurements will be performed in both groups.
Intervention Type
Diagnostic Test
Intervention Name(s)
Final Spirometry
Intervention Description
Determination of Vital Capacity by spirometry after (within 30 minutes) spiroergometry. Measurements will be performed in both groups.
Intervention Type
Diagnostic Test
Intervention Name(s)
Pulmonary microbiome (16S rDNA profiling)
Intervention Description
Harvesting of deep induced sputum and determination of the airway microbiome by 16S ribosomal RNA (rRNA) pyrosequencing. Evaluation of alpha and beta diversity and relative bacterial abundance at the genus level. Measurements will be performed in both groups (samples will be harvested within 30 minutes after spiroergometry).
Intervention Type
Diagnostic Test
Intervention Name(s)
Maximum oxygen uptake
Intervention Description
Determination of the maximum oxygen uptake (ml/kg/min) corrected for gender, age and body weight by bicycle spiroergometry. Measurements will be performed in both groups.
Intervention Type
Diagnostic Test
Intervention Name(s)
Maximum performance
Intervention Description
Determination of the maximum performance (W/kg) corrected for body weight by bicycle spiroergometry. Measurements will be performed in both groups.
Intervention Type
Diagnostic Test
Intervention Name(s)
weight
Intervention Description
Determined by Kilogram on a medical weight scale
Intervention Type
Other
Intervention Name(s)
age
Intervention Description
Determination of age by patient's Report and past medical history
Primary Outcome Measure Information:
Title
Pulmonary microbiome (16S rDNA profiling) - Alpha diversity
Description
Determination of alpha diversity (Chao1 Test) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of Alpha diversity (Chao1 Analysis) between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year
Title
Pulmonary microbiome (16S rDNA profiling) - Beta diversity
Description
Determination of beta diversity (unweighted UniFrac test) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of beta-diversity (Unweighted UniFrac Analysis) between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year
Title
Pulmonary microbiome (16S rDNA profiling) - relative bacterial abundance
Description
Determination of relative bacterial abundance (in per Cent) at the genus level of deep induced Sputum by 16S rDNA profiling. Comparison of relative bacterial abundance (Mann-Whitney-U-Test) between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Maximum oxygen uptake (ergospirometer)
Description
Maximum oxygen uptake (corrected for age, gender and body weight ) as determined by bicycle ergospirometer. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year
Title
Maximum Performance (ergospirometer)
Description
Maximum performance as determined by bicycle ergospirometer. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year
Title
Vital capacity (spirometry)
Description
Vital capacity as determined by spirometry. Comparison of parameters between patients after repair of esophageal atresia and age and sex matched healthy controls.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age from 12 years Status post surgical correction of esophageal atresia with and without fistula Granted consent Exclusion Criteria: Acute infections within the last 14 days Other associated serious malformations Acute, temporary respiratory complaints (cough, allergies etc.) Physical and mental illnesses or disabilities that do not allow the examination to be carried out non-granted consent
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jana Windhaber, MD.
Phone
01143316358
Ext
83770
Email
jana.windhaber@klinikum-graz.at
First Name & Middle Initial & Last Name or Official Title & Degree
Christoph Arneitz, MD.
Phone
01143316358
Ext
80358
Email
christoph.arneitz@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jana Windhaber, MD
Organizational Affiliation
Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Holger Till, MD
Organizational Affiliation
Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Christoph Arneitz, MD
Organizational Affiliation
Department of Paediatric and Adolescent Surgery, Medical University of Graz, Austria
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University of Graz
City
Graz
ZIP/Postal Code
8010
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jana Windhaber, MD
Phone
01143316385
Ext
83770
Email
jana.windhaber@medunigraz.at
First Name & Middle Initial & Last Name & Degree
Christoph Arneitz, MD
Phone
01143316385
Ext
80358
Email
christoph.arneitz@gmail.com

12. IPD Sharing Statement

Learn more about this trial

Cardiorespiratory Performance and Pulmonary Microbiome in Patients After Repair of Esophageal Atresia

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