Evaluation of Regional Ventilation Distribution in Patients Affected by Abdominal Sepsis After Emergent Laparotomy (CHESTOMY)
Primary Purpose
Abdominal Sepsis, Acute Respiratory Failure, Ventilation Therapy; Complications
Status
Not yet recruiting
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
Arterial blood gas analysis
Venous blood gas analysis
Esophageal pressure monitoring
Intrabdominal pressure
Electrical impedance tomopgraphy
Sponsored by
About this trial
This is an interventional prevention trial for Abdominal Sepsis focused on measuring Electrical impedance tomography, Emergent laparotomy, Compliance partinioning
Eligibility Criteria
Inclusion Criteria: Age > 18 and < 90 years Admitted to the ICU after emergent laparotomy for abdominal sepsis Acute respiratory failure Exclusion Criteria: Controindications to electrical impedance tomography monitoring body mass index > 40 kg/m2 Haemodinamic instability Pneumothorax - Pneumomediastinum refusal to participate
Sites / Locations
- Azienda Ospedaliero Universitaria Sant'Anna
Arms of the Study
Arm 1
Arm 2
Arm Type
Other
Other
Arm Label
Open Abdomen
Closed Abdomen
Arm Description
Outcomes
Primary Outcome Measures
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Secondary Outcome Measures
Regional ventilation distribution measured using Electrical impedance tomography
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Regional ventilation distribution measured using Electrical impedance tomography
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Regional ventilation distribution measured using Electrical impedance tomography
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Mortality in the intensive care unit
Mortality rate in ICU
Infection rate during ICU stay
New diagnosis of infections during the ICU stay
Full Information
NCT ID
NCT05726500
First Posted
January 13, 2023
Last Updated
February 2, 2023
Sponsor
Università degli Studi di Ferrara
Collaborators
University of Milan
1. Study Identification
Unique Protocol Identification Number
NCT05726500
Brief Title
Evaluation of Regional Ventilation Distribution in Patients Affected by Abdominal Sepsis After Emergent Laparotomy
Acronym
CHESTOMY
Official Title
Evaluation of Regional Ventilation Distribution in Patients Affected by Abdominal Sepsis After Emergent Laparotomy
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 15, 2023 (Anticipated)
Primary Completion Date
May 30, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Università degli Studi di Ferrara
Collaborators
University of Milan
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The goal of this clinical trial is to evaluate regional ventilation distribution in patients admitted to the intensive care unit after emergent laparotomy due to abdominal sepsis. The main question it aims to answer is:
• evaluate if patients admitted after an open abdomen strategy have a different regional ventilation distribution compared to patients in which abdomen is closed at the end of the procedure
Participants will undergo non-invasive monitoring (esophageal pressure and electrical impedance tomography) and an blood gas analysis samples.
Researchers will compare open abdomen group and closed abdomen group to see if the ventilation distribution pattern is different.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Abdominal Sepsis, Acute Respiratory Failure, Ventilation Therapy; Complications, Emergencies
Keywords
Electrical impedance tomography, Emergent laparotomy, Compliance partinioning
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Open Abdomen
Arm Type
Other
Arm Title
Closed Abdomen
Arm Type
Other
Intervention Type
Diagnostic Test
Intervention Name(s)
Arterial blood gas analysis
Intervention Description
The researches will collect 2 ml of arterial blood using an arterial line already in place for clinical purposes to perform and arterial gas analysis.
Intervention Type
Diagnostic Test
Intervention Name(s)
Venous blood gas analysis
Intervention Description
The researches will collect 2 ml of arterial blood using a central venous line already in place for clinical purposes to perform a gas analysis.
Intervention Type
Diagnostic Test
Intervention Name(s)
Esophageal pressure monitoring
Intervention Description
The researchers will position an esophageal balloon to evaluate esophageal pressure
Intervention Type
Diagnostic Test
Intervention Name(s)
Intrabdominal pressure
Intervention Description
The researches will assess intrabdominal pressure using the urinary catheter system already in place for clinical purposes .
Intervention Type
Diagnostic Test
Intervention Name(s)
Electrical impedance tomopgraphy
Intervention Description
The researches will evaluate regional ventilation distribution using Electrical impedance tomography at different levels of positive end-expiratory pressure
Primary Outcome Measure Information:
Title
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Description
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Time Frame
Day 0
Title
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Description
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Time Frame
Day 1
Title
Chest-wall compliance (Ccw) measured using respiratory parameters from the Ventilator
Description
Different chest wall compliance between the two groups measured using the esophageal catheter. Chest wall compliance will be calculated using the data provided from the respiratory monitoring (i.e. esophageal balloon catheter).
Time Frame
Day 2
Secondary Outcome Measure Information:
Title
Regional ventilation distribution measured using Electrical impedance tomography
Description
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Time Frame
Day 0
Title
Regional ventilation distribution measured using Electrical impedance tomography
Description
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Time Frame
Day 1
Title
Regional ventilation distribution measured using Electrical impedance tomography
Description
The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on:
Regional ventilation distribution Regional inhomogeneity Regional compliance distribution Center of Ventilation Regional ventilation delay Regional compliance
Time Frame
Day 2
Title
Mortality in the intensive care unit
Description
Mortality rate in ICU
Time Frame
Up to 28 days
Title
Infection rate during ICU stay
Description
New diagnosis of infections during the ICU stay
Time Frame
Up to 28 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age > 18 and < 90 years
Admitted to the ICU after emergent laparotomy for abdominal sepsis
Acute respiratory failure
Exclusion Criteria:
Controindications to electrical impedance tomography monitoring
body mass index > 40 kg/m2
Haemodinamic instability
Pneumothorax - Pneumomediastinum
refusal to participate
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gaetano Scaramuzzo
Phone
0532238108
Ext
+39
Email
scrtn@unife.it
Facility Information:
Facility Name
Azienda Ospedaliero Universitaria Sant'Anna
City
Ferrara
ZIP/Postal Code
44121
Country
Italy
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Savino Spadaro, MD
Phone
+390532239780
Email
savinospadaro@gmail.com
12. IPD Sharing Statement
Plan to Share IPD
No
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Evaluation of Regional Ventilation Distribution in Patients Affected by Abdominal Sepsis After Emergent Laparotomy
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