| CTRI Number |
CTRI/2024/03/063677 [Registered on: 06/03/2024] Trial Registered Prospectively |
| Last Modified On: |
29/02/2024 |
| Post Graduate Thesis |
Yes |
| Type of Trial |
Observational |
|
Type of Study
|
Prospective |
| Study Design |
Other |
|
Public Title of Study
|
A study to assess the Arterial blood to expired carbon dioxide difference to predict mortality and morbidity in patients with sepsis. |
|
Scientific Title of Study
|
Arterial To End Tidal Carbon dioxide Difference As A Predictor Of Mortality And Morbidity In Patients With Sepsis - A Prospective Observational Study. |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| Version 1.0 dated 30/07/2022 |
Protocol Number |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Dr Radhika K T |
| Designation |
DrNB Critical Care Medicine Resident |
| Affiliation |
Narayana Health City |
| Address |
Mazumdar Shaw Medical Centre, Medical Intensive Care Unit, 2nd Floor, Narayana Health City, Bommasandra, Bengaluru
Bangalore KARNATAKA 560099 India |
| Phone |
6363604104 |
| Fax |
|
| Email |
radhikadivakaran92@gmail.com |
|
Details of Contact Person Scientific Query
|
| Name |
Dr Arjun Alva |
| Designation |
Consultant, Critical Care Medicine |
| Affiliation |
Narayana Health City |
| Address |
Mazumdar Shaw Medical Centre, Medical Intensive Care Unit, 2nd Floor, Narayana Health City, Bommasandra, Bengaluru.
Bangalore KARNATAKA 560099 India |
| Phone |
9108026001 |
| Fax |
|
| Email |
arjun.alva.dr@narayanahealth.org |
|
Details of Contact Person Public Query
|
| Name |
Dr Radhika K T |
| Designation |
DrNB Critical Care Medicine Resident |
| Affiliation |
Narayana Health City |
| Address |
Mazumdar Shaw Medical Centre, Medical Intensive Care Unit, 2nd Floor, Narayana Health City, Bommasandra, Bengaluru
Bangalore KARNATAKA 560099 India |
| Phone |
6363604104 |
| Fax |
|
| Email |
radhikadivakaran92@gmail.com |
|
|
Source of Monetary or Material Support
|
| Narayana Health City, 258/A Bommasandra Industrial area, Hosur Road, Bengaluru, 560099 |
|
|
Primary Sponsor
|
| Name |
Dr Radhika K T |
| Address |
Narayana Health City, 258/A Bommasandra Industrial area, Hosur Road, Bengaluru, 560099 |
| Type of Sponsor |
Other [Self] |
|
|
Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr Radhika K T |
Medical Intensive Care Unit |
Mazumdar Shaw Building, Medical Intensive Care Unit, 2nd Floor, Narayana Health City, 258/A Bommasandra Industrial area, Hosur Road, Bengaluru, 560099 Bangalore KARNATAKA |
6363604104
radhikadivakaran92@gmail.com |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| Narayana Health Academic Ethics Committee |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: A419||Sepsis, unspecified organism, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
NIL |
NIL |
| Comparator Agent |
NIL |
NIL |
|
|
Inclusion Criteria
|
| Age From |
18.00 Year(s) |
| Age To |
80.00 Year(s) |
| Gender |
Both |
| Details |
1. Aged above 18 years
2.Clinically suspected or proven sepsis with or without septic shock requiring invasive ventilator support. |
|
| ExclusionCriteria |
| Details |
1. Chronic obstructive pulmonary disease
2. Interstitial lung disease
3. Bronchial asthma
4. Obstructive sleep apnoea
5. Cardiogenic shock
6. More than 7 days since the suspicion of sepsis
7. Post cardiac arrest resuscitated patients
8. Pregnancy
9. Pulmonary embolism
10. Patients requiring all non invasive methods of ventilatory support |
|
|
Method of Generating Random Sequence
|
Not Applicable |
|
Method of Concealment
|
Not Applicable |
|
Blinding/Masking
|
Double Blind Double Dummy |
|
Primary Outcome
|
| Outcome |
TimePoints |
| Arterial to end tidal carbon dioxide difference as a marker of in-hospital mortality in patients with suspected or proven sepsis. |
28 days from the day of admission. |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
Arterial to end tidal carbon dioxide difference as a marker of morbidity in patients with suspected sepsis in terms of
-No of days of hospital stay
-No of days of ICU stay
-No of days of ventilatory support
-Need for vasoactive support; average dose per day and duration
-Requirement of renal replacement therapy |
28 days from the day of admission |
| Correlation between Arterial to end tidal carbon dioxide difference and SOFA Score as well as Capillary refill time. |
28 days from the day of admission |
|
|
Target Sample Size
|
Total Sample Size="110" Sample Size from India="110"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
N/A |
|
Date of First Enrollment (India)
|
11/03/2024 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="0" Months="9" Days="0" |
|
Recruitment Status of Trial (Global)
|
Not Yet Recruiting |
| Recruitment Status of Trial (India) |
Not Yet Recruiting |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - NO
|
|
Brief Summary
|
Sepsis is life-threatening multi-organ dysfunction caused by a dysregulated immune response to an infectious cause. Sepsis and septic shock are major healthcare problems, affecting millions of people around the world. Early recognition and appropriate management in the initial phases of sepsis improve outcomes. The difference between arterial carbon dioxide tension (PaCO2) and ETCO2 is shown to correlate with the physiologic dead space (VD/VT), which is normally 3–5 mmHg in healthy adults. Higher value of arterial to end tidal CO2 difference has been found to predict worse outcomes in trauma and respiratory distress patients. Sepsis can be associated with myocardial depression and changes in total peripheral vascular resistance , Acute respiratory distress syndrome (ARDS) and respiratory failure irrespective of aetiology of sepsis. Septic encephalopathy, with its associated reduction in respiratory drive, appears outcomes. Thus reduced cardiac output, diminished respiratory drive, impaired alveolar ventilation with arteriovenous shunting and/or sepsis related ARDS may act in isolation or together manifesting as an increased arteriolar- end tidal CO2 gap and thus predict reduced survival and increased need for intensive care support in patients with sepsis. In this study we intend to evaluate arterial to end tidal carbon dioxide difference as predictor of mortality and morbidity in patients with suspected sepsis. We also extend our study to find the correlation between arteriolar - end tidal CO2 gap and already established prognostic markers of sepsis like Lactate level, capillary refill time and Sequential Organ Failure Assessment Score (SOFA). |