Association Between the Level of Extracellular Vesicle - Associated Tissue Factor and the Occurence of Pulmonary Embolism in Patients With Acute Respiratory Distress Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 170
- 试验地点
- 1
- 主要终点
- Difference in EV-TF levels at inclusion between patients with and without pulmonary embolism at day 7 postinclusion
研究概览
简要总结
In this study, 120 patients with Acute Respiratory Distress Syndrome (ARDS) will be included on a two years-period in an intensive care unit (Assistance Publique des Hôpitaux de Marseille, France). Those patients will benefit from a blood test at inclusion in order to measure several coagulation biomarkers, including EV-TF. Subsequently, these patients will be treated according to the usual practices of the department, following recommendations. Patients who received an injected CT scan between Day 5 and Day 28 will be divided into two groups based on the presence or absence of a pulmonary embolism on imaging. The measured values of EV-TF levels and other studied biomarkers will be compared between these two groups in order to detect a possible association between them and the diagnosis of pulmonary embolism. It should be noted that patients receiving an injected CT-scan between Day 5 and Day 7 will be included in the main analysis while those receiving it between Day 8 and Day 28 will be included in the secondary analysis. Others will be excluded from any analysis. At the same time, several collections of clinical data will be carried out: on Day 1, Day 7, Day 28, and on the day of the CT scan if it is performed at another time.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient 18 years of age or older,
- •Patient who has given his/her non-opposition to participate in this study, or alternatively, patient for whom a relative has given his/her non-opposition to participate in this study,
- •Patient admitted to intensive care for less than 24 hours,
- •Patient with ARDS according to the Berlin criteria,
- •Hypoxemia with PaO2/FiO2 ratio ≤ 300 on mechanical ventilation under PEEP ≥ 5 cmH2O,
- •Bilateral alveolar-interstitial opacities on chest imaging (chest X-ray or CT),
- •Exclusion of a cardiogenic cause on echocardiography,
- •Acute or subacute onset within 7 days based on the clinical-radiological profile.
排除标准
- •Positive SARS-CoV-2 PCR in a pharyngeal or respiratory sample (cytobacteriological examination of sputum, bronchial aspiration or bronchoalveolar lavage) prior to admission to the intensive care unit,
- •Patient with a pathology affecting the coagulation process or endothelial function (hemophilia, von Willebrand disease, etc.),
- •Patient receiving curative anticoagulant treatment before admission to the intensive care unit,
- •Patient undergoing extracorporeal veno-venous respiratory assistance (ECMO-VV) before admission to the intensive care unit,
- •Patient undergoing extra-renal purification with systemic anticoagulation with heparin before admission to the intensive care unit,
- •Persons referred to in articles L. 1121-5 to L. 1121-8 of the Public Health Code (minor patients, adult patients under tutorship or guardianship, patients deprived of their liberty, pregnant or nursing women),
- •Moribund patients for whom the life expectancy is less than 24 hours according to the opinion of the investigating physician.
研究组 & 干预措施
Patients with pulmonary embolism
The presence of pulmonary embolism is determined from a CT scan realized between Day 5 and Day 28.
干预措施: Blood sample (Other)
Patients without pulmonary embolism
The absence of pulmonary embolism is determined from a CT scan realized between Day 5 and Day 28.
干预措施: Blood sample (Other)
结局指标
主要结局
Difference in EV-TF levels at inclusion between patients with and without pulmonary embolism at day 7 postinclusion
时间窗: Day 7
EV-TF level is determined from a blood sample realized at inclusion and the presence of pulmonary embolism from a CT scan realized during the first week of patient care in intensive care unit.
次要结局
- Difference in EV-TF levels at inclusion between patients with and without pulmonary embolism at day 28 postinclusion(Day 28)
- Association between EV-TF level and alveolar dead space at day 28 postinclusion(Day 28)
- Association between EV-TF level and alveolar dead space at thoracic CT scan day(Between day 5 and day 28)
- Difference in EV-TF levels at inclusion between patients with and without venous thrombo-embolic disease at day 7 postinclusion(Day 7)
- Difference in EV-TF levels at inclusion between patients with and without venous thrombo-embolic disease at day 28 postinclusion(Day 28)
- Association between EV-TF levels and patient prognosis(Day 60)
- Association between EV-TF level and alveolar dead space at inclusion(Day 1)
- Association between EV-TF level and alveolar dead space at day 7 postinclusion(Day 7)
- Optimal threshold value of EV-TF associated with the occurrence of pulmonary embolism.(Day 28)
- Optimal threshold value of EV-TF associated with the occurrence of venous thrombo-embolic disease.(Day 28)
- Optimal threshold value of EV-TF associated with the occurrence of death(Day 60)
- Predictive value of Willebrand antigen at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of ADAMTS13 activity at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of circulating levels of antithrombin (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of fibrin monomers (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of circulating levels of protein C (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of circulating levels of protein S (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of circulating levels of protein C (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of circulating levels of protein S (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of D-dimers (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of circulating PAI-1 (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 7.(Day 7)
- Predictive value of Willebrand antigen at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of ADAMTS13 activity at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of circulating levels of antithrombin (coagulation inhibitor) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of D-dimers (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of circulating PAI-1 (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of Willebrand antigen at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of fibrin monomers (circulating fibrinolytic potential) at inclusion on the occurrence of pulmonary embolism at day 28.(Day 28)
- Predictive value of ADAMTS13 activity at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of circulating levels of antithrombin (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of circulating levels of protein C (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of circulating levels protein S (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of D-dimers (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of circulating levels of antithrombin (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of circulating levels of protein C (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of fibrin monomers (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of circulating PAI-1 (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 7.(Day 7)
- Predictive value of ADAMTS13 activity at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of Willebrand antigen at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of circulating levels of protein S (coagulation inhibitor) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of D-dimers (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of fibrin monomers (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of circulating PAI-1 (circulating fibrinolytic potential) at inclusion on the occurrence of venous thrombo-embolic disease at day 28.(Day 28)
- Predictive value of Willebrand antigen at inclusion on the patients' death.(Day 60)
- Predictive value of ADAMTS13 activity at inclusion on the patients' death.(Day 60)
- Predictive value of of circulating levels of antithrombin (coagulation inhibitor) at inclusion on the patients' death.(Day 60)
- Predictive value of of circulating levels of protein C (coagulation inhibitor) at inclusion on the patients' death.(Day 60)
- Predictive value of of circulating levels of protein S (coagulation inhibitor) at inclusion on the patients' death.(Day 60)
- Predictive value of D-dimers (circulating fibrinolytic potential) at inclusion on the patients' death.(Day 60)
- Predictive value of fibrin monomers (circulating fibrinolytic potential) at inclusion on the patients' death.(Day 60)
- Predictive value of circulating PAI-1 (circulating fibrinolytic potential) at inclusion on the patients' death.(Day 60)
