Measurement of Changes in Ventilation and Catheter Placement During Non-directed Bronchoalveolar Lavage Using Electrical Impedance Tomography With and Without a One-way Valve
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 50
- Locations
- 2
- Primary Endpoint
- Measure changes in lung ventilation using EIT during the performance of an NBL with and without a one-way adapter valve attached to the catheter mount.
Study Overview
Brief Summary
Surveillance of the lungs for bacteria is routinely undertaken in artificially ventilated patients as these individuals are at high risk of developing pneumonia. Knowledge of the types of bacteria present allows the rapid treatment with the correct antibiotics if a pneumonia develops. Surveillance is undertaken using a technique called non-directed bronchoalveolar lavage (NBL), which can be performed by the bedside nurse. This involves suctioning some of the lung secretions into a sample pot and sending it to the microbiology laboratory to identify any bacteria present. When this procedure is performed there is some collapse of the lung due to escaping gas. The purpose of this study is:
- To use a non-invasive imaging technique known as electrical impedance tomography (EIT) to measure the amount of lung collapse during an NBL. Half of the patients in the study will have a one-way adapter valve connected to the breathing circuit. This adapter is designed to make the insertion of a suction catheter easier and prevent the loss of gas.
- Look at which region of the lung the sample is being collected from as the suction tube used to take the samples may pass into either the left or right lung.
EIT is a simple non-invasive technique which has been in use for many years. It uses pairs of electrodes around the chest through which imperceptible currents are passed. A computer shows an image of which parts of the lungs have the most or least air in them. This has the advantage over other imaging techniques in critical care that it does not use radiation and gives a real time picture at the bedside of the variations in ventilation throughout the lungs.
Detailed Description
This study has two objectives. The first is to measure changes in lung ventilation using EIT during the performance of an NBL with and without a one-way adapter valve attached to the catheter mount. This will be done by randomising half of the patients to having the one-way adapter valve attached to the catheter mount. Assignment will be by randomisation.
The second objective of the study is to locate the placement of catheter tips during the performance of NBLs, using electrical impedance tomography.
Equipment: A sixteen-electrode single frequency electrical impedance tomography device with on-line image analysis (CareFusion). One-way adapter valves which attach to the catheter mount (CareFusion).
Study Population: Critically ill adult patients admitted to the intensive care unit at the University Hospital of Wales Cardiff in whom NBLs are performed as part of their routine care.
Recruitment: All patients satisfying inclusion and exclusion criteria, admitted to the adult ICU at the University Hospital of Wales from the start date of the study will be considered eligible for recruitment. Patients identified by the duty consultant will be notified to the research team. Patients will be randomly allocated to have NBLs performed with or without the one-way valve attached to the catheter mount.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients aged >18 years
- •Patients in whom an NBL is indicated as part of standard treatment
- •Patient on mechanical ventilation with PEEP
Exclusion Criteria
- •NBL contraindicated
- •Age <18 years
- •Patient not on mechanical ventilation with PEEP
Outcomes
Primary Outcomes
Measure changes in lung ventilation using EIT during the performance of an NBL with and without a one-way adapter valve attached to the catheter mount.
Time Frame: Up to 4 hours
Secondary Outcomes
- Locate the placement of catheter tips during the performance of NBLs, using electrical impedance tomography(Up to 4 hours)