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RecruitingNCT05681962Updated Dec 30, 2024

Practice of Oxygenation and Respiratory Support During Fiberoptic Bronchoscopy

An observational study in Acute Respiratory Failure, Pneumonia and Lung Cancer, sponsored by University Magna Graecia. Recruiting at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-12-30.

Sponsored by University Magna Graecia · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
10,000
Ages
18 Years and older
Sex
All
01

Study summary

The current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy is very heterogeneous among studies published in the literature; in addition, clear outcomes advantages of one strategy over another currently lack.

The goal of this observational study is to describe the current practice of oxygenation and/or ventilation supports in patients undergoing Fiberoptic Bronchoscopy (FOB), stratified by baseline respiratory condition, co-morbidities, type of procedure and hospital settings.

Investigators will enroll all adult patients undergoing any fiberoptic bronchoscopy in any clinical settings (from outpatients to critically ill patients). No specific exclusion criteria are indicated for enrollment in this study.

Investigators will record the following data:

  • Patient's baseline data.
  • Type of FOB procedure: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS). The type and size of bronchoscope (with or without an internal/external camera) and the time of the procedure will be also recorded.
  • Type of supportive strategy: no support, Standard Oxygen Therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure and or non invasive ventilation trough mask or helmet, invasive mechanical ventilation.
  • Sedation
  • Intra-procedural vital parameters
  • Occurrence of adverse events: desaturation (i.e. SpO2\< 90% for at least 10 seconds), severe desaturation (i.e. SpO2\< 80%), need for procedure interruption, hypotensive (systolic blood pressure \<90 mmHg) or hypertensive (systolic blood pressure >140 mmHg) events, new onset of cardiac arrhythmias (specify the rhythm) or myocardial ischemia or electrocardiographic ST-alterations, neurological events (i.e. severe sensorium depression, psychomotor agitation).
  • Post-procedural vital parameters (15 minutes after the procedure).
  • Clinical outcomes: need for support escalation, need for admission to ward (for outpatient) or ICU (for outpatients and ward-admitted patient).
02

Conditions studied

  • Acute Respiratory Failure
  • Pneumonia
  • Lung Cancer
  • Fibrosis Lung
  • Interstitial Lung Disease

Keywords

  • Bronchoscopy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

We will include all adult patients requiring a flexible bronchoscopy for diagnostic or procedural reasons from all possible settings (from outpatients in dedicated ambulatories to patients admitted in any hospital ward or Intensive Care Unit)

Inclusion criteria

  • Need for any procedure with flexible FOB
  • Either outpatients in dedicated ambulatories, and admitted to any hospital ward or Intensive Care Unit (ICU)

Exclusion criteria

Exclusion Criteria:

  • None
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
10,000 participants (estimated)
Patient registry
No

Groups and cohorts

  • Standard Oxygen Therapy (SOT)

    Patients receiving low oxygen flow administration through nasal prongs, oxygen mask with or without reservoir, and Venturi mask.

    Diagnostic Test: Bronchoscopy

  • High Flow oxygen through Nasal Cannula (HFNC)

    Administration of high flows (up to 60 L/min) of air/oxygen admixtures, heated (at temperatures ranging from 31 to 37°C) and fully humidified (up to 44 mg H2O/L), providing an inspired oxygen fraction ranging from 21 to 100%

    Diagnostic Test: Bronchoscopy

  • Continuous Positive Airway Pressure (CPAP)

    application of positive end-expiratory pressure (PEEP) throughout the whole respiratory cycle by means of interfaces such as mask or helmet

    Diagnostic Test: Bronchoscopy

  • Non-Invasive Ventilation (NIV)

    application of a PEEP by means of a mask or helmet, with an inspiratory pressure support triggered by the patient and delivered by a ventilator and through interfaces such as mask or helmet

    Diagnostic Test: Bronchoscopy

  • Invasive Mechanical Ventilation (iMV)

    application of a ventilatory assistance in controlled or partial assisted modalities through an endotracheal or tracheostomy tube

    Diagnostic Test: Bronchoscopy

Interventions

  • Diagnostic testBronchoscopy

    Patients will undergo to the bronchial endoscopy procedure required for their clinical condition: toilet bronchoscopy (for secretions, blood, mucus plugs removal), broncho-aspirate (BAS), bronchoalveolar lavage (BAL), brushing for cytology, biopsy, endobronchial ultrasound (EBUS).

05

What researchers measure

Primary outcomes

  1. Type of oxygenation strategy adopted

    The type of oxygenation strategy (standard oxygen therapy, high flow nasal cannula, continuous positive airway pressure, non invasive ventilation or invasive mechanical ventilation) adopted during the bronchoscopy will be recorded.

    Time frame: Through the endoscopy completion, an average of 30 minutes

Secondary outcomes

  1. Type of sedation strategy adopted

    The type of sedation strategy (topical anesthesia, midazolam, propofol, remifentanil, fentanyl, dexmedetomidine, neuromuscular blocking agents) adopted during the bronchoscopy will be recorded.

    Time frame: Through the endoscopy completion, an average of 30 minutes

  2. Lowest peripheral oxygen saturation

    The lowest peripheral oxygen saturation recorded during the procedure

    Time frame: Through the endoscopy completion, an average of 30 minutes

  3. Lowest heart rate

    The lowest heart rate recorded during the procedure

    Time frame: Through the endoscopy completion, an average of 30 minutes

  4. Highest heart rate

    The highest heart rate recorded during the procedure

    Time frame: Through the endoscopy completion, an average of 30 minutes

  5. Lowest systolic blood pressure

    The lowest systolic blood pressure recorded during the procedure

    Time frame: Through the endoscopy completion, an average of 30 minutes

  6. Highest systolic blood pressure

    The highest systolic blood pressure recorded during the procedure

    Time frame: Through the endoscopy completion, an average of 30 minutes

  7. Duration of the procedure

    The time duration of the procedure in minutes, from the beginning to the end of the endoscopy procedure

    Time frame: From the beginning to the end of the endoscopy procedure

  8. Desaturation events

    Occurrence of peripheral oxygen saturation \< 90% for at least 10 seconds

    Time frame: Through the endoscopy completion, an average of 30 minutes

  9. Severe desaturation events

    Occurrence of peripheral oxygen saturation \< 80%

    Time frame: Through the endoscopy completion, an average of 30 minutes

  10. Hypotensive events

    Occurrence of systolic blood pressure \<90 mmHg

    Time frame: Through the endoscopy completion, an average of 30 minutes

  11. Hypertensive events

    Occurrence of systolic blood pressure \>140 mmHg

    Time frame: Through the endoscopy completion, an average of 30 minutes

  12. Need for support escalation

    Need to escalate the oxygenation/ventilation support from from standard oxygen therapy (lowest support) to High Flow Nasal Cannula, Continuous Positive Airway Pressure, Non Invasive Ventilation or invasive Mechanical Ventilation (highest grade of support)

    Time frame: Through the endoscopy completion, an average of 30 minutes

  13. Admission to ward or intensive care unit

    Need for admission to ward or intensive care unit after the endoscopy completion

    Time frame: At the end of the endoscopy completion, after an average of 30 minutes from study start

06

Study locations

1 of 1 sites recruiting
07

References and documents

Individual participant data

Plan to share: Yes — Anonymous data will be shared after study publication on a peer-reviewed journal in english language, on a reasonable request to the principal investigator

Supporting information: Study protocol, Csr, Analytic code

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT05681962
Lead sponsor
University Magna Graecia
Responsible party
Federico Longhini (Director of the Intensive Care and Anesthesia Department, University Magna Graecia) — Principal investigator
First posted
Jan 12, 2023
Start date
Feb 15, 2023
Primary completion
Dec 31, 2025 (estimated)
Completion
Jan 31, 2026 (estimated)
Last update
Dec 30, 2024

Study contacts

Federico Longhini, MD
Contact
longhini.federico@gmail.com
+393475395967
Federico Longhini, MD
principal investigator · Magna Graecia University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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