An observational study in Multi-organ Failure After Severe Trauma, sponsored by Assistance Publique - Hôpitaux de Paris. Recruiting at 2 sites in France. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-15.
Sponsored by Assistance Publique - Hôpitaux de Paris · Observational
Severe trauma remains the leading cause of death in people under 50, and is associated with high morbidity, including severe disability, with a substantial socio-economic impact. Secondary to trauma, multiple mechanisms (inflammatory, ischemic, oxidative, etc.) setting in rapidly, leads to organ failure, one of the three first cause of death. Vascular damage, with vasoplegia, renal damage, with acute kidney injury (AKI), and pulmonary damage, with acute respiratory distress syndrome (ARDS), are the most frequently observed but all organs can be affected whatever the type of trauma. For these reasons, identifying the pathophysiological pathways involved in organ failure induced by severe trauma is a major step towards limiting the morbidity and mortality induced by trauma, and proposing therapies to prevent them.
Because of the variability of lesions in these patients, and the multiplicity of pathways activated, the mechanisms involved and their causality with organ failure following severe trauma, are still poorly understood. Given their frequency and importance in terms of morbidity and mortality, the investigators decided to take a particular interest in the mechanisms leading to renal and pulmonary injury. The investigators' hypothesis is that the study of urinary and blood markers not performed as part of clinical routine would provide a better understanding of the pathophysiological mechanisms leading to organ failure secondary to severe trauma, and more specifically to renal and pulmonary injuries. With TRAUMATEC study, the investigators will explore mechanisms leading to AKI and ARDS through blood and urine samples of 60 severe trauma patients sampled over the first 48 hours after ICU admission and a reference of 20 healthy volunteers.
The investigators plan to include 60 patients over 18 years old with severe trauma, defined with an ISS≥9 and 20 healthy volunteers 18 years old as a reference group.
Blood and urine samples will be collected at ICU arrival, 12-, 24- and 48- hours after ICU admission. Specific dosages will then be realized on blood and urines to study metabolic and hormonal pathway leading to AKI and ARDS.
The primary objective of the study is to explore the association between renal metabolic changes and renal function impairment following severe trauma.
Secondary objectives are (1) to explore mitochondrial changes observed at the renal cellular level, on in vitro renal culture cells after exposure to trauma patient serum (2) to explore the association between plasma metabolic changes and renal and pulmonary function impairment following severe trauma (3) to explore the association between hormonal metabolic changes and renal and pulmonary function impairment following severe trauma (4) to explore the association between red blood cell-induced oxidative stress and renal function impairment following severe trauma (5) to explore the association between changes in the hemoglobin recycling (chelation) system and impaired renal function following severe trauma (6) to explore renal tubular damage secondary to severe trauma (7) to explore the pathophysiological mechanisms associated with pulmonary damage following severe trauma (8) to describe mortality at day 30.
2,217 studies on the registry are indexed under Wounds and Injuries; 441 are open to participants now.
This study's planned enrollment of 80 is below the median of 169 across 690 observational studies indexed under Wounds and Injuries.
Browse Wounds and Injuries studies →Assistance Publique - Hôpitaux de Paris is the lead sponsor of 3,592 studies on the registry; 1,033 are open to participants now.
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polytrauma patients : a population of severe trauma patients at risk of failure secondary organs.
healthy volonteers
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Trauma patients :
Healthy volunteers :
Exclusion Criteria:
Trauma patients :
Healthy volunteers :
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
polytrauma patients
healthy volunteers
Profile of urinary metabolite concentrations measured by mass spectometry
Metabolomic study of patients urine according to AKI and compared to healthy volunteers measured by mass spectometry
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
mitochondrial enzymatic activities of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to serum from healthy volunteers
In vitro mitochondrial function of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to healthy volunteer serum assessed by enzymatic activities by Seahorse XFe96 analyzer
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
mitochondrial membrane potential of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to serum from healthy volunteers
In vitro mitochondrial function of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to healthy volunteer serum assessed by measurement of mitochondrial membrane potential by fluorescence
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
mitochondrial Adenosine TriPhosphate (ATP) content of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to serum from healthy volunteers
In vitro mitochondrial function of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to healthy volunteer serum assessed by measurement of ATP content by spectrofluorimetry
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
expression levels of mitochondrial of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to serum from healthy volunteers
In vitro mitochondrial function of cultured Human Kidney 2 (HK2) kidney cells exposed to patient serum and exposed to healthy volunteer serum assessed by measurement of expression levels of mitochondrial by Western-blot
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Plasma metabolite concentration profile measured by mass spectrometry
Metabolomic study of patients plasma measured by mass spectrometry according to AKI and ARDS and compared to healthy volunteers
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
advanced glycation end products (AGEs) produced by red blood cells
Measurement of oxidative stress produced by red blood cells assessed by advanced glycation end products (AGEs)
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
reactive oxygen derivatives produced by red blood cells
Measurement of oxidative stress produced by red blood cells assessed by reactive oxygen derivatives
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
erythrocyte NO production produced by red blood cells
Measurement of oxidative stress produced by red blood cells assessed by erythrocyte NO production
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
haptoglobin level
Hemoglobin recycling system assessed by haptoglobin
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
haptoglobin-hemoglobin complexes level
Hemoglobin recycling system assessed by haptoglobin-hemoglobin complexes
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
free hemoglobin level
Hemoglobin recycling system assessed by free hemoglobin
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
monocyte CD163 receptor from peripheral blood mononuclear cell (PBMC) isolation level
Hemoglobin recycling system assessed by monocyte CD163 receptor from peripheral blood mononuclear cell (PBMC) isolation
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Heme oxygenase-1 (HO-1) enzyme catabolizing heme level
Hemoglobin recycling system assessed by Heme oxygenase-1 (HO-1) enzyme catabolizing heme
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
renin-angiotensin-aldosterone (RASS) profile
Measurement of RASS
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Antidiuretic hormone (ADH) profile
Measurement of ADH
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
cortisol profile
Measurement of cortisol
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
leptine profile
Measurement of leptine
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Intensity of renal tubular injury
Renal tubular injury assessed by standard urinary markers: neutrophil gelatinase-associated lipocalin (NGAL), Kidney injury molecule 1 (KIM-1), IGFB-7, tissue inhibitor of metalloproteinases-2 (TIMP-2), cystatin C
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
hypoxemia level
Pulmonary injury during hospitalization in intensive care evaluated by hypoxemia assessed by the PaO2/FiO2 ratio
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
use of mechanical ventilation
Pulmonary injury during hospitalization in intensive care evaluated by use of mechanical ventilation
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Radiographic Assessment of Lung Edema (RALE) score
Pulmonary injury during hospitalization in intensive care evaluated by Radiographic Assessment of Lung Edema (RALE) score
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
alveolar epithelial lesions
Pulmonary injury during hospitalization in intensive care evaluated by evaluation of alveolar epithelial lesions by circulating soluble Receptor for Advanced Glycation Endproducts (sRAGE) assay.
Time frame: On admission, at 12 hours, 24 hours and 48 hours of hospital admission
Death
Vital status at day 30
Time frame: Day 30
Plan to share: Undecided
No publications or documents are linked to this record.
Started Jun 2024 (actual). Primary completion is estimated for Sep 2025, 15 months after the start.
Of 265 non-industry observational studies under Wounds and Injuries, half reached primary completion within 28 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 60. This study's planned 15 months is below that.
Counting every sponsor, half of 312 studies reached it within 28 months; a quarter within 12 and three quarters within 60.
Wounds and Injuries covers many different conditions, not one, so the studies compared here vary widely. Read these figures as a rough guide.
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