Ventilator Induced Diaphragm DysfunctionRESCUE2NCT03096639
Percutaneous Temporary Placement of a Phrenic Nerve Stimulator for Diaphragm Pacing
A study testing Diaphragmatic Pacing Therapy DPTS in people with Ventilator Induced Diaphragm Dysfunction, run by Lungpacer Medical Inc. at 21 sites in 2 countries.
Trial summary
A randomized clinical trial to investigate the use of the temporary Diaphragm Pacing Therapy System (DPTS) to rehabilitate the diaphragm in mechanically ventilated patients who have failed at least two weaning attempts. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Ventilator Induced Diaphragm Dysfunction
- What is being tested?
- Diaphragmatic Pacing Therapy DPTS
- Type of treatment
- Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 110 participants
- Where
- 21 sitesin 2 countries
- Study dates
- 14 Sep 2017to 30 Jan 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 years of age or older
- have been mechanically ventilated for > or = to 96 hours (4 days), and
- have satisfied the Readiness-to-Wean criteria and
- have failed at least two VLTs, one of which is the study specific VLT.
Who cannot join
- currently on extracorporeal membrane oxygenation (ECMO);
- weaning failure due to hypervolemia;
- medical history or known anatomy that prevents insertion of the LIVE Catheter into the left subclavian vein;
- currently being treated with neuromuscular blockade;
- clinically overt congestive heart failure that is preventing weaning;
- pre-existing neuromuscular diseases that could affect the respiratory muscles;
Show all 16Show fewer
- pre-existing severe chronic pulmonary fibrosis;
- pleural effusions occupying greater than one third of the pleural space on either side;
- BMI > or = 40;
- known or suspected phrenic nerve paralysis;
- any electrical device (implanted or external) that may be prone to interaction with or interference from the Lungpacer DPTS including neurological pacing/stimulator devices, cardiac pacemakers and defibrillators;
- prior bacteremia reported within the last 48 hours;
- current hemodynamic instability, sepsis or septic shock;
- terminally ill with 6 months or less life expectancy or not committed to full care;
- known or suspected to be pregnant or lactating; and
- currently being treated in another clinical trial studying an experimental treatment that could affect the study primary outcome.
Trial locations and contacts
21 sites in 2 countries.
21 sites in 2 countries
Germany14 sites
Uniklinik RWTH Aachen
Aachen, 52074
Heart and Diabetes Center Bad Oeynhausen
Bad Oeynhausen, 32545
Charite Universitatsmedizin Berlin - Mitte campus
Berlin, 10117
Universitatsklinikum Bonn
Bonn, 53105
Universitatsklinik Dresden
Dresden, 01307
Universitatsmedizin Gottingen, Georg-August-Universitat
Göttingen, 37075
Asklepios Kliniken Hamburg GmbH - Asklepios Klinikum Harburg
Hamburg, 21075
Universitätsklinikum Hamburg-Eppendorf (UKE)
Hamburg
Med Uni-Heidelberg
Heidelberg, 69126
Universitätsklinikum Jena
Jena
Klinikum Nuernberg
Nuremberg, 90419
Universitatsklinikum Regensburg
Regensburg, 93053
Fachkrankenhaus Kloster Grafschaft
Schmallenberg
Wissenschaftliches Institut Bethanien fur Pneumologie e.V.
Solingen, 42699
France7 sites
CHU Angers, Reanimation Medicale
Angers, 49933
Hopital Louis-Mourier
Colombes, 92700
CHU Montpellier
Montpellier
Centre Hospitalier Universitaire de Nice (CHU Nice)
Nice, 06001
Hopital Europeen Georges-Pompidou
Paris, 75015
Pitie Salpetriere Hospital
Paris, 75651
Centre Hospitalier Universitaire CHU
Strasbourg, 67000
About this study
A randomized clinical trial to investigate the use of the temporary Diaphragm Pacing Therapy System (DPTS) to rehabilitate the diaphragm in mechanically ventilated patients who have failed at least two weaning attempts. The goal is to strengthen and rehabilitate the diaphragm to liberate the patient more quickly from mechanical ventilation.
Read the detailed description
Mechanical ventilation (MV) is a life saving technology but can also cause damage to the lungs and diaphragm such as ventricular induced diaphragmatic dysfunction (VIDD). Research has shown that after being on mandatory MV and sedated the diaphragm begins to atrophy within as short as 18 hours. The Lungpacer Diaphragm Pacing Therapy System (DPTS) is a temporary therapy that consists of the Lungpacer IntraVenous Electrode Catheter (LIVE Catheter) and the Lungpacer Control Unit system. The LIVE Catheter is a proprietary central venous catheter that incorporates pacing electrodes in strategic areas that align with the left and right phrenic nerves. The LIVE Catheter can also be used for fluid delivery like any other central venous catheter. The randomized clinical trial will investigate the safety, effectiveness and performance of the Lungpacer DPTS. By stimulating the diaphragm through daily therapy sessions, with the intention of exercising and rehabilitating the diaphragm muscle so the patient may be able to be more quickly liberated from MV. The patient population includes those who have been mechanically ventilated for greater than or equal to 96 hours (4days), have failed two or more spontaneous breathing trials (SBT), and were not hypervolemic during the latest spontaneous breathing trial. Patients must have resolution of the initial indication for placement on mechanical ventilation before entering the trial.
- Conditions
- Ventilator Induced Diaphragm Dysfunction
- Being tested
- Diaphragmatic Pacing Therapy DPTS
- Keywords
- Diaphragm atrophy, VIDD, Weaning failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Diaphragmatic Pacing Therapy DPTSDevice
Also called DPTS, LIVE Catheter
Subjects will undergo DPTS 2 times a day until successfully extubated with no reintubation within 48 hours.
| Study group | Role | What they receive |
|---|---|---|
| Diaphragm Pacing Therapy DPTS | Active comparator | Diaphragm Pacing intervention will be conducted 2x a day using the Diaphragmatic Pacing Therapy System (DPTS). The DPTS includes the Lungpacer IntraVenous Electrode Catheter (LIVE Catheter) which is inserted temporarily into the left subclavian vein, the Lungpacer Control Unit (LCU external unit) and an intermediate cable that connects the LCU to the LIVE Catheter. Receives: Device: Diaphragmatic Pacing Therapy DPTS |
| Control Group | No intervention | Standard of care treatment of weaning failure, no intervention is involved in this control group. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion successfully weaned by 30 days for subjects randomized to Treatment (Lungpacer DPTS) as compared to subjects randomized to Control.
"Successfully weaned" is defined as passing the protocol-specific Ventilator Liberation Trial (VLT), or removed from MV, and not reintubated (subjects with an oral or nasal, endotracheal tube) or returned to MV (subjects with a tracheostomy) within 48 hours
Measured: Patients will be allowed to stay in the study for up to 30 (+2 days of follow up for adverse events) days if not removed from mechanical ventilation sooner
Secondary outcomes (7)
Days on mechanical ventilation
Days on mechanical ventilation from randomization to removal from MV associated with successful weaning or Day 30, whichever comes first
Measured: from randomization to 30 days
Changes in diaphragmatic thickening fraction on diaphragm ultrasound
Evaluate difference in changes in diaphragmatic thickening fraction between study allocation groups from randomization to successful weaning or on day 30 whichever comes first;
Measured: to successful weaning or on day 30 which ever comes first.
Changes in MIP
Change in MIP from randomization to last available measure; Change in MIP over time from randomization (baseline).
Measured: to successful weaning, or on day 30, whichever comes first.
Change in MIP
Rate of MIP change per day from randomization (baseline) to last available measure;
Measured: to successful weaning, or on day 30 whichever comes first.
Changes in RSBI
Change in RSBI from randomization (baseline) to last available measure; Change in RSBI over time from randomization (baseline);
Measured: to successful weaning, or on day 30, whichever comes first
Change in RSBI
Rate of RSBI change per day from randomization (baseline) to last available measure;
Measured: to successful weaning, or on day 30, whichever comes first
Mortality
30-day mortality
Measured: on day 30
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Mar 2017
- Study start14 Sep 2017
- Primary completion29 Dec 2019
- Study completion30 Jan 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Ventilator Induced Diaphragm DysfunctionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- 1:1 randomization of treatment and control group
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 110 participants (actual)
Sponsor and investigators
- Lead sponsor
- Lungpacer Medical Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Syntactx
- Responsible party
- Sponsor
- Investigators
- Linda H Clark, BSN, Study director, Vice President of Clinical Affairs, Lungpacer Medical, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03096639
- Sponsor's protocol ID
- P-200
- Acronym
- RESCUE2
- Status last verified
- Nov 2022
- First submitted
- 15 Mar 2017
- Last updated
- 16 Nov 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- Undecided: Only investigators participating in this clinical trial will be able to see final de-identified participant data at the completion of the study and it will be available through the clinical research organization (CRO).
Publications
Evans D, Shure D, Clark L, Criner GJ, Dres M, de Abreu MG, Laghi F, McDonagh D, Petrof B, Nelson T, Similowski T. Temporary transvenous diaphragm pacing vs. standard of care for weaning from mechanical ventilation: study protocol for a randomized trial. Trials. 2019 Jan 17;20(1):60. doi: 10.1186/s13063-018-3171-9.
PubMed 30654837Dres M, de Abreu MG, Merdji H, Muller-Redetzky H, Dellweg D, Randerath WJ, Mortaza S, Jung B, Bruells C, Moerer O, Scharffenberg M, Jaber S, Besset S, Bitter T, Geise A, Heine A, Malfertheiner MV, Kortgen A, Benzaquen J, Nelson T, Uhrig A, Moenig O, Meziani F, Demoule A, Similowski T; RESCUE-2 Study Group Investigators. Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients. Am J Respir Crit Care Med. 2022 May 15;205(10):1169-1178. doi: 10.1164/rccm.202107-1709OC.
PubMed 35108175
Study at a glance
From the registry record, last updated by the sponsor on 16 Nov 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Percutaneous Temporary Placement of a Phrenic Nerve Stimulator for Diaphragm Pacing
- ClinicalTrials.gov ID
- NCT03096639
- Acronym / sponsor ID
- RESCUE2 / P-200
- Conditions
- Ventilator Induced Diaphragm Dysfunction
- Keywords
- Diaphragm atrophy, VIDD, Weaning failure
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 110 participants (actual)
- Lead sponsor
- Lungpacer Medical Inc.Industry (pharma, biotech, devices)
- Collaborators
- Syntactx
- Study start
- 14 Sep 2017 (actual)
- Primary completion
- 29 Dec 2019 (actual)
- Study completion
- 30 Jan 2020 (actual)
- First posted
- 30 Mar 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A randomized clinical trial to investigate the use of the temporary Diaphragm Pacing Therapy System (DPTS) to rehabilitate the diaphragm in mechanically ventilated patients who have failed at least two weaning attempts. The goal is to strengthen and rehabilitate the diaphragm to liberate the patient more quickly from mechanical ventilation.
Detailed description
Mechanical ventilation (MV) is a life saving technology but can also cause damage to the lungs and diaphragm such as ventricular induced diaphragmatic dysfunction (VIDD). Research has shown that after being on mandatory MV and sedated the diaphragm begins to atrophy within as short as 18 hours. The Lungpacer Diaphragm Pacing Therapy System (DPTS) is a temporary therapy that consists of the Lungpacer IntraVenous Electrode Catheter (LIVE Catheter) and the Lungpacer Control Unit system. The LIVE Catheter is a proprietary central venous catheter that incorporates pacing electrodes in strategic areas that align with the left and right phrenic nerves. The LIVE Catheter can also be used for fluid delivery like any other central venous catheter. The randomized clinical trial will investigate the safety, effectiveness and performance of the Lungpacer DPTS. By stimulating the diaphragm through daily therapy sessions, with the intention of exercising and rehabilitating the diaphragm muscle so the patient may be able to be more quickly liberated from MV. The patient population includes those who have been mechanically ventilated for greater than or equal to 96 hours (4days), have failed two or more spontaneous breathing trials (SBT), and were not hypervolemic during the latest spontaneous breathing trial. Patients must have resolution of the initial indication for placement on mechanical ventilation before entering the trial.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- 1:1 randomization of treatment and control group
| Arm | Type | Receives |
|---|---|---|
| Diaphragm Pacing Therapy DPTS | Active comparator | Device: Diaphragmatic Pacing Therapy DPTSDiaphragm Pacing intervention will be conducted 2x a day using the Diaphragmatic Pacing Therapy System (DPTS). The DPTS includes the Lungpacer IntraVenous Electrode Catheter (LIVE Catheter) which is inserted temporarily into the left subclavian vein, the Lungpacer Control Unit (LCU external unit) and an intermediate cable that connects the LCU to the LIVE Catheter. |
| Control Group | No intervention | –Standard of care treatment of weaning failure, no intervention is involved in this control group. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- 18 years of age or older
- have been mechanically ventilated for > or = to 96 hours (4 days), and
- have satisfied the Readiness-to-Wean criteria and
- have failed at least two VLTs, one of which is the study specific VLT.
Key exclusion criteria (16 listed)
- currently on extracorporeal membrane oxygenation (ECMO);
- weaning failure due to hypervolemia;
- medical history or known anatomy that prevents insertion of the LIVE Catheter into the left subclavian vein;
- currently being treated with neuromuscular blockade;
- clinically overt congestive heart failure that is preventing weaning;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Diaphragmatic Pacing Therapy DPTSAlso: DPTS, LIVE CatheterSubjects will undergo DPTS 2 times a day until successfully extubated with no reintubation within 48 hours. | Device | Diaphragm Pacing Therapy DPTS |
Primary outcome
Proportion successfully weaned by 30 days for subjects randomized to Treatment (Lungpacer DPTS) as compared to subjects randomized to Control.
Time frame: Patients will be allowed to stay in the study for up to 30 (+2 days of follow up for adverse events) days if not removed from mechanical ventilation sooner
"Successfully weaned" is defined as passing the protocol-specific Ventilator Liberation Trial (VLT), or removed from MV, and not reintubated (subjects with an oral or nasal, endotracheal tube) or returned to MV (subjects with a tracheostomy) within 48 hours
7 secondary outcomes
Days on mechanical ventilation
Time frame: from randomization to 30 days
Changes in diaphragmatic thickening fraction on diaphragm ultrasound
Time frame: to successful weaning or on day 30 which ever comes first.
Changes in MIP
Time frame: to successful weaning, or on day 30, whichever comes first.
Change in MIP
Time frame: to successful weaning, or on day 30 whichever comes first.
Changes in RSBI
Time frame: to successful weaning, or on day 30, whichever comes first
Change in RSBI
Time frame: to successful weaning, or on day 30, whichever comes first
Mortality
Time frame: on day 30
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Nov 2022.
- Background: PubMed 30654837Evans D, Shure D, Clark L, Criner GJ, Dres M, de Abreu MG, Laghi F, McDonagh D, Petrof B, Nelson T, Similowski T. Temporary transvenous diaphragm pacing vs. standard of care for weaning from mechanical ventilation: study protocol for a randomized trial. Trials. 2019 Jan 17;20(1):60. doi: 10.1186/s13063-018-3171-9.
- Results publication: PubMed 35108175Dres M, de Abreu MG, Merdji H, Muller-Redetzky H, Dellweg D, Randerath WJ, Mortaza S, Jung B, Bruells C, Moerer O, Scharffenberg M, Jaber S, Besset S, Bitter T, Geise A, Heine A, Malfertheiner MV, Kortgen A, Benzaquen J, Nelson T, Uhrig A, Moenig O, Meziani F, Demoule A, Similowski T; RESCUE-2 Study Group Investigators. Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients. Am J Respir Crit Care Med. 2022 May 15;205(10):1169-1178. doi: 10.1164/rccm.202107-1709OC.
- Individual participant dataSharing planned: Undecided. Only investigators participating in this clinical trial will be able to see final de-identified participant data at the completion of the study and it will be available through the clinical research organization (CRO).
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Linda H Clark, BSN study director
Vice President of Clinical Affairs, Lungpacer Medical, Inc.
21 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Diaphragmatic Pacing Therapy DPTS in people with Ventilator Induced Diaphragm Dysfunction, run by Lungpacer Medical Inc. at 21 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 21 sites in Germany, France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion successfully weaned by 30 days for subjects randomized to Treatment (Lungpacer DPTS) as compared to subjects randomized to Control. (time frame: Patients will be allowed to stay in the study for up to 30 (+2 days of follow up for adverse events) days if not removed from mechanical ventilation sooner). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03096639, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Nov 2022.