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Cystic FibrosisMUCOCAPNCT04814797

Use of Capnography for the Follow-up of Cystic Fibrosis Children

An observational study of Cystic Fibrosis, run by Central Hospital, Nancy, France at 2 sites in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The respiratory system involvement in cystic fibrosis(CF) influences the prognosis and course of disease. Respiratory assessment is based on spirometry, but its main parameter, the maximal expiratory volume in the first second (FEV1), does not reflect the initial peripheral impairment of airways. Read more about this study

Who is it for?
Ages 6 to 17 years
Conditions the study is for
Cystic Fibrosis
What is being tested?
Capnography data included in Lung Clearance Index measurement
How many people
76 participants
Where
2 sitesFrance
Study dates
5 May 2021to 31 Dec 2021
Phase
Observational
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 6 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: Children are recruited from subjects diagnosed with cystic fibrosis followed-up at the pediatric reference center of University Children's Hospital of Nancy and Trousseau of Paris (46 children from Nancy and 30 children from Paris). These children are referred by the pneumopediatricians to the Pediatric Pulmonary Function Testing Lab for a complete, annually, routinely follow-up assessment of respiratory function. An analysis of the capnography data included in the Lung Clearance Index measurement, which is part of the routine assessment of the CF child, will be performed. The complete routine yearly PFT in order to ensure the follow-up in CF children is composed of 4 techniques: measurement of lung volumes by plethysmography (1), measurement of lung volumes by helium dilution technique (2); LCI measurement (3); spirometry (4). The outcomes needed for this research are obtained by these techniques.

Who may be able to join

None listed.

Who cannot join

  • other chronic respiratory pathology (bronchopulmonary dysplasia, virosis sequelae, inhalation pathology, thoraco-pulmonary malformation, tracheomalacia);
  • anatomical or functional abnormalities of the pharyngolaryngeal pathway (tonsils hypertrophy grade 3 or 4, laryngomalacia, subglottic stenosis, vocal cord paralysis, any other laryngeal obstacle);
  • congenital or acquired heart disease.

Trial locations and contacts

2 sites in 1 country.

Iulia Ioan, MD PhD contact

+33 3 83 15 47 94

ic.ioan@chru-nancy.fr

France2 sites, 2 recruiting
  • CHRU de NANCY

    Nancy, 54035

    Iulia-Cristina IOAN

    Iulia-Cristina IOAN

    Not yet recruiting
  • Hôpital ARMAND TROUSSEAU

    Paris, 75571

    Nicole BEYDON

    Nicole BEYDON

    Recruiting

Other trials in France

About this study

Official title: The Study of Capnography for the Follow-up of Cystic Fibrosis Children With or Without Gas Trapping

The respiratory system involvement in cystic fibrosis(CF) influences the prognosis and course of disease. Respiratory assessment is based on spirometry, but its main parameter, the maximal expiratory volume in the first second (FEV1), does not reflect the initial peripheral impairment of airways. Another pulmonary function test (PFT) validated for CF children follow-up is measurement of "gas trapping", reflecting ventilation inhomogeneity and incipient airways impairment. "Gas trapping" can be obtained by lung volume measurement (functional residual capacity, FRC) by plethysmography and helium dilution technique, but these tests are inconvenient for children due to their long length (~30min). A complete PFT is routinely performed once a year. It also includes a measurement of Lung Clearance Index (LCI) reflecting ventilation inhomogeneity. Capnography is a non-invasive PFT technique, does not require subject's active cooperation, is of short duration and could replace the traditional PFT for CF children follow-up. The capnograph is integrated into the device measuring LCI and data can be retrieved and analyzed afterwards. Capnographic indices reflect ventilation inhomogeneity.

The hypothesis is that capnographic indices change in the presence/absence of "gas trapping" in CF children.

Read more

The main objective is to show that the capnographic index of efficacy (EFFi) is significantly different between CF children "with gas trapping" and CF children "without gas trapping". The secondary objectives are:

  • to compare the other capnographic indices between CF children "with gas trapping" and CF children "without gas trapping": the slope of the ascending phase, α; the slope of the alveolar plateau, β; the angle Q between α and β; the positive peak of the first-order derivative, F'CO2, which reflects the ascending phase; the first negative peak of the 2nd order derivative, F "CO2, which reflects the curvature between the ascending phase and the alveolar plateau.
  • to compare the results of the capnographic indices with the results of the FEV1 in identifying the presence / absence of "gas trapping";
  • to compare the results of the capnographic indices with the results of the LCI in identifying the presence / absence of "gas trapping"
Read the detailed description

Cystic fibrosis (CF) is the most common inherited genetic disorder in Caucasian children. It affects several organs, the most important being the involvement of the respiratory system. The respiratory condition influences the prognosis and the course of the disease, the respiratory complications being the main cause of mortality and morbidity. The respiratory assessment is based on spirometry, but the maximal expiratory volume in the first second (FEV1) does not reflect the initial peripheral impairment of airways and can remain within normal limits for a long time. Another pulmonary function test (PFT) validated for the follow-up of CF children is the measurement of "gas trapping", very frequent in these children, reflecting the ventilation inhomogeneity and incipient airways impairment. "Gas trapping" can be obtained by the measurement of lung volume (functional residual capacity, FRC) by plethysmography and helium dilution technique, but these tests are very inconvenient for children due to their long length (~ 30 minutes). This complete PFT is routinely performed every year. It also includes a measurement of Lung Clearance Index (LCI) which reflects the presence of ventilation inhomogeneity. Capnography is a non-invasive PFT technique that does not require subject's active cooperation, is of short duration and could replace the traditional PFT techniques for the follow-up of CF children. Capnographic indices also reflect the presence of ventilation inhomogeneity. The capnograph is integrated into the device that measures the LCI and data can be retrieved and analyzed following the LCI measurement.

In this study, 2 groups of children will be identified by the gold-standard: 1 / children with "gas trapping" (defined by the ratio between the difference in the plethysmographic FRC (FRCpleth) and FRC obtained by the helium dilution technique (FRCHe) divided by FRCpleth of >10%) and 2 / children without "gas trapping" (defined by (FRCpleth-FRCHe) / FRCpleth of ≤ <10%). Capnography data (included in LCI measurement) will be collected in these children and capnographic indices will be compared between these two groups.

The study hypothesis is that capnographic indices change in the presence or absence of "gas trapping" in CF children.

The importance of capnography is that is a test less inconvenient for follow-up and better accepted by children because of its short length, easy-to-use tool for monitoring disease progression and monitoring the effectiveness of treatments.

The main objective is to show that the capnographic index of efficacy (EFFi), in CF children is significantly different between subjects "with gas trapping" (defined by the gold standard ((FRCpleth - FRCHe) / FRCpleth) > 10%) and subjects "without gas trapping" (defined by the gold standard ((FRCpleth-FRCHe) / FRCpleth) ≤10%).

The secondary objectives are:

  • to compare the other capnographic indices between CF children "with gas trapping" and CF children "without gas trapping": the slope of the ascending phase, α; the slope of the alveolar plateau, β; the angle Q between α and β; the positive peak of the first-order derivative, F'CO2, which reflects the ascending phase; the first negative peak of the 2nd order derivative, F"CO2, which reflects the curvature between the ascending phase and the alveolar plateau.
  • to compare the results of the capnographic indices with the results of the FEV1 in identifying the presence / absence of "gas trapping";
  • to compare the results of the capnographic indices with the results of the LCI in identifying the presence / absence of "gas trapping",
Conditions
Cystic Fibrosis
Being tested
Capnography data included in Lung Clearance Index measurement
Keywords
Pulmonary function testing
Medical subject headings
Cystic Fibrosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Capnography data included in Lung Clearance Index measurementOther

    Capnography data included in Lung Clearance Index measurement (a pulmonary function test included in routinely yearly follow-up of cystic fibrosis children) will be collected and analyzed

Study groups in NCT04814797
Study groupRoleWhat they receive
CF children "with gas trapping"CF children "with gas trapping" will be defined by a ratio between the difference of functional residual capacity (FRC) obtained by plethysmography (FRCpleth) and FRC obtained by helium dilution method (FRCHe) divided by the FRCpleth of >10%
Receives: Other: Capnography data included in Lung Clearance Index measurement
CF children "without gas trapping"CF children "without gas trapping" will be defined by a ratio between the difference of the functional residual capacity (FRC) obtained by plethysmography (FRCpleth) and FRC obtained by helium dilution method (FRCHe) divided by the FRCpleth of ≤10%
Receives: Other: Capnography data included in Lung Clearance Index measurement

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Efficiency index (EFFi) Gold standard (CRFpleth - CRFHe) / CRFpleth to differentiate between subjects "with" gas trapping (defined by> 10%) and subjects "without" gas trapping (defined by ≤10%).

    Value of the capnographic efficiency index (EFFi), for each of the children of the two groups studied . easurement included in the device that measures LCI, collected after LCI measurement

    Measured: through study completion, an average of 6 months

Secondary outcomes (3)
  1. Other capnographic indices

    Value of capnographic indices for each of the children of the two groups studied ; Data collected after PFT

    Measured: through study completion, an average of 6 months

  2. Forced expiratory volume in the first second (FEV1)

    The value of FEV1 obtained by spirometry for each of the children of the two groups studied

    Measured: through study completion, an average of 6 months

  3. Lung Clearance Index (LCI)

    Value of Lung Clearance Index for each of the children of the two groups studied

    Measured: through study completion, an average of 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Mar 2021
  2. Study start5 May 2021
  3. Primary completion30 Oct 2021 (estimated)
  4. Study completion31 Dec 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
76 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04814797
Sponsor's protocol ID
2020PI150
Acronym
MUCOCAP
Status last verified
Jul 2021
First submitted
18 Mar 2021
Last updated
30 Jul 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Robinson PD, Latzin P, Ramsey KA, Stanojevic S, Aurora P, Davis SD, Gappa M, Hall GL, Horsley A, Jensen R, Lum S, Milla C, Nielsen KG, Pittman JE, Rosenfeld M, Singer F, Subbarao P, Gustafsson PM, Ratjen F; ATS Assembly on Pediatrics. Preschool Multiple-Breath Washout Testing. An Official American Thoracic Society Technical Statement. Am J Respir Crit Care Med. 2018 Mar 1;197(5):e1-e19. doi: 10.1164/rccm.201801-0074ST.

    PubMed 29493315
  • BEDELL GN, MARSHALL R, DUBOIS AB, COMROE JH. Plethysmographic determination of the volume of gas trapped in the lungs. J Clin Invest. 1956 Jun;35(6):664-70. doi: 10.1172/JCI103323. No abstract available.

    PubMed 13319505
  • Kraemer R, Schoni MH. Ventilatory inequalities, pulmonary function and blood oxygenation in advanced states of cystic fibrosis. Respiration. 1990;57(5):318-24. doi: 10.1159/000195864.

    PubMed 2284509
  • O'Donnell CR, Bankier AA, Stiebellehner L, Reilly JJ, Brown R, Loring SH. Comparison of plethysmographic and helium dilution lung volumes: which is best for COPD? Chest. 2010 May;137(5):1108-15. doi: 10.1378/chest.09-1504. Epub 2009 Dec 18.

    PubMed 20022972
  • Jarenback L, Tufvesson E, Ankerst J, Bjermer L, Jonson B. The Efficiency Index (EFFi), based on volumetric capnography, may allow for simple diagnosis and grading of COPD. Int J Chron Obstruct Pulmon Dis. 2018 Jun 27;13:2033-2039. doi: 10.2147/COPD.S161345. eCollection 2018.

    PubMed 29988757
  • Ioan I, Demoulin B, Duvivier C, Leblanc AL, Bonabel C, Marchal F, Schweitzer C, Varechova S. Frequency dependence of capnography in anesthetized rabbits. Respir Physiol Neurobiol. 2014 Jan 1;190:14-9. doi: 10.1016/j.resp.2013.09.002. Epub 2013 Sep 12.

    PubMed 24035836
  • Gustafsson PM, Aurora P, Lindblad A. Evaluation of ventilation maldistribution as an early indicator of lung disease in children with cystic fibrosis. Eur Respir J. 2003 Dec;22(6):972-9. doi: 10.1183/09031936.03.00049502.

    PubMed 14680088
  • You B, Peslin R, Duvivier C, Vu VD, Grilliat JP. Expiratory capnography in asthma: evaluation of various shape indices. Eur Respir J. 1994 Feb;7(2):318-23. doi: 10.1183/09031936.94.07020318.

    PubMed 8162985

Questions about this trial

What is this clinical trial studying?

An observational study of Cystic Fibrosis, run by Central Hospital, Nancy, France at 2 sites in France.

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 0 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 30 Jul 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Iulia Ioan, MD PhD (+33 3 83 15 47 94, ic.ioan@chru-nancy.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficiency index (EFFi) Gold standard (CRFpleth - CRFHe) / CRFpleth to differentiate between subjects "with" gas trapping (defined by> 10%) and subjects "without" gas trapping (defined by ≤10%). (time frame: through study completion, an average of 6 months). 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 NCT04814797, which also lists 8 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 30 Jul 2021.

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