Active Clearance Technology (ACT) II German Multicenter Trial
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|ClinicalTrials.gov Identifier: NCT02479737|
Recruitment Status : Recruiting
First Posted : June 24, 2015
Last Update Posted : May 2, 2017
Postoperative bleeding is a common consequence after heart surgery which can significantly impact outcomes and costs [Wynne R, Christensen MC, Dixon B]. When bleeding occurs, reliable postoperative blood evacuation of the pleural, mediastinal and pericardial spaces with chest tubes is imperative to facilitate pulmonary re-expansion and mediastinal decompression as the patient recovers. When postoperative blood evacuation is inadequate, retained blood complications can result (herein described as the Retained Blood Complications (RBC). RBC is the presence of post-operative pericardial and/or pleural fluid or blood that is diagnosed and may necessitate drainage in the acute or sub-acute setting. The need for treatment and interventions for these conditions represents an impediment to patient recovery and involves both resource and economic consumption for a heart program and the healthcare system at large.
Clinically, Retained Blood Complications (RBC) can be recognized acutely or subacutely. When it presents acutely, it is usually fresh thrombus around the heart or lungs presenting as tamponade or hemothorax. When it presents subacutely, it results in bloody pleural or pericardial effusions. These effusions are often driven by the breakdown of remaining thrombus. Once RBC occurs, subsequent procedures may be needed to remedy it.
A recent review of the literature indicated that additional procedures for RBC are demonstrated in approximately 15% to 20% of patients after heart surgery. In a prospectively collected United States Nationwide Inpatient Sample (NIS) data from 2010, RBC could be demonstrated in 17% of patients. In this analysis, mortality was doubled from 4% to 8%, length of stay was increased by 5 days, and average costs were 55% higher. Patients with RBC, therefore, represent an increased at risk population for complications and costs.
Postoperative obstruction of conventional chest tubes with blood and other fibrinous material in the setting of postoperative bleeding contributes to RBC. (Shalli) In a recent study of postoperative cardiac surgery patients at the Cleveland Clinic, 36% of patients were found to have evidence of chest tube obstruction . Active Clearance with PleuraFlow has been shown to prevent chest tube clogging, and reduce RBC.
|Condition or disease||Intervention/treatment|
|Heart Surgery||Device: Blood drainage post cardiac surgery using PleuraFlow System|
Complications from RBS are defined as those requiring re-operation or surgical interventions to evacuate blood, blood clot, bloody fluid, and air accumulation within the operative site after closure of the surgical wound. This is a prospective multicenter observational post-market study with a retrospective component. The study is open to up to five (5) German sites enrolling a consecutive cohort of cardiac surgery patients.
There are two conditions for participation in this registry. First, sites are required to enter into the study database anonymized matched historical data elements from a cohort of cardiac surgery patients done over the preceding 12 to 24-month period (Phase 0). These retrospective data elements will be used as baseline information for the purpose of comparative analyses with the prospective data sets. Second, sites that have not been using the PleuraFlow System before enrolling patients to this study are required to participate in a roll-in phase (Phase 1). The purposes of the roll-in phase are to allow the users at participating sites to familiarize themselves with the product use and with ACT, to implement Clinical Use Protocols provided by ClearFlow, Inc. to all commercial users as part of product training, and to demonstrate consistency and compliance with the clinical use protocols.
|Study Type :||Observational [Patient Registry]|
|Estimated Enrollment :||1113 participants|
|Target Follow-Up Duration:||30 Days|
|Official Title:||The Active Clearance Technology (ACT) II German Multicenter Trial|
|Study Start Date :||April 2016|
|Estimated Primary Completion Date :||July 2017|
|Estimated Study Completion Date :||December 2017|
- Percent reduction in the rate of interventions to treat Retained Blood Syndrome (RBS) [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 12 days ]
RBS is a composite endpoint defined as an intervention to treat one or more of the following conditions:
-Re-exploration for bleeding, tamponade or washout of retained bloo
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02479737
|Contact: Theodor Fischlein, Prof.||0049 911 398 ext 5441||mailto:email@example.com|
|Contact: Joachim Sirch, Dr||0049 911 398 ext 5441||mailto:firstname.lastname@example.org|
|Herz- und Gefäßklinik GmbH||Recruiting|
|Bad Neustadt an der Saale, Bavaria, Germany, 97616|
|Contact: Anno Diegeler, Prof. Dr. med. +49 9771 66 ext 2417 Anno.Diegeler@herzchirurgie.de|
|Contact: Monika Back +49 9771 66 ext 5690 Monika.Back@herzchirurgie.de|
|Paracelsus Medical University, Klinikum, Nuremberg, Germany||Recruiting|
|Nuremberg, Bavaria, Germany, 90471|
|Contact: Theodor Fischlein, Prof. 0049 911 398 ext 5441 email@example.com|
|Contact: Joachim Sirch, Dr. 0049 911 398 ext 5441 firstname.lastname@example.org|
|Principal Investigator:||Theodor Fischlein, Prof.||Paracelsus Medical University, Klinikum, Nuremberg, Germany|