Menu
Recruiting NCT07154589

Effects of AbClo Fascial Approximation Device in Patients With Open Abdomen on Respiratory Mechanics

— Observational Open Abdomen Mechanical Ventilation

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
This is an observational study: the protocol does not assign a study treatment.
Who it may be relevant to
Registry conditions: Open Abdomen, Mechanical Ventilation. Basic parameters: from 18 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Canada
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

Effects of AbClo Fascial Approximation Device in Patients With Open Abdomen on Respiratory Mechanics (AbClo-Resp)

Overview

Patients who underwent an abdominal surgery and had the abdomen remain open are called to have an "open abdomen". To limit the risk of further widening of their wounds, surgeons can use AbClo, which is a non-invasive abdominal binding device, to keep the abdominal wall together (i.e., approximate the fascia). However, as the device also compresses on the abdomen and adjacent lungs, this study aims: * To assess whether the abdominal binding device causes changes in the pressure compressing the lungs, the lung volume, and the function of the lungs. * To assess whether adjusting the breathing machine can mitigate such negative changes. Participants will already be on the abdominal binding device when joining the study. Measurements on various aspects of the lung function (including its physical properties and capability to oxygenate the blood) will be done before and after adjustment of the abdominal binding device to the pressure (measured in the device itself) recommended by the manufacturer, as well as after the surgery to close the abdomen.

Primary outcome measures

  • Changes in End-expiratory Transpulmonary Pressure [Time frame: On the day of enrolment and on the day of surgery to close the abdomen]
Secondary outcome measures (3)
  • Changes in Lung Volume [Time frame: On the day of enrolment]
  • Changes in oxygenation function [Time frame: On the day of enrolment and on the day of surgery to close the abdomen]
  • Response in End-expiratory Transpulmonary Pressure to PEEP Increase [Time frame: On the day of enrolment]

Eligibility criteria

Inclusion criteria

  • Adult patients aged 18 years or older
  • Patients admitted to an ICU
  • Patients with postoperative abdominal surgery with open abdomen
  • Patients treated with AbClo device
  • Patients intubated and mechanically ventilated
  • Patients treated with intravenous sedation with a sedation-agitation scale score of 1-3

Exclusion criteria

  • Transient criteria: Patients with severe hemodynamic instability, defined systolic blood pressure less than 75 mmHg or mean arterial pressure less than 60 mmHg despite vasopressor use
  • Transient criteria: Patients with severe bleeding diathesis, defined as the latest platelet count less than 20 · 109/L, or the latest INR higher than 2.0
  • Patients with concurrent injuries to upper gastrointestinal tract that would preclude esophageal balloon insertion
  • Patients with bronchopleural fistula
  • Patients with measured and uncontrolled increased intracranial pressure

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Cohort

Study locations

Canada · 1 center
  • St. Michael's Hospital — Toronto

Publications

  • Wauters J, Wilmer A, Valenza F. Abdomino-thoracic transmission during ACS: facts and figures. Acta Clin Belg. 2007;62 Suppl 1:200-5. PMID 17469720
  • Regli A, Pelosi P, Malbrain MLNG. Ventilation in patients with intra-abdominal hypertension: what every critical care physician needs to know. Ann Intensive Care. 2019 Apr 25;9(1):52. doi: 10.1186/s13613-019-0522-y. PMID 31025221
  • Beitler JR, Sarge T, Banner-Goodspeed VM, Gong MN, Cook D, Novack V, Loring SH, Talmor D; EPVent-2 Study Group. Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure-Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial. JAMA. 2 PMID 30776290
  • Yoshida T, Amato MBP, Grieco DL, Chen L, Lima CAS, Roldan R, Morais CCA, Gomes S, Costa ELV, Cardoso PFG, Charbonney E, Richard JM, Brochard L, Kavanagh BP. Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury. Am J Respir Crit Care Med. 2018 Apr 15;197(8):1018-1026. doi: 10.1164/rccm.201709-1806OC. PMID 29323931
  • Naveed A, Martin ND, Bawazeer M, Jastaniah A, Rezende-Neto JB. Early placement of a non-invasive, pressure-regulated, fascial reapproximation device improves reduction of the fascial gap in open abdomens: a retrospective cohort study. Trauma Surg Acute Care Open. 2024 Oct 12;9(1):e001529. doi: 10.1136/tsaco-2024-001529. eCollection 2024. PMID 39411009
  • Rezende-Neto JB, Camilotti BG. New non-invasive device to promote primary closure of the fascia and prevent loss of domain in the open abdomen: a pilot study. Trauma Surg Acute Care Open. 2020 Nov 11;5(1):e000523. doi: 10.1136/tsaco-2020-000523. eCollection 2020. PMID 33225070
  • Diaz JJ Jr, Cullinane DC, Dutton WD, Jerome R, Bagdonas R, Bilaniuk JW, Collier BR, Como JJ, Cumming J, Griffen M, Gunter OL, Kirby J, Lottenburg L, Mowery N, Riordan WP Jr, Martin N, Platz J, Stassen N, Winston ES. The management of the open abdomen in trauma and emergency general surgery: part 1-damage control. J Trauma. 2010 Jun;68(6):1425-38. doi: 10.1097/TA.0b013e3181da0da5. PMID 20539186
  • Roberts DJ, Leppaniemi A, Tolonen M, Mentula P, Bjorck M, Kirkpatrick AW, Sugrue M, Pereira BM, Petersson U, Coccolini F, Latifi R. The open abdomen in trauma, acute care, and vascular and endovascular surgery: comprehensive, expert, narrative review. BJS Open. 2023 Sep 5;7(5):zrad084. doi: 10.1093/bjsopen/zrad084. PMID 37882630

Identifiers

NCT: NCT07154589 · 25-034

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗