Drainage Of Pleural Effusions in the Intensive Care Unit (DOPE-ICU) - Feasibility Trial

Recruiting now · Not applicable

Conditions studied: Pleural Effusions, Respiratory Failure

In brief

This trial evaluates the feasibility of ultrasound-guided pleural drainage versus no drainage in adult ICU patients with pleural effusions (fluid buildup around the lungs) and respiratory failure. Half of the patients will undergo drainage, while the other half will not unless their condition worsens to a prespecified degree. Outcomes include feasibility measures, clinical parameters, mortality, serious adverse events, and life support use over 90 days.

Key facts

Study ID

NCT06709456

Run by

Olav Schjørring

People needed

88

Starts

2024-12-02

Expected to finish

2025-10-01

Last updated by the study team

2025-04-11

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Acute admission to the ICU.
• Age ≥ 18 years.
• Pleural effusion ≥ 2 cm in either pleural cavity assessed by ultrasonography, computed tomography or magnetic resonance imaging (measured between the parietal and visceral pleura perpendicularly to the chest wall at the largest-separation point).
• Respiratory failure defined as one or more of the following: any oxygen supplementation in an open system, invasive or non-invasive mechanical ventilation (including non-intermittent mask CPAP), or most recent arterial blood gas analysis with arterial partial pressure of carbon dioxide (PaCO2) > 6.0 kPa and pH < 7.35.

You may not qualify if…

• Mediastinal drain or pleural drain in situ on either side.
• Suspected or confirmed haemothorax (e.g., due to recent thoracic trauma or intrathoracic surgery).
• Suspected or confirmed pneumothorax (e.g., by anamnesis, on radiographic or ultrasonographic assessment, or by clinical presentation, e.g., due to presence of subcutaneous emphysema).
• Suspected or confirmed pleural empyema (e.g., by anamnesis or clinical presentation, or on CT, MRI or ultrasonographic assessment).
• Pleural malignancy (suspected or confirmed pleural lymphoma, pleural metastases or direct pleural invasion, or malignant mesothelioma).
• Antithrombotic treatment or coagulation deficiency incompatible with conducting pleural drainage as by local recommendations, and contraindications to reversal of this (clinical assessment).
• Clinically assessed absolute indication for therapeutic pleural drainage and:
• invasive or non-invasive mechanical ventilation or mask CPAP with PaO2/FiO2 ratio ≤ 13.3 kPa in the most recent ABG analysis.
• high-flow humidified oxygen therapy with a flow ≥ 50 L/min and a PaO2/FiO2 ratio ≤ 13.3 kPa in the most recent ABG analysis.
• persistent respiratory acidosis with a pH < 7.25 and a PaCO2 > 6.0 kPa in the most recent ABG analysis in spite of non-invasive ventilation for > 1 hour.
• Withdrawal from active therapy or brain death deemed imminent.
• Expected ICU stay < 24 hours from randomisation.
• Pregnancy (in females < 60 years of age, non-pregnancy must be confirmed by a negative urine or plasma human chorionic gonadotropin, or presence a condition incompatible with pregnancy, e.g., previous hysterectomy, or conducted caesarean section during current hospitalisation).
• Under coercive measures (i.e., ongoing involuntary hospital admission or under correctional authorities' jurisdiction).
• Consent not obtainable as per Danish legislation.
• Previously randomised in the DOPE-ICU feasibility trial.

Where it is running

• Department of Anaesthesia and Intensive Care, Aalborg University Hospital — Aalborg, Denmark (enrolling)
• ICU department 4131, Copenhagen University Hospital, Rigshospitalet — Copenhagen, Denmark (enrolling)
• Department of Anaesthesia and Intensive Care, Nordsjællands Hospital, University of Copenhagen, Hillerød — Hillerød, Denmark (enrolling)
• Department of Anaesthesiology and Intensive Care Medicine, Sygehus Lillebælt, Kolding — Kolding, Denmark (enrolling)
• Department of Anaesthesia and Intensive Care, Zealand University Hospital, Køge — Køge, Denmark
• Department of Anaesthesia and Intensive Care, Zealand University Hospital, Roskilde — Roskilde, Denmark

Full record on ClinicalTrials.gov

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