The Value of Partial Arterial Carbon Dioxide Pressure - End-Tidal Carbon Dioxide Gradient Courses… (NCT07654010) | Clinical Trial Compass
CompletedNot Applicable
The Value of Partial Arterial Carbon Dioxide Pressure - End-Tidal Carbon Dioxide Gradient Courses in Predicting Acute Renal Injury in Critically Ill Patients on Mechanical Ventilation: A Novel Hemodynamic Marker?
End-tidal carbon dioxide (EtCO₂) refers to the level of carbon dioxide in the air exhaled during expiration and is measured using capnography. EtCO₂ is an important monitoring parameter in the management of critically ill patients on mechanical ventilation, providing indirect information about the patient's cardiac output, pulmonary perfusion-ventilation (V/Q) status, and metabolic activity. The Pa-EtCO₂ gradient, the difference between EtCO₂ and arterial CO₂ partial pressure (PaCO₂), changes significantly, especially in cases of hemodynamic deterioration, microcirculatory failure, and increased dead space. Therefore, the gradient is considered a potential indicator of perfusion in critically ill patients. In critically ill patients on mechanical ventilation, the usability of changes (courses) of the Pa-EtCO₂ gradient over time is being evaluated not only as an indicator of ventilation but also as a dynamic and indirect predictor of hemodynamic status and renal perfusion. Therefore, it should be investigated whether the Pa-EtCO2 gradient is a suitable parameter for early detection of AKI (acute kidney injury) development in patients with renal perfusion impairment.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Patients over 18 years of age
* patients under mechanical ventilation
* initiation of EtCO₂ monitoring within the first hour of admission to the ICU
* patients monitored in the ICU for at least 24 hours
* having undergone arterial blood gas analysis (for PaCO₂ measurement) within the first 24 hours.
Exclusion Criteria:
* Patients under 18 years of age
* intensive care unit monitoring shorter than 24 hours
* missing or inaccessible clinical data
* chronic renal failure
* acute renal failure present at admission to intensive care unit
* advanced pulmonary diseases affecting EtCO₂ measurement (e.g., severe obstruction, giant bulla, advanced emphysema)
* patients in whom PaCO₂ measurement cannot be performed
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1This study tracked a measurement called the PaCO₂-EtCO₂ gradient — the difference between carbon dioxide in the blood and carbon dioxide in exhaled breath — at 6, 12, and 24 hours after ICU admission to predict kidney injury. Is my care team already monitoring this measurement for me, and what would it mean if my numbers changed significantly over those time points?
2Since this trial is completed and involved critically ill patients on mechanical ventilation, has the research produced any findings that might change how doctors like you monitor kidney function in ventilated ICU patients, and could those findings be relevant to my situation?
3The study was looking at this CO₂ gradient as a possible early warning sign for acute kidney injury — does my doctor think this marker would add useful information on top of the standard kidney function tests I'm already getting, or would it be redundant given my current monitoring plan?
4Because this was an observational study rather than a treatment trial, it wasn't testing a new therapy — so how would knowing my PaCO₂-EtCO₂ gradient actually change the decisions my care team makes about preventing or treating kidney injury while I'm on the ventilator?
5Given that acute kidney injury in the ICU can develop quickly and have serious consequences, are there steps my care team would take differently or earlier if this gradient measurement suggested my kidneys were at risk?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Change From Baseline in PaCO₂-EtCO₂ Gradient at 6, 12, and 24 Hours After ICU Admission
Timeframe: Baseline, 6 hours, 12 hours, and 24 hours after ICU admission