FBS-ASaP: Fibrobronchoscopy in ASpiration Pneumonia in the Emergency Department

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorAzienda Ospedaliero-Universitaria Careggi

About this trial

Non-Profit Prospective Observational Pilot Study

The study will have an overall duration of 3 years, with patient enrollment starting after ethical committee approval.

In this study, all patients with a diagnosis of aspiration pneumonia who require aspiration of secretions or ingesta in the Emergency Department will be considered. A registry will be created with the patients\' data, noting the type of procedure performed: laryngotracheal aspiration with a probe or with fibrobronchoscopy.

This observational registry pilot study aims to evaluate the utility and adverse events related to the use of aspiration via videobronchoscopy performed in the Emergency Department and to compare the clinical outcomes of patients undergoing bronchoscopy with those treated only with blind laryngotracheal aspiration using a probe.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Radiological evidence of pneumonia (Chest X-ray/CT scan/Chest ultrasound)

Clinical diagnosis of aspiration pneumonia

Presence of secretions in the upper airways

Respiratory distress in a dysphagic patient

Disqualifiers

Lack of consent

Age < 18 years

Pregnancy

Hemorrhagic diathesis

Trial population

The study will be conducted on patients with a diagnosis of aspiration pneumonia who, based on the judgment of the attending physician, require aspiration of secretions or ingesta in the emergency department using a probe and/or a fiberscope. Enrollment in the study will be determined by the Emergency Department physician in charge of the patient. Estimated number of patients to be enrolled: 100.

Trial design

Design model

Case-control

Time perspective

Prospective

Treatments tested in this trial

  • Laryngotracheal Aspiration Procedure Using a Probe in the Emergency Department

    Procedure/Surgery

    For laryngotracheal aspiration using a blind probe, the patient will be positioned in a seated or semi-seated position; if this is not possible, the aspiration will be performed in a supine position. A soft, sterile catheter connected to the suction apparatus will be inserted into one nostril while keeping the patient\'s head tilted back. When the tip of the catheter reaches the back of the pharynx, the patient will need to breathe to facilitate the insertion and allow the catheter to advance into the larynx and trachea. At this point, using negative suction pressure for a maximum of 3-5 seconds, the secretions will be aspirated. The aspiration will be repeated multiple times in cycles of 3-5 seconds.

  • Aspiration Procedure Using Fibrobronchoscopy in the Emergency Department

    Procedure/Surgery

    Equipment Setup: A sterile bronchoscope will be connected to the suction apparatus. Procedure: The bronchoscope will be gently inserted through the patient\'s nostril or mouth, advancing carefully through the pharynx and larynx into the trachea and bronchi. The physician will visually inspect the airways through the bronchoscope. Using the bronchoscope's suction channel, secretions will be aspirated from the trachea and bronchi. Suctioning will be performed intermittently to avoid hypoxia, with each suctioning cycle lasting no more than 3-5 seconds. The procedure may be repeated as necessary to ensure thorough aspiration of secretions.

Treatment groups

100 Participants
are divided into 2 treatment groups
Group A: Laryngotracheal Aspiration Procedure Using a Probe in the Emergency Department1 intervention
Group B: Aspiration Using Fibrobronchoscopy in the Emergency Department1 intervention

Trial outcomes

Primary outcomes

1

Length of hospital stay in days

Length of hospital stay in days

Time frame
up to 3 months
2

Mortality rate within 30 days from the time of admission to the Emergency Department

Mortality rate within 30 days from the time of admission to the Emergency Department

Time frame
30 days from admission to the ed

Secondary outcomes

1

Respiratory parameters before and after the procedure

(SpO2, FiO2)before and after the procedure

Time frame
on the admission and 30 minutes after the procedure
2

Rate of patient treated with Non invase ventilation and with orotracheal intubation

Oxygen therapy devices before and after the procedure

Time frame
on the admission and 30 minutes after the procedure
3

Rate of admission in Intensive care unit and High dependency unit

Hospitalization setting

Time frame
immediately after the procedure
4

Procedure-related complications

Procedure-related complications

Time frame
perioperatively/periprocedurally

Other outcomes

Sponsors and contacts

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