Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

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Lung Neoplasms

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Respiratory Tract Diseases

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Signs and Symptoms, Respiratory

Hemoptysis

Disease Attributes

Bacterial Infections

Gram-Positive Bacterial Infections

Bacterial Infections and Mycoses

Pathological Conditions, Anatomical

Thrombosis

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Lung Diseases, Obstructive

Congenital Abnormalities

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Cardiovascular Abnormalities

Vascular Fistula

Patients over 18 years of age presenting with hemoptysis at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) between the periods of 2005 to 2010.

Brian Grondin-Beaudoin, MD

Matthieu Poirier, MD

Amelie Blanchard, MD

Brian Grodin-Beaudoin, MD

The study consist of a retrospective analysis of the etiologies, investigations and outcomes of patients presenting between 2005 to 2010 with hemoptysis in a North-American Tertiary center.

RATIONALE:

Hemoptysis, mild or massive, is worrisome for both patients and physicians. The management is different depending on the causes, which are not well defined for the North American population. Despite the fact that this symptom is commonly reported in clinic, there are only a few studies published on this subject in the North-American population. Tuberculosis was a frequent cause of hemoptysis described in populations overseas, which seems less prevalent in the investigators center.

Also, there are no known official guidelines regarding the investigation and management of hemoptysis. The investigators hypothesized that the use of modern technology in a North American population may result in different findings and provide a more accurate diagnostic approach.

Therefore, the study compares the different etiologies of hemoptysis and investigation modalities used in patients presenting in a North-American tertiary center.

METHOD:

The investigators did a retrospective analysis of medical chart from patients with hemoptysis who visited the investigators center between 2005 and 2010. Each visit has been reviewed individually to describe the characteristics of patients, etiologies of hemoptysis and investigation modalities used. All-cause mortality at 2 years was also recorded.

Descriptive statistical analyses will conducted on the data available.

Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis

Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis in a North-American Tertiary Center at the Beginning of the 21st Century

Defining the prevalence of pulmonary diseases by measuring the percentage of patients presenting with hemoptysis caused by lung cancer, bronchiectasis, pulmonary embolism, arteriovenous fistula, pneumonia, bronchitis, tuberculosis, mycosis, heart failure, pseudohemoptysis, cryptogenic and other causes.

Determining the sensitivity in obtaining the etiology of the hemoptysis episode of each diagnostic modality that follows : chest X-ray, chest CT-scan and CT-angiography, bronchoscopy, ventilation-perfusion with single-photon emission computed tomography and pulmonary angiography in the diagnosis of different etiologies of hemoptysis.

All-cause mortality at 2 years after the diagnosis of hemoptysis.

Determining the percentage of patients who : never smoked, is an active smoker, former smoker or unknown status.

Determining the average age of the enrolled patients.

Determining the percentage of each gender of the enrolled patients.

Determining the median of the international normalized ratio (INR).

Determining the median of the partial thromboplastin time (PTT).

Determining the average of the platelet count measured per microliter of blood.

Université de Sherbrooke

Medical Doctor

Immune System Diseases

Blood and Lymph Conditions

Rare Diseases

Heart Failure

Respiratory Aspiration

Asthma

Anemia

Post-Acute COVID-19 Syndrome

Lung Diseases, Interstitial

Respiration Disorders

Syndrome

COVID-19

Pneumonia, Viral

Virus Diseases

Coronavirus Infections

Coronaviridae Infections

Nidovirales Infections

RNA Virus Infections

Post-Infectious Disorders

Chronic Disease

Heart Diseases

Acute Graft Versus Host Disease

Chronic Graft Versus Host Disease

245 participants - GOLD 1, 2, 3 / A, B, C

55 participants - Mild to moderate, not labelled as severe.

55 participants - with at least 50% of participants recruited having no history of chronic cardiorespiratory conditions

55 participants - Acquired or genetic, e.g. cystic fibrosis or other primary ciliary dyskinesias

55 participants - including rare types e.g. mesothelioma

55 participants - including pulmonary fibrosis pneumoconiosis, asbestosis, sarcoidosis, amyloidosis

55 participants - with no previous or current chronic cardiorespiratory diagnoses

Participants are to use the 'N-Tidal C' handset every day for 14 days. This will ideally be two times a day (once in the morning and once in the evening, before using any regular inhalers). Each breath record requires the participant to breathe through the mouthpiece for 75 seconds in a relaxed manner.

N-Tidal C handset

Zishan Ali, MBBS BSc

Elango Vijaykumar, MBBS, FRCG

This study uses a new breathing device called 'N-Tidal C' handset which measures breathing patterns. Investigators have found that people with cardiac and respiratory illnesses breathe out a gas, called carbon dioxide (CO2), in a different way to healthy people. The pattern of breathed out CO2 (the waveform) varies according to the underlying health of the user's lungs. Monitoring these changes may help doctors to more accurately diagnose and monitor the most common and serious respiratory conditions.

Chronic Obstructive Pulmonary Disease (COPD) is among the most prevalent respiratory conditions, and in the top five causes of death worldwide. However, mis-diagnosis rates are high (both under- and over- diagnosis), owing to the lack of a simple, reliable and specific diagnostic test. In addition, COPD is often diagnosed late in the natural history of the disease, which misses the opportunity for early intervention, with early treatment and health-behaviour changes (smoking cessation).

Spirometry, the current gold standard for diagnosis, is unreliable (technique-dependent), crude (measures airflow), and non-specific (multiple respiratory conditions can produce similar patterns on spirometry). It also relies on proper administration by specially trained members of staff. As a result, spirometry is often (a) not performed before a speculative diagnosis of COPD is made, and (b) performed poorly, resulting in poor-quality information on which to base a respiratory diagnosis.

There is therefore a need for a simple, reliable, robust and accurate test for diagnosing COPD which is non-operator dependent, and non-technique dependent.

Currently, capnography is invasive, expensive and can only be recorded in specialist centres via a nasal cannula and micro-stream sampling of expired carbon dioxide in the intensive care setting. The N-Tidal C (NTC) handset, a new (CE-marked), hand-held, wireless device has been developed to monitor the user's Tidal Breathing CO2 (TBCO2) waveforms at rest, during normal tidal breathing. This device can be safely operated in the home environment, has a battery life of weeks, and has an isolated, disposable, breath pathway that isolates an individual's breath from the rest of the device, making it safe to reuse between patients after the outer casing has been decontaminated using a 3-stage disinfection process.

The N-Tidal technology has the potential to offer new insights into lung physiology (above and beyond those currently available from spirometry and lung function testing), and early evidence from TidalSense's previous clinical studies suggests that the TBCO2 data could be used to fingerprint and diagnose COPD.

Cardiorespiratory Diagnostic Study

A Longitudinal Observational Study to Investigate the Patterns of Change in the Tidal Breathing CO2 Waveform, Measured Using the N-Tidal C Handset, in Patients With COPD Compared to Patients With Other Common Cardiorespiratory Conditions

Tidal Breathing CO2 waveform data from 245 participants collected using the N-Tidal C Handset.

Each participant delivering 2 x breath records per day for 14 days = 6860 records

Tidal Breathing CO2 waveform data from 55 participants collected using the N-Tidal C Handset.

Each participant delivering 2 x breath records per day for 14 days = 1540 records

Innovate UK

National Institute for Health Research, United Kingdom

TidalSense

Wounds and Injuries

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Hypertension

Pulmonary Disease, Chronic Obstructive

Respiratory Distress Syndrome

Respiratory Distress Syndrome, Newborn

Fibrosis

Pulmonary Fibrosis

Acute Lung Injury

Pulmonary Arterial Hypertension

Hypertension, Pulmonary

Lymphangioleiomyomatosis

Lung Injury

Familial Primary Pulmonary Hypertension

Premature Birth

Infant, Premature, Diseases

Infant, Newborn, Diseases

Lymphangiomyoma

Neoplasms by Histologic Type

Perivascular Epithelioid Cell Neoplasms

Neoplasms, Connective and Soft Tissue

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Respiratory Distress Syndrome, Infant

Acute Respiratory Distress Syndrome

Veno-veno-arterial ECMO

ECMO(Extracorporeal membrane oxygenation) is being essential for cardiopulmonary failure patients. There are two types of ECMO, which is veno-veno (V-V) that can be used in respiratory failure patients and veno-arterial (V-A) that can be used in cardiac failure patients. V-A ECMO can also be used during lung transplantation, substitution of cardiopulmonary bypass, which can show sufficient performance during operation and better postoperative outcome. However, regarding V-A ECMO circulating from femoral vein to femoral artery, there is a pro blem of differential hypoxia which might influence coronary artery and head vessels. In this prospective study, the investigators are planning to put another ECMO catheter into internal jugular vein which takes a role of left to right shunt, to mitigate the hypoxia of coronary artery.

The Effect of Lt to Rt Shunt Using Veno-veno-arterial Extracorporeal Membrane Oxygenation (ECMO) on Coronary Oxygenation in Lung Transplantation Patients

Yonsei University

Nervous System Diseases

Digestive System Diseases

Ear, Nose, and Throat Diseases

Occupational Diseases

Behaviors and Mental Disorders

Hypersensitivity

Apnea

Sleep Apnea Syndromes

Sleep Apnea, Obstructive

Pulmonary Emphysema

Emphysema

Cystic Fibrosis

Mesothelioma

Mesothelioma, Malignant

Rhinitis, Allergic, Seasonal

Asbestosis

Parasomnias

Sleep Disorders, Intrinsic

Dyssomnias

Sleep Wake Disorders

Pancreatic Diseases

Gastrointestinal Diseases

Genetic Diseases, Inborn

Adenoma

Neoplasms, Glandular and Epithelial

Neoplasms, Mesothelial

Pneumoconiosis

Malignant Mesothelioma

Coal Worker's Pneumoconiosis

Central Nervous System Depressants

All Drugs and Chemicals

Xenon

Participants will inhale investigational gases (HP 3He, HP 129Xe, PFP and SF6) according to the procedure for that intervention. All participants can potentially inhale all the gases. Magnetic resonance imaging will be performed during breath-holds or continuous breathing (gas-dependent) with the appropriate investigational human lung coil (3He Human Lung Coil, 129Xe Small and Large Human Lung Coil, or PFP and SF6 Human Lung Coil), using the 3T Research MRI at the Thunder Bay Regional Health Sciences Centre.

3He will be hyperpolarized using a custom-built polarizer to enhance its MRI signal. Hyperpolarization does not change the chemical or physical properties of helium gas.

HP 3He

129Xe will be hyperpolarized using a Xemed polarizer to enhance its MRI signal. Hyperpolarization does not change the chemical or physical properties of xenon gas.

HP 129Xe

Perfluoropropane (PFP) will be premixed and delivered to the participants with no further processing.

Sulfur hexafluoride (SF6) will be premixed and delivered to the participant with no further processing.

The investigational 129Xe small and large quadrature lung coils are sensitive to 129Xe resonant frequencies and therefore will be paired with the investigational drug 129Xe. The size of the coil used will depend on the participants' body size.

129Xe Small and Large Human Lung Coil

The investigational 3He quadrature lung coil is sensitive to 3He resonant frequencies and therefore will be paired with the investigational drug 3He.

3He Human Lung Coil

The investigational PFP and SF6 quadrature lung coil is sensitive to inert fluorinated gas resonant frequencies and therefore will be paired with both PFP and SF6.

PFP and SF6 Human Lung Coil

Mitchell S Albert, PhD

Yurii Shepelytskyi, MSc

Birubi Biman, MD

Karl Granberg, MD

Yurii Shepelytskyi, PhD

The goal of this research is to optimize the MRI system to obtain ideal lung images using Hyperpolarized (HP) Noble and Inert Fluorinated Gases as contrast agents. Lung coils tuned to the frequencies of these gases will be used. This study will take place at TBRHSC in the Cardiorespiratory Department and in the Research MRI facility.

MR images of the lung obtained using HP 3He, HP 129Xe, and inert fluorinated gases essentially show the distribution of the inhaled gas inside the lungs. Measurements can be performed on these images to provide additional information that can be related to pulmonary function.

Participation will involve at least two study visits. During the first visit, participants will provide written, informed consent, and undergo eligibility screening. Study drug administration, use of the investigational devices, and MR imaging for this study will be performed at the 3T Research MRI at the Thunder Bay Regional Health Sciences Centre (TBRHSC). Pulmonary Function Tests (PFTs) will be performed at TBRHSC by a Registered Respiratory Therapist (RRT) and an MR Tech will be present for the duration of participant scans.

Participants will be placed in the MRI with the appropriate chest coil wrapped around them like a vest. Several inhalation procedures will be carried out during scanning. Participants safety will be closely monitored throughout the entire study.

Developing Optimal Parameters for Hyperpolarized Noble Gas and Inert Fluorinated Gas MRI of Lung Disorders

Developing Optimal Parameters for Hyperpolarized Noble Gas (3He and 129Xe) and Inert Fluorinated Gas Magnetic Resonance Imaging of Lung Disorders

The primary objective of this study is to determine an optimized set of scan parameters that will produce clear, anatomically and clinically relevant images of the lungs for healthy participants and various types of lung disorder participants, and using one or more gas type (3He, 129Xe, PFP, SF6).

The secondary objective of this study is to correlate the results with PFTs, including spirometry and plethysmography.

Thunder Bay Regional Health Sciences Centre

St. Joseph's Care Group

Lakehead University

Thunder Bay Regional Health Research Institute

Chest X-ray

computed tomography of the chest

In patients with haemoptysis bronchoscopy will be performed with flexible bronchoscope. A systemic research of bleeding site and causes will be done. Microbiological or pathological sampling will be executed if clinically required. In selected patients, bronchoscopy might be performed with the rigid instrument or the flexible bronchoscope in intubated patients.

Bronchoscopy

Michele Mondoni, MD

Paolo Carlucci, MD

Stefano Centanni, MD, PhD

Haemoptysis is the coughing up of blood originating from the respiratory tract. It is a common and worrying clinical symptom which can be due to different aetiologies including lung cancer, tuberculosis, COPD, bronchiectasis, pneumonia, acute bronchitis or unknown origin (cryptogenic haemoptysis). Epidemiology and optimal diagnostic approach are largely unclear. Aims of this study are to define current epidemiology and to provide the best diagnostic approach by providing a diagnostic algorithm.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis	NCT02913365	Hemoptysis Haemoptysis Lung Disease Pneumonia Tuberculosis Bronchiectasis Respiratory Tra... Respiratory Tra... Bronchitis Mycobacterium I... Bronchial Disea... Pulmonary Hemor... Signs and Sympt... Signs and Sympt... Pathologic Proc... Mycosis Hemorrhage Lung Cancer Pulmonary Embol... Arteriovenous F...		18 Years -	Université de Sherbrooke
Cardiorespiratory Diagnostic Study	NCT04939558	COPD Asthma Lung Cancer Anemia Congestive Card... Bronchiectasis Interstitial Lu... Long COVID Upper Respirato... Healthy	N-Tidal C hands...	18 Years -	TidalSense
The Effect of Lt to Rt Shunt Using Veno-veno-arterial Extracorporeal Membrane Oxygenation (ECMO) on Coronary Oxygenation in Lung Transplantation Patients	NCT02859194	Interstitial Pu... COPD (Chronic O... Bronchiectasis Lymphangioleiom... Primary Pulmona... ARDS (Acute Res...	Veno-veno-arter...	20 Years - 80 Years	Yonsei University
Developing Optimal Parameters for Hyperpolarized Noble Gas and Inert Fluorinated Gas MRI of Lung Disorders	NCT02748798	Lung Transplant Lung Resection Lung Cancer Asthma Cystic Fibrosis Chronic Obstruc... Emphysema Mesothelioma Asbestosis Pulmonary Embol... Interstitial Lu... Pulmonary Fibro... Bronchiectasis Seasonal Allerg... Cold Virus Lung Infection Pulmonary Hyper... Pulmonary Dyspl... Obstructive Sle...	HP 3He HP 129Xe PFP SF6 129Xe Small and... 3He Human Lung ... PFP and SF6 Hum...	18 Years -	Thunder Bay Regional Health Research Institute
Epidemiology and Diagnosis of Haemoptysis: a Multicenter Study	NCT02045394	Lung Cancer Tuberculosis Bronchiectasis Pneumonia Acute Bronchiti... Chronic Obstruc... Cryptogenic Hae...	Chest X-ray computed tomogr... Bronchoscopy	18 Years -	University of Milan
Reducing Chronic Breathlessness in Adults by Following a Self-guided, Internet Based Supportive Intervention (SELF-BREATHE)	NCT06326957	Chronic Obstruc... Bronchiectasis Interstitial Lu... Lung Cancer Asthma Dyspnea Fibrotic Lung D... Chronic Lung Di...	SELF-BREATHE	18 Years - 110 Years	King's College Hospital NHS Trust
Epidemiology and Diagnosis of Haemoptysis: a Multicenter Study	NCT02045394	Lung Cancer Tuberculosis Bronchiectasis Pneumonia Acute Bronchiti... Chronic Obstruc... Cryptogenic Hae...	Chest X-ray computed tomogr... Bronchoscopy	18 Years -	University of Milan

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