Symptoms and General Pathology

All Conditions

Emergencies

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Huseyin Oz, Prof Dr

The demographic data, mortality rates and clinical diagnoses of the patients who were evaluated, intubated and interned to ICU by the anesthesiology department due to an urgent consultation call from the emergency department in 2010-2011.

Primary outcome: an examination of demographic data, predicted mortality rates and the clinical diagnosis of the patients Secondary outcome: to determine the terminal cancer ratio Inclusion criteria: patients throughout the hole hospital whom was intubated by the anaesthesiology team due to an emergency consultation call Exclusion criteria: patients who refused treatment

The demographic data and findings completed in the Emergency Department were obtained from the patient cards and information related to existing diseases was obtained from the patient records for the cases included in the study.

Predicted mortality values were calculated for each patient with Apache II and SAPS II values using the worst or most critical physiological and laboratory parameters in the first 24 hours in the Emergency Department.

Assessment of the Patients of Emergency Consultation

The Demographics, Mortality and Clinical Diagnosis of the Patients Who Were Evaluated, Intubated and Interned to ICU by the Anesthesiology in 2010-2011

The rate of CPR, the APACHE II and SAPS II expanded values of the patients required CPR .

To determine the ratio of patients with terminal phase cancer who were intubated and interned to the intensive care unit.

The evaluation of the demographics, clinical diagnosis and the calculated values of APACHE II, SAPS II and predicted mortality of the patients who were intubated and interned to the ICU by anesthesiology department due to an urgent consultation call.

Gulsah Karaoren

Doctor

Respiratory Tract (Lung and Bronchial) Diseases

Neoplasms

Blood and Lymph Conditions

Immune System Diseases

Diseases and Abnormalities at or Before Birth

Rare Diseases

Respiratory Insufficiency

Lymphoma

Leukemia

Syndrome

Respiratory Distress Syndrome

Respiratory Distress Syndrome, Newborn

Respiration Disorders

Respiratory Tract Diseases

Lung Diseases

Lymphosarcoma

Acute Graft Versus Host Disease

Respiratory Distress Syndrome, Infant

Acute Respiratory Distress Syndrome

Dimercaprol

Chelating Agents

Fiberoptic bronchoscopy and bronchoalveolar lavage

Elie Azoulay, MD,PhD

The MiniMax® study is a multicenter randomized controlled study aimed at demonstrating that a combination of non-invasive diagnostic tools are as effective as fiberoptic bronchoscopy and bronchoalveolar lavage (FO-BAL) in performing the etiological diagnosis of acute respiratory failure in cancer patients.

Acute respiratory failure is a dreadful complication in cancer patients. Indeed, about 20% of the patients will present with pulmonary infiltrates, but Intensive Care Unit (ICU) admission and mechanical ventilation will be needed in half of them resulting in mortality for most of the patients. Managing cancer patients with respiratory failure implicates three mandatory tasks: 1) early antibiotics administration covering suspected pathogens; 2) search for the actual aetiology; and 3) adequate supportive care with access to invasive or non invasive respiratory support. Performing the etiological diagnosis is crucial. Fiberoptic bronchoscopy and bronchoalveolar lavage (FO-BAL) remains the cornerstone of the management of pulmonary infiltrates in cancer patients. However, non-invasive diagnostic tools have been validated in the recent years. Diagnostic and therapeutic impacts of FO-BAL are only of 30% to 60% and 15% to 60% respectively. In neutropenic patients and recipients of bone marrow or stem cell transplantation, this impact is significantly altered. Moreover, reports have highlighted significant rates of complications such as haemorrhage (5%), respiratory deterioration (11% to 40%), possibly heading to intubation and subsequent death. Therefore, balancing advantages to risks of FO-BAL is in order. The MiniMax® study is a multicenter randomized controlled study aimed at demonstrating that a combination of non-invasive diagnostic tools are as effective as FO-BAL in performing the etiological diagnosis of acute respiratory failure in cancer patients. In addition, these non-invasive tests might not lead to deterioration of the respiratory status and corresponding requirement to intubation and mechanical ventilation. The group of investigators is used to manage cancer patients with pulmonary involvement. In the 21 centres, patients will be randomized to be managed either with FO-BAL or with only non-invasive tools. In each case, patients will be managed with the best supportive care including adequate antibiotics, respiratory support and all needed life sustaining therapies. Our hypothesis is to reduce intubation rate using a non-invasive approach (without FO-LBA). Surrogate markers will be hospital mortality and the number of diagnostic procedures in each group of patients.

Réa-MiniMax: Severe Acute Respiratory Failure in Hematology and Cancer Patients Without Bronchoalveolar Lavage

Severe Acute Respiratory Failure in Hematology and Cancer Patients Without Bronchoalveolar Lavage. A Multicentric Randomized Controlled Trial

Assistance Publique - Hôpitaux de Paris

Saliha DJANE

Mouth and Tooth Diseases

Ear, Nose, and Throat Diseases

Critical Illness

Mouth Neoplasms

Hypopharyngeal Neoplasms

Pharyngeal Neoplasms

Disease Attributes

Head and Neck Neoplasms

Mouth Diseases

Stomatognathic Diseases

Otorhinolaryngologic Neoplasms

Pharyngeal Diseases

Otorhinolaryngologic Diseases

Oral Cancer

Hypopharyngeal Cancer

Lip and Oral Cavity Cancer

Antiemetics

Gastrointestinal Agents

Anti-Infective Agents

Cardiotonic Agents

Metoclopramide

Ethanol

Dopamine

Dopamine Antagonists

Dopamine Agents

Neurotransmitter Agents

In addition to routine ICU treatments, patients in the specific acupuncture group will also receive daily bilateral traditional Chinese medicine style acupuncture on the following acupuncture points: ST36 (Zu San Li), ST37 (Shangjuxu), ST39 (Xiajuxu), PC6 (Nei Guan) and LI4 (He Gu). The acupoints indications in this group are specific to treat indigestion related conditions. The treatment will take place once a day, over three days, for a total of three treatments. A total of 10 Needles will be used in each session Acupuncture treatment will be performed with sterile needles manufactured by "Yu Kuang" acupuncture needles 40mm with 30G.

Acupuncture doctor will disinfect the acupoints with alcohol and will perform acupuncture on the marked points with needle Needle retention time will be 30 minutes. The needles will be withdrawn by acupuncture doctor.

Patients' in the non-specific acupuncture group (Con-Acu) will receive routine ICU treatment as well as a total of 3 daily non digestion related Traditional Chinese medicine style acupuncture treatments at the following acupoints: LI 15 (Jianyu), SJ 14 (JianLiao) LU3 (Tianfu), GB35 (Yangjiao), BL 59 (Fuyang). The selected control points are not indicated for the treatment of digestion related pathologies, and are not reported to improve digestive function.

Acupuncture doctor 1 will disinfect the marked acupoints with alcohol and will perform acupuncture on the marked points. Needle retention time will be 30 minutes. The needles will be withdrawn by acupuncture doctor

In addition to routine ICU treatments, patients in the specific acupuncture group will also receive daily bilateral traditional Chinese medicine style acupuncture on the following acupuncture points: ST36 (Zu San Li), ST37 (Shangjuxu), ST39 (Xiajuxu), PC6 (Nei Guan) and LI4 (He Gu). The acupoints indications in this group are specific to treat indigestion related conditions. The treatment will take place once a day, over three days, for a total of three treatments. A total of 10 Needles will be used in each session Acupuncture treatment will be performed with sterile needles manufactured by "Yu Kuang" acupuncture needles 40mm with 30G.

Specific acupuncture group

Patients in all groups will receive Metoclopramide 10mg/ per 8 hours in the case of poor digestion, alongside the individualized drug treatment prescribed by the ICU medical doctor as per individual patient needs.

Metoclopramide 10mg

Patients' in the non-specific acupuncture group (Con-Acu) will receive routine ICU treatment as well as a total of 3 daily non digestion related Traditional Chinese medicine style acupuncture treatments at the following acupoints: LI 15 (Jianyu), SJ 14 (JianLiao) LU3 (Tianfu), GB35 (Yangjiao), BL 59 (Fuyang). The selected control points are not indicated for the treatment of digestion related conditions, and are not reported to improve digestive function.

Non-specific acupuncture group

Pei-Yu Kao, M.D.

Background: Head and neck cancer patients are in high risk to suffer from malnourishment, a risk that increase in postoperative condition and with the use of enteral nutrition (EN). Until now patients who are suffering from indigestion in the ICU received treatment in the form of prokinetic drugs, drags that can lead to serious side effects and only can partially improve digestion. Acupuncture was used successfully in several clinical trials to improve postoperative indigestion in cancer patients without any reported adverse events. This study aims is to design a double blind settings in order to investigate acupuncture effect in combination of prokinetic drugs in the prevention of indigestion in postoperative oral and hypo-pharyngeal cancer patients in the Intensive Care Unit (ICU).

Methods: Single center, double blind randomize control trial will compare between two equal groups. A total of 28 patients that will meet the inclusion criteria: Age 30-80, Post plastic surgery for oral cancer or hypo-pharyngeal cancer, Apache score below 20 needed EN. Patients will be randomly divided into specific acupuncture (ACU) or non-specific acupuncture (CON) for 3 treatments in 3 days by a blind acupuncturist along with prokinetic drugs. The main outcome measurement will be the amount of days a patient need to reach Total Energy Expenditure (TEE).

Expected outcome: The results will shed light on the effectiveness and safety of acupuncture in a double blind design for posts-surgery ICU cancer patients. In addition, the study presents a revolutionary double blind design that if will prove as successful might influence the way double blind acupuncture studies are performed today.

Background: Head and neck cancer patients are in high risk to suffer from malnourishment, a risk that increase in postoperative condition and with the use of enteral nutrition (EN). Until now patients who are suffering from indigestion in the ICU received treatment in the form of prokinetic drugs, drags that can lead to serious side effects and only can partially improve digestion. Acupuncture was used successfully in several clinical trials to improve postoperative indigestion in cancer patients without any reported adverse events. This study aims is to design a double blind settings in order to investigate acupuncture effect in combination of prokinetic drugs in the prevention of indigestion in postoperative oral and hypo-pharyngeal cancer patients in the Intensive Care Unit (ICU).

Methods: Single center, double blind randomize control trial will compare between two equal groups. A total of 28 patients that will meet the inclusion criteria: Age 30-80, Post plastic surgery for oral cancer or hypo-pharyngeal cancer, Apache score below 20 needed EN. Patients will be randomly divided into specific acupuncture (ACU) or non-specific acupuncture (CON) for 3 treatments in 3 days by a blind acupuncturist along with prokinetic drugs. The main outcome measurement will be the amount of days a patient need to reach his Total Energy Expenditure (TEE).

Expected outcome: The results will shed light on the effectiveness and safety of acupuncture in a double blind design for posts-surgery ICU cancer patients. In addition, the study presents a revolutionary double blind design that if will prove as successful might influence the way double blind acupuncture studies are performed today.

Other information: The study will be conducted in the surgical ICU department, of china medical university hospital, Taichung 404, Taiwan. The study in conducted on stable ICU patients and is anticipated to have a minimum risk for adverse events. Patients enrollment and data collection will start immediately after china medical hospital research ethics committee approval. The study expected completion time: June 2021

two groups, randomized, pre-post intervention study

Patients will be randomized to one of two groups: Acu/ Con in a 1:1 ratio. The random number and patient name will be written down on an non transparent envelope by a study nurse. The study nurse will provide an envelope containing a sheet depicting the acupoint name, location and picture (Acu / Con) to the acupuncture doctor. Acupuncture doctor (blind) will preform acupuncture on the points. 30 minutes after needle insertion, acupuncture doctor will withdraw the needles. Acupuncturists, ICU nurses, ICU doctors, researchers and statisticians will all be blind to group allocation and to the meaning of the random numbers until all acupuncture treatments have been completed.

Acupuncture Effect on Digestion in Critically Ill Post-Operative Oral and Hypo-pharyngeal Cancer Patients

Acupuncture Effect on Digestion in Critically Ill Post-Operative Oral and Hypo-pharyngeal Cancer Patients: A Protocol for Double Blind Randomized Control Trial

Number of days in takes for each patient to achieve the Total Energy Expenditure

Secondary outcomes measures are the amount of prokinetic drugs prescribed by the ICU doctor in total dosage

After 5 days of conservative treatment for the poor digestion (naso-gastric tube drainage of more than 500ml per day or severe diarrhea of more than 1000 ml per day)

In patients who cannot digest with daily naso-gastric tube drainage of more than 500ml per day or severe diarrhea of more than 1000 ml per day

Incidents of vomits in total number of times and volume in micro liters

Patient's Albumin blood levels will help to assets patient's nutrition status

A day of mechanical ventilation is at least 6 hours of mechanical ventilation in one day

In case of mortality ,total mortality will be compered between the two groups

Incidents of diarrhea in number of times and volume in micro liters

No stool passage in 3 days will be considered as constipation

Incidents of nausea in number of times , measured by patient complains

Positive occult blood test of the naso-gastric tube drainage and in the stool

Body temperature more than 38 degrees Celsius

China Medical University Hospital

Lung Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Each lung cancer patient with organ failure, admitted in emergency, thoracic oncology or directly in ICU

TIMSIT Jean-François, PU/PH

Investigators will evaluate determinants of the patients' care type : palliative, medical or intensive care. The place of patient or family on care's decision will be noticed. Investigators will evaluate 3 month-survival and patients' feelings (visit with a psychologist) according to type of care they benefited.

Two hundred patients have to be enrolled in 2 years in the Grenoble Teaching Hospital and in the Saint Louis hospital in Paris between November 2010 and November 2012. Each lung cancer patient with at least one organ failure, admitted in emergency, thoracic oncology or directly in ICU will be included.

The objectives are to identify patients' characteristics associated with proposition for intensive care unit admission and those associated with the decision of intensive care unit admission.

Determinants of Intensity of Care of Lung Cancer Patients With Organ Failure

hospital anxiety and depression scale, SF-36 scale and Impact of Event Scale-R and a visit with a psychologist

univariate and multivariate logistic regression

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Assessment of the Patients of Emergency Consultation	NCT02216929	Demographics of...		-	Umraniye Education and Research Hospital
Assessment of the Patients of Emergency Consultation	NCT02216929	Demographics of...		-	Umraniye Education and Research Hospital
Réa-MiniMax: Severe Acute Respiratory Failure in Hematology and Cancer Patients Without Bronchoalveolar Lavage	NCT00248443	Lymphoma Cancer Acute Respirato... Leukemia	Fiberoptic bron...	18 Years -	Assistance Publique - Hôpitaux de Paris
Acupuncture Effect on Digestion in Critically Ill Post-Operative Oral and Hypo-pharyngeal Cancer Patients	NCT03934294	Oral Cancer Hypopharyngeal ...	Specific acupun... Metoclopramide ... Non-specific ac...	30 Years - 80 Years	China Medical University Hospital
Réa-MiniMax: Severe Acute Respiratory Failure in Hematology and Cancer Patients Without Bronchoalveolar Lavage	NCT00248443	Lymphoma Cancer Acute Respirato... Leukemia	Fiberoptic bron...	18 Years -	Assistance Publique - Hôpitaux de Paris
Determinants of Intensity of Care of Lung Cancer Patients With Organ Failure	NCT01999621	Lung Cancer		18 Years -	University Hospital, Grenoble

Spots Global Cancer Trial Database for intensive care