CESAR: Conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure

ISRCTN ISRCTN47279827
DOI https://doi.org/10.1186/ISRCTN47279827
Secondary identifying numbers HTA 99/01/01
Submission date
25/04/2003
Registration date
25/04/2003
Last edited
07/12/2010
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Study website

Contact information

Prof Diana Elbourne
Scientific

Medical Statistics Unit
London School of Hygiene and Tropical Medicine
Keppel Street
London
WC1E 7HT
United Kingdom

Phone +44 (0)20 7927 2629
Email diana.elbourne@lshtm.ac.uk

Study information

Study designMulti-centre randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeNot Specified
Scientific title
Study acronymCESAR
Study hypothesisThe objective of this study is to test the hypotheses that, for patients with severe but potentially reversible respiratory failure, extracorporeal membrane oxygenation ECMO:
1. Will increase the rate of survival without severe disability by six months post randomisation.
2. Will be cost effective, compared to conventional ventilatory support.
Ethics approval(s)Not provided at time of registration
ConditionRespiratory tract diseases: Severe acute respiratory failure
InterventionConventional positive pressure ventilation vs. Extracorporeal Membrane Oxygenation (ECMO)
Intervention typeOther
Primary outcome measureDeath or severe disability at six months. Severe disability will be defined as requiring full time nursing care at home, or continued residence in hospital.
Secondary outcome measures1. Hospital Indices: duration of ventilation, length of ITU stay, length of hospital stay. Daily APACHE II score. In addition, data will be collected on ventilator settings, arterial blood gases, total intake minus output excluding blood loss and replacement, weight, full nutrition, haemoglobin, white blood cell count, blood products administered, prone position, nitric oxide, creatinine, bilirubin and maximum temperature. For ECMO patients only, data will be collected on mode (VV/VA), blood flow and sweep flow.
2. Follow up: Survivors will be contacted 6 months after randomisation for a detailed domicillary by a chest physician using a structured data collection form. Patients (or their carers, if necessary) will also complete questionnaires, assessment using standard scales to assess their activities of daily living, respiratory symptoms and psychological state.

Economic issues: The trial will assess the cost of treatment to the health and social services and to patients and their families in each treatment group. An incremental cost-effectiveness ratio will be calculated and compared to that for similar life-extending treatments. Information for the costs of inpatient and domicillary care will be collected using methods adapted from the neonatal ECMO Trial.
Overall study start date01/07/2000
Overall study end date31/12/2007

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit65 Years
SexBoth
Target number of participants180
Participant inclusion criteria1. Adult patients (18-65 years in UK)
2. With severe, but potentially reversible respiratory failure. Severe respiratory failure will be defined as a Murray score >3.0, or uncompensated hypercapnoea with a pH <7.20
Participant exclusion criteria1. Duration of high pressure and/or high FiO2 ventilation >7 days
2. Intra-cranial bleeding
3. Any other contra-indication to limited heparinisation
4. Patients who are moribund and have any contra-indication to continuation of active treatment
Recruitment start date01/07/2000
Recruitment end date31/12/2007

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Medical Statistics Unit
London
WC1E 7HT
United Kingdom

Sponsor information

Department of Health (UK)
Government

Quarry House
Quarry Hill
Leeds
LS2 7UE
United Kingdom

Phone +44 (0)1132 545 843
Email Sheila.Greener@doh.gsi.gov.uk
Website http://www.dh.gov.uk/en/index.htm
ROR logo "ROR" https://ror.org/03sbpja79

Funders

Funder type

Government

NIHR Health Technology Assessment Programme - HTA (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 23/12/2006 Yes No
Protocol article protocol 30/04/2008 Yes No
Results article results 17/10/2009 Yes No
Results article results 01/07/2010 Yes No