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Brachial Plexus Injury After Prone Positioning (BPX)

I

Institute of Hospitalization and Scientific Care (IRCCS)

Status

Enrolling

Conditions

Nerve Compression
Brachial Plexus Injury

Treatments

Diagnostic Test: Muscle strength measurement
Diagnostic Test: Electromyography

Study type

Observational

Funder types

Other

Identifiers

Details and patient eligibility

About

The goal of this prospective observational study is to estimate the prevalence of brachial plexus injury after prone positioning in patients with ARDS and to evaluate the safety of swimmer position. The main questions it aims to answer are:

  • Could arm positioning during pronation play a role in the development of any nerve injury at the brachial plexus level?
  • Is swimmer position safe when adopted during prone positioning?

Participants will be studied at selective time points using EMG assessment.

Full description

Prone positioning will be performed according to the current guidelines. Particularly, face and limbs will be placed according to the "swimmer position", ensuring the face position in the direction of ventilator and limbs (one arm above head and opposite arm at side) positioned as to prevent abnormal extension or flexion against the shoulders and elbows. Patients will lie on low air loss pressure mattresses, thus avoiding the utilization of any thoraco-pelvic supports, which are not recommended. Electromyography (EMG) will be performed to evaluate the occurrence of brachial plexus injury (BPI).

Enrollment

54 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age ≥ 18 years old
  • Admission to ICU for severe ARDS
  • Administration of sedation and neuromuscular blocking agents
  • Presence of endotracheal intubation and mechanical ventilation
  • Use of prone positioning to treat hypoxemia

Exclusion criteria

  • Extracorporeal membrane oxygenation
  • Prone positioning performed in other centers
  • Prone positioning contraindications
  • Neurodegenerative disorders
  • Previous known brachial plexus injury

Trial contacts and locations

1

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Central trial contact

Filippo Binda, MSc

Data sourced from clinicaltrials.gov

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