Clinical trial NCT01179022: Incidence of Bacteremia Following Argon Plasma Coagulation in Patients With Endobronchial Lesions
Official title: Incidence of Bacteremia Following Argon Plasma Coagulation in Patients With Endobronchial Lesions
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Bacteremia
Keywords: Bacteremia
Argon Plasma Coagulation
Endobronchial Lesions
Lead sponsor: Meir Medical Center
Sponsor class: OTHER
First posted: 2010-08-10
Enrollment: 46
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: 50 patients that undergo bronchoscopy with the use of APC

Brief summary: Incidence of Bacteremia Following Argon Plasma Coagulation in Patients with Endobronchial Lesions

Detailed description: Bacteremia is a well-recognized invasive medical condition. In most cases, it is a transient phenomenon without clinical consequences. In certain patients, such as those with structural cardiac abnormalities, it may lead to the development of infectious endocarditis. According to an American Heart Association statement, routine endocarditis prophylaxis is indicated prior to invasive procedures with relatively high bacteremia rates, such as dental care,certain types of catheterization and rigid bronchoscopy \[1\].Fibreoptic bronchoscopy, with or without biopsy is not included in this list due to a very low bacteremia rate \[1\].This even applies to particularly high risk patients with prosthetic valve or previous endocarditis. Yigla et al. assessed the incidence of bacteremia following bronchoscopy and found 6.5% of bacteremia rate. (2) Recently, Steinfort et al. assessed the bacteremia rate following endobronchial ultrasound and found 7% of bacteremia rate following the procedure. All bacterial isolates were typical oropharyngeal commensal organisms. The transbronchial needle aspiration washing culture was positive in 35% of the patients. However, none of the bacteremic patients had clinical features suggestive of infection and no complications were seen among the cohort. (3) No data are available, however about the bacteremic rate following interventional bronchoscopy for endobronchial obstruction and advance lung carcinoma. In these cases, palliative setting of alleviating central airway obstruction, laser resection, electrocautery, argon plasma coagulation and stenting are techniques that can provide immediate relief.

Argon plasma coagulation (APC) is uses ionize argon gas jet flow to conduct electrons allowing a noncontact mode of treatment (lightning effect). (4, 5) APC has been popular in gastrointestinal endoscopy for superficial coagulation of large mucosal surfaces. The argon gas quite flexibly flows around bends and corners. Coagulated tissue has a higher resistance that automatically drives the argon gas flow away to nearby untreated tissue. An immediate effect really can be seen during electrocautery treatment, which corresponds well with the histological effect of coagulative necrosis.

We therefore conduct a prospective study to assess the bacteremic rate following APC in patients with endobronchial involvement.

Eligibility criteria: Inclusion Criteria:

* All patients that undergo bronchoscopy with the use of APC

Exclusion Criteria:

* All patients under 18 years old All Patients with evidence of current respiratory infection or febrile illnesses and those that will receive antibiotic therapy within a week prior to the bronchoscopy

Primary outcomes:
measure: The bacteremic rate following APC in patients with endobronchial involvment.
timeFrame: Two years
Secondary outcomes:
Other outcomes:
Locations:
city: Kfar Saba
country: Israel
facility: Meir MC
Study officials:
affiliation: Meir Medical Center
name: DAVID SHITRIT, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Matveychuk A, Guber A, Talker O, Shitrit D. Incidence of bacteremia following bronchoscopy with argon plasma coagulation: a prospective study. Lung. 2014 Aug;192(4):615-8. doi: 10.1007/s00408-014-9583-8. Epub 2014 Apr 27.