Can newly trained clinicians use bedside lung ultrasound to detect a collapsed lung after heart surgery?
The CLEAR Vanguard Feasibility Study: Comparative Evaluation of Novice-Performed Lung Ultrasound Versus Chest X-Ray for Pneumothorax Detection Post-Chest Tube Removal in Cardiac Surgery Patients
This study will test whether medical trainees can use a bedside lung ultrasound to find a collapsed lung in adults after heart surgery.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 120 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Sunnybrook Health Sciences Centre Academic / other |
| Drugs / interventions | radiation |
| Locations | 1 site (Toronto, Ontario) |
| Trial ID | NCT07018856 on ClinicalTrials.gov |
What this trial studies
In this feasibility study, medical trainees receive focused training in lung ultrasound and then perform bedside exams within two hours after chest tube removal. Their ultrasound findings will be compared to routine chest X-rays and reviewed by blinded expert clinicians. The study will enroll about 120 adults across three Ontario hospitals and will track protocol adherence, diagnostic accuracy, and patient experience. Results will inform whether a larger trial is warranted.
Who should consider this trial
Good fit: Adults (18+) recovering from cardiac surgery who are scheduled for chest tube removal in the participating cardiovascular intensive care units and who can undergo bedside ultrasound and chest X-ray.
Not a fit: Patients with severe chronic lung disease (eg, significant COPD or interstitial lung disease with poor lung function), subcutaneous emphysema, those already mechanically ventilated, or those too unstable for imaging may not benefit from this approach.
Why it matters
Potential benefit: If successful, patients could receive faster, bedside, radiation-free checks for pneumothorax that may speed treatment and reduce routine chest X-rays.
How similar studies have performed: Prior research shows lung ultrasound is sensitive for detecting pneumothorax when used by experienced clinicians, but novice-performed lung ultrasound in the immediate post-cardiac surgery setting is less well studied and needs confirmation.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18 years or older * Undergoing cardiac surgery * Scheduled for chest and/or mediastinal chest tube removal in the cardiovascular intensive care unit (CVICU) Exclusion Criteria: * Severe chronic lung disease that may impair lung ultrasound interpretation, including: * Subcutaneous emphysema * COPD or emphysema with FEV₁ \< 50% predicted * Interstitial lung disease with FEV₁ \< 75% predicted * Documented history of pneumothorax prior to chest tube removal requiring intervention * Mechanical ventilation at the time of eligibility screening * Inability to undergo lung ultrasound or chest X-ray (e.g., due to hemodynamic instability or positioning limitations)
Where this trial is running
Toronto, Ontario
- Sunnybrook Health Sciences Centre — Toronto, Ontario, Canada (Recruiting)
Study contacts
- Study coordinator: Jacobo Moreno Garijo, MD, PhD
- Email: jacobo.morenogarijo@sunnybrook.ca
- Phone: 416-480-4864
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.