Early detection of deep vein thrombosis in critically ill patients

Diagnosing Deep-vein Thrombosis Early in Critically Ill Patients (DETECT) Trial

This study tests if regular ultrasound checks can help find blood clots in critically ill patients to see if it can lower the risk of serious complications and improve survival rates.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 1800 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: King Abdullah International Medical Research Center (other)
• Locations: 1 site (Riyadh, Riyadh Region)
• Trial ID: NCT05112705 on ClinicalTrials.gov

What this trial studies

This trial investigates whether regular ultrasound screenings can help detect deep vein thrombosis (DVT) in critically ill patients, potentially reducing the risk of pulmonary embolism (PE) and lowering overall mortality rates within 90 days. Patients admitted to the ICU will be screened for eligibility and randomized to receive either twice-weekly ultrasounds of their lower limbs or standard care. The study aims to determine if proactive monitoring can improve patient outcomes in this high-risk population.

Who should consider this trial

Good fit: Ideal candidates are critically ill patients aged 18 and older who are expected to remain in the ICU for more than two days.

Not a fit: Patients with a recent diagnosis of DVT or PE, those on chronic anticoagulation therapy, or those with conditions preventing adequate ultrasound will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly reduce the incidence of pulmonary embolism and improve survival rates among critically ill patients.

How similar studies have performed: Previous studies have shown that early detection of DVT can lead to better outcomes, suggesting this approach may be effective.

Eligibility criteria

Inclusion criteria

1. Medical, surgical or trauma ICU patients ≥18 years old.
2. Patients who are expected to stay in the ICU more than 2 calendar days (unlikely to be discharged out of ICU on the day of admission or on the next day).

Exclusion Criteria

1. Patients with DVT or PE diagnosed within the last year.
2. Patients receiving chronic systemic anticoagulation.
3. Patients who have received up to the time of ICU admission or are receiving therapeutic doses of anticoagulation with UFH, LMWH, or other anticoagulants.
4. Inability or contraindication to obtain adequate ultrasound on the lower extremities (Burns in the lower extremities, lacerations, active skin infection, \& ischemic limb in the legs, large dressings in the thighs that prevent adequate ultrasounds OR amputated foot or leg on one or two sides)
5. Patients with Inferior Vena Cava (IVC) Filter.
6. Known or suspected pregnancy.
7. Limitation of life support, life expectancy \<7 days or palliative care.
8. Previously enrolled in DETECT trial within the last 180 days.
9. Enrolled in another trial for which co-enrolment is not approved.

Where this trial is running

Riyadh, Riyadh Region

• King Abdulaziz Medical City — Riyadh, Riyadh Region, Saudi Arabia (RECRUITING)

Study contacts

• Principal investigator: Yaseen M Arabi — King Saud bin Abdulaziz University of Health Sciences
• Study coordinator: Yaseen M Arabi

Conditions: Deep Vein Thrombosis, Pulmonary Embolism