Pv-aCO2 gap–guided resuscitation for adults with multiple traumatic injuries
Evaluation of Effect of Pv-aCO2-Gap on Clinical Outcomes With Standard Resuscitation End-points in Adult Poly-trauma Patients Admitted to the ICU --- Prospective Randomized Control Trial
This trial will test whether using the difference between venous and arterial carbon dioxide levels to guide resuscitation helps adults with multiple traumatic injuries recover better during ICU care.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 60 (estimated) |
| Ages | 18 Years to 70 Years |
| Sex | All |
| Sponsor | Pakistan Institute of Medical Sciences Government |
| Locations | 1 site (Islamabad, Federal) |
| Trial ID | NCT07480655 on ClinicalTrials.gov |
What this trial studies
Adult polytrauma patients admitted to the ICU are randomized 1:1 to either a Pv-aCO2 gap–targeted resuscitation arm or a control arm managed by conventional resuscitation end points. All participants receive a central venous catheter and an arterial line, with arterial and venous blood gas samples taken within 1 hour of ICU admission and at 6, 12, 24, 48, and 72 hours using a point-of-care analyzer. The intervention arm uses the measured venous-to-arterial CO2 difference to guide hemodynamic management, while the control arm follows standard critical care targets. Results from the serial measurements will be compared to determine whether gap-guided management changes physiological parameters and early clinical course.
Who should consider this trial
Good fit: Adults with polytrauma (penetrating or blunt) admitted to the ICU from the operating room, emergency department, or wards who can have central venous and arterial catheters placed and meet the inclusion criteria.
Not a fit: Patients with chest trauma, obstructive or restrictive lung disease, obstructive sleep apnea, septic shock, pregnancy, those requiring ECMO, or those expected to be readmitted within 48 hours are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, this approach could help clinicians tailor resuscitation more precisely and potentially reduce organ dysfunction and complications after major trauma.
How similar studies have performed: Observational studies have shown the Pv-aCO2 gap correlates with tissue perfusion and outcomes, but randomized trials of gap-guided resuscitation in trauma patients are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Either Gender * Poly-trauma patients ○ Both penetrating and blunt trauma * Both surgical and non-surgical * Shock States Exclusion Criteria: * Any Chest trauma * Patients with Obstructive and restrictive lung disease * Obstructive sleep apnea * Septic shock * Pregnant patients * Patients who will require readmission within 48 h after step-down from the ICU. * Patients who will need extra-corporeal membrane oxygenation support
Where this trial is running
Islamabad, Federal
- Department of Anesthesia, Pakistan Institute of Medical Sciences — Islamabad, Federal, Pakistan (Recruiting)
Study contacts
- Study coordinator: Muhammad Haroon Anwar, MBBS
- Email: haroonanwar22@gmail.com
- Phone: +92-333-5236956
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.