A Randomized Trial Comparing a Ventilatory Strategy To Prevent Atelectasis Versus a Lateral Decubitus Strategy During Robotic Bronchoscopy (VESPA vs. LADS Trial)

Launched by M.D. ANDERSON CANCER CENTER · Jan 26, 2023

Keywords

ClinConnect Summary

The VESPA vs. LADS trial is studying two different methods to help prevent a condition called atelectasis, which is when part of the lung collapses, during a procedure known as robotic bronchoscopy. This procedure is used to examine lung nodules that might be cancerous. The trial aims to find out if the LADS method is more effective than the VESPA method in keeping the lungs fully inflated during the procedure.

To participate in this trial, you need to be at least 18 years old and scheduled for a robotic bronchoscopy due to a lung nodule that is smaller than 3 cm. It's important that the nodule is located in specific areas of the lung and that you have had a chest CT scan within the last month. If you have certain health conditions, such as significant lung problems or are currently pregnant, you may not qualify for the study. If you join, you’ll receive one of the two ventilatory strategies during your procedure, and the team will monitor how well it works in preventing atelectasis. This trial is currently recruiting participants, so if you think you might be eligible, it could be a good opportunity to consider.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Adult patients (≥ 18 years old) undergoing diagnostic robotic bronchoscopy for a lung nodule suspicious for malignancy bronchoscopy under general anesthesia.
• • 2. Lung nodules should be up to 3 cm in diameter and located in right or left bronchial segments B2, B6, B9, and B10. Greater than 50% of the volume of the lesion needs to be below a horizontal line traced at the most anterior edge of the corresponding vertebral body.
• • 3. Chest CT performed \< 45 days prior to bronchoscopy.
• • 4. Voluntary informed consent to participate in the study.
• Exclusion Criteria:
• • 1. Patients with prior lung consolidation, interstitial changes or lung masses (\> 3 cm in diameter) as seen on most recent CT
• • 2. Lesions outside of the designated lung areas defined as inclusion criteria.
• • 3. Known pregnancy
• • 4. Vulnerable population
• • 5. Ascites
• • 6. Known diaphragmatic paralysis
• • 7. Smokers or ex-smokers with known or suspected severe air-trapping defined as residual volume \> 150% of predicted
• • 8. History of primary or secondary spontaneous pneumothorax
• • 9. Lung bullae \> 5 cm
• • 10. Patients with mediastinal or hilar adenopathy with high suspicion for malignancy in whom lymph node sampling is indicated and should occur prior to robotic bronchoscopy of the peripheral lesion.
• • 11. Patient with active COVID pneumonia.