[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"diaphragmatic-paralysis\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:diaphragmatic-paralysis":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,4,0,[8,48,85,117],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":30,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":36,"lastUpdatePostDateStruct":37,"startDateStruct":40,"completionDateStruct":42,"leadSponsor":44,"locationsCount":47},"100637906","optimized-costoclavicular-block-for-elderly-proximal-humeral-fracture-surgery-100637906",false,"NCT07612514","Optimized Costoclavicular Block for Elderly Proximal Humeral Fracture Surgery","Effect of an Optimized Ultrasound-Guided Costoclavicular Brachial Plexus Block Strategy on Anesthetic Efficacy and Diaphragmatic Function in Elderly Patients Undergoing Internal Fixation of Proximal Humeral Fractures: A Multicenter, Prospective, Randomized Controlled Clinical Trial","OptCCB","Inclusion Criteria:\n\n* Signed informed consent\n* Age ≥65 years\n* BMI \\\u003C30\n* American Society of Anesthesiologists (ASA) physical status I to III\n* Unilateral proximal humeral fracture scheduled for open reduction and internal fixation via an anterior surgical approach (including deltopectoral approach and anteromedial deltoid approach)\n\nExclusion Criteria:\n\n* Inability to perform T2 thoracic paravertebral block for any reason\n* Coagulation dysfunction or current use of anticoagulant therapy\n* History of upper extremity nerve injury or phrenic nerve injury\n* Severe polytrauma\n* Preoperative uncontrolled severe respiratory dysfunction (resting SpO2 \\\u003C90% or home oxygen therapy, or FEV1 \\\u003C30% of predicted value)\n* Preoperative uncontrolled asthma, pulmonary infection, pneumothorax, or history of prior lung surgery\n* Preoperative uncontrolled hypertension with admission systolic blood pressure \\>180 mmHg or diastolic blood pressure \\>110 mmHg\n* Preoperative uncontrolled coronary artery disease, valvular heart disease, or arrhythmia\n* Any condition that precludes nerve block performance (e.g., local infection or swelling at the puncture site, inability to change position)\n* Inability to communicate or cooperate with anesthesia administration (e.g., language barrier, intellectual disability, Alzheimer's disease, Parkinson's disease)\n* Allergy to ropivacaine or any other contraindication to nerve block","ALL","65 Years",{"count":20,"type":21},356,"ESTIMATED","INTERVENTIONAL",[24],"NA","Background: Proximal humeral fractures are common in elderly patients and often require surgical fixation (open reduction and internal fixation). Traditional regional anesthesia techniques, such as the interscalene brachial plexus block, may provide incomplete pain relief in the medial upper arm area and carry a high risk of hemidiaphragmatic paralysis, which can lead to breathing difficulties.\n\nObjective: This study aims to evaluate whether an optimized nerve block strategy-ultrasound-guided costoclavicular brachial plexus block combined with superficial cervical plexus block and T2 thoracic paravertebral block-improves anesthetic success and reduces diaphragm dysfunction compared to the traditional interscalene approach in elderly patients undergoing proximal humeral fracture surgery.\n\nStudy Design: This is a multicenter, prospective, randomized, controlled, double-blind (participants and outcome assessors), superiority clinical trial.\n\nPopulation: A total of 356 elderly patients (aged ≥65 years) with unilateral proximal humeral fractures scheduled for open reduction and internal fixation via an anterior surgical approach will be enrolled from three centers in Shanghai, China.\n\nIntervention: Participants will be randomly assigned in a 1:1 ratio to one of two groups:\n\n* Experimental Group (Optimized Strategy): Receives ultrasound-guided costoclavicular brachial plexus block + superficial cervical plexus block + T2 thoracic paravertebral block (0.375% ropivacaine 20 mL for brachial plexus, 0.25% ropivacaine 10 mL for each of the other blocks).\n* Control Group (Traditional Strategy): Receives ultrasound-guided interscalene brachial plexus block + superficial cervical plexus block + T2 thoracic paravertebral block (same drug regimen).\n\nAll nerve blocks will be performed under ultrasound guidance by a single anesthesiologist. Patients and outcome assessors will be blinded to group assignment; the performing anesthesiologist cannot be blinded due to the distinct anatomical approaches.\n\nMain Outcomes:\n\n* Primary Outcome: Nerve block success rate, defined as no pain or only mild pain requiring no rescue analgesics (e.g., intravenous opioids, conversion to general anesthesia, or local infiltration) during surgery.\n* Key Secondary Outcomes: Rate of hemidiaphragmatic paralysis (assessed by ultrasound M-mode); rate of conversion to general anesthesia; postoperative pain (NRS, 0-10) at 24 hours; perioperative stress biomarkers (cortisol, ACTH, IL-6, HMGB-1, CRP, galectin-3); and postoperative shoulder function recovery.\n\nSafety Monitoring: Adverse events, including unplanned conversion to general anesthesia, respiratory depression, pneumothorax, and severe hemidiaphragmatic paralysis, will be recorded and managed according to predefined protocols. An independent Data Monitoring Committee will review safety data and conduct interim analyses for futility.\n\nStudy Duration: The study is expected to take approximately 24 months from first patient enrollment to final follow-up completion.\n\nEthical Approval: This study has been approved by the Ethics Committee of Shanghai Tongren Hospital. Approvals from the ethics committees of the other participating centers (Shanghai Sixth People's Hospital and Shanghai Xuhui Central Hospital) will be obtained before study initiation at those sites.",[27,28,29],"Proximal Humeral Fracture","Anesthesia, Regional","Diaphragmatic Paralysis",[27,31,32,33,29,34],"Elderly","Costoclavicular Block","Interscalene Block","Randomized Controlled Trial","NOT_YET_RECRUITING","2026-05-21",{"date":38,"type":39},"2026-05-28","ACTUAL",{"date":41,"type":21},"2026-10-01",{"date":43,"type":21},"2029-09-30",{"name":45,"class":46},"Shanghai Tong Ren Hospital","OTHER",3,{"id":49,"slug":50,"hasResults":11,"nctId":51,"briefTitle":52,"officialTitle":53,"acronym":4,"eligibilityCriteria":54,"healthyVolunteers":11,"sex":17,"minAge":55,"maxAge":4,"enrollmentInfo":56,"targetDuration":4,"studyType":22,"phases":58,"briefSummary":59,"conditions":60,"keywords":4,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":75,"lastUpdatePostDateStruct":76,"startDateStruct":78,"completionDateStruct":80,"leadSponsor":82,"locationsCount":84},"100557458","clinical-utility-of-portable-dynamic-chest-x-ray-ddr-in-the-icu-100557458","NCT06538376","Clinical Utility of Portable Dynamic Chest X Ray (DDR) in the ICU","Clinical Utility of Portable Dynamic Chest X-Ray (DDR) in the ICU: Clinical Trial to Demonstrate the Feasibility of Deploying DDR Technology in the ICU - A Study to Prove Its Increased Diagnostic Value","Inclusion Criteria: Participants must meet all the following inclusion criteria to participate in this study:\n\n* Adults (at least 18 years of age) including both intubated\u002Fventilated and non-intubated patients\n* Likely to have pathology related to either, abnormal diaphragmatic excursion and lung aeration, pulmonary perfusion, increased lung water content or all the above, as well as for cricopharyngeal dysfunction\u002Fswallowing difficulties at risk for aspiration.\n* The subject or a legally authorized representative has provided written informed consent.\n\nExclusion Criteria: Candidates meeting any of the exclusion criteria at baseline will be excluded from study participation. These criteria are:\n\n* Special populations, including women with known pregnancy, prisoners, or institutionalized individuals\n* Patients where additional radiation is clinically contraindicated\n* Care team does not provide assent for approaching patient\u002Fsurrogate\n* For women of child-bearing potential, defined as premenopausal women, a pregnancy test will be administered to determine pregnancy status and confirm eligibility for the study. A pregnancy test will NOT be administered to women who are post-menopausal or have documentation of surgical sterilization.","18 Years",{"count":57,"type":21},230,[24],"Dynamic digital radiography (DDR) is a new advanced version of chest radiography that captures dynamic images at a rate of 15 frames per second. It is coupled with an analytical software that allows it to provide more advanced measures of lung motion, ventilation, and perfusion compared to traditional chest radiography. While implementation of DDR fixed machines are beginning elsewhere in the US, this trial involves the first applications of an FDA-approved portable DDR machine, for use at the bedside in the ICU.\n\nThe goal of this clinical trial is to determine the feasibility and safety of portable DDR technology in the ICU, as well as to evaluate the improved clinical diagnostic value of the portable DDR system over current standards of care.\n\nParticipants will receive one to three sets of DDR images, which will then be compared to their clinical gold standard exams (such as chest x-rays, CTs, or VQ scans) to assess and improve the precision and accuracy of measurements such as diaphragmatic motion, lung movement, and perfusion.",[61,62,63,64,65,66,67,68,69,70,71,72,73,29],"Pulmonary Edema","Pneumonia","Atelectasis","Pleural Effusion","Acute Rejection of Lung Transplant (Disorder)","Airway Obstruction","Rib Fractures","Acute Copd Exacerbation","Asthma COPD","Pulmonary Embolism","Hemothorax","Pneumothorax","Mesothelioma","RECRUITING","2025-10-28",{"date":77,"type":39},"2025-10-29",{"date":79,"type":39},"2023-12-12",{"date":81,"type":21},"2027-11",{"name":83,"class":46},"Brigham and Women's Hospital",1,{"id":86,"slug":87,"hasResults":11,"nctId":88,"briefTitle":89,"officialTitle":90,"acronym":91,"eligibilityCriteria":92,"healthyVolunteers":11,"sex":17,"minAge":55,"maxAge":93,"enrollmentInfo":94,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":97,"conditions":98,"keywords":101,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":107,"lastUpdatePostDateStruct":108,"startDateStruct":110,"completionDateStruct":112,"leadSponsor":114,"locationsCount":84},"100586731","short--and-long-term-effects-of-robot-assisted-plication-in-diaphragmatic-paralysis-100586731","NCT06919185","Short- and Long-term Effects of Robot-assisted Plication in Diaphragmatic Paralysis","Short- and Long-term Effects of Robot-assisted Plication in Diaphragmatic Paralysis - the Prospective RAPIDLY-study","RAPIDLY","Inclusion Criteria:\n\n* Patients with symptomatic unilateral diaphragmatic paralysis persisting for ≥1 year\n* Patients are scheduled for RATS at thoracic surgery clinics in five Swedish university hospitals (Gothenburg, Linköping, Lund, Umeå, and Uppsala).\n\nExclusion Criteria:\n\n* Inability to complete forms in Swedish\n* Neuromuscular disease as the cause of diaphragmatic paralysis\n* Other significant causes of dyspnea\n* Impaired physical capacity from other causes than diaphragmatic paralysis.","85 Years",{"count":95,"type":21},50,"OBSERVATIONAL","Diaphragmatic paralysis may lead to severe symptoms such as breathlessness and reduced physical capacity.\n\nDiaphragmatic plication using Robotic-Assisted Thoracic Surgery (RATS) is a minimally invasive surgical technique developed to improve lung function by correcting diaphragmatic elevation.\n\nWhile its benefits have been reported in retrospective reports, prospective studies are lacking.\n\nThis prospective observational cohort study aimsto evaluate the short- and long-term effects of robot-assisted diaphragmatic plication on subjective breathlessness, physical performance, lung function, blood gases, and imaging findings at five Swedish university hospitals: Gothenburg, Linköping, Lund, Umeå, and Uppsala.\n\nPatients will be assessed preoperatively and postoperatively after one to three months and after one and three years.",[99,29,100],"Diaphragmatic Plication","Diaphragmatic Eventration",[102,103,104,105,106],"RATS","robot-assisted thoracic surgery","plication","dyspnea","thoracotomy","2025-04-08",{"date":109,"type":39},"2025-04-11",{"date":111,"type":21},"2025-05",{"date":113,"type":21},"2031-12",{"name":115,"class":116},"Uppsala County Council, Sweden","OTHER_GOV",{"id":118,"slug":119,"hasResults":11,"nctId":120,"briefTitle":121,"officialTitle":122,"acronym":4,"eligibilityCriteria":123,"healthyVolunteers":11,"sex":17,"minAge":55,"maxAge":124,"enrollmentInfo":125,"targetDuration":4,"studyType":96,"phases":4,"briefSummary":127,"conditions":128,"keywords":131,"overallStatus":74,"whyStopped":4,"lastUpdateSubmitDate":136,"lastUpdatePostDateStruct":137,"startDateStruct":139,"completionDateStruct":141,"leadSponsor":143,"locationsCount":145},"100534814","phrenic-nerve-reconstruction-for-the-treatment-of-diaphragmatic-paralysis-patient-experiences-and-reported-outcomes-100534814","NCT06243718","Phrenic Nerve Reconstruction for the Treatment of Diaphragmatic Paralysis: Patient Experiences and Reported Outcomes.","A Grounded Theory of Phrenic Nerve Reconstruction for the Treatment of Diaphragmatic Paralysis - A Biopsychosocial Approach to Surgical Evaluation and Outcomes.","Inclusion Criteria:\n\n* Individuals with a confirmed diagnosis of Diaphragmatic Paralysis.\n* Individuals who are scheduled to undergo phrenic nerve reconstructive surgery for the treatment of Diaphragmatic Paralysis.\n\nExclusion Criteria:\n\n\\- Individuals who do not comprehend the English language.","70 Years",{"count":126,"type":21},45,"This study utilizes a grounded theory methodology to explore patient experiences of phrenic nerve reconstructive surgery as a treatment for diaphragmatic paralysis.",[29,129,130],"Pain, Chest","Breath Shortness",[132,29,133,134,135],"Grounded Theory","Diaphragm","Respiratory System","Pain","2024-02-05",{"date":138,"type":39},"2024-02-06",{"date":140,"type":39},"2023-10-10",{"date":142,"type":21},"2026-10-10",{"name":144,"class":116},"Advanced Reconstructive Surgery Alliance",2]