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Trial registered on ANZCTR
Registration number
ACTRN12611000022965
Ethics application status
Approved
Date submitted
20/12/2010
Date registered
7/01/2011
Date last updated
10/11/2021
Date data sharing statement initially provided
10/11/2021
Date results provided
10/11/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
The use of Near-Infrared Spectroscopy to assist in the diagnosis of Compartment Syndrome in paediatrics
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Scientific title
The use of Near-Infrared Spectroscopy to assist in the diagnosis of Compartment Syndrome in paediatrics
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Secondary ID [1]
253316
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nil
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Universal Trial Number (UTN)
U1111-1113-2639
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
compartment syndrome
258851
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complications of fractures
258852
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Condition category
Condition code
Musculoskeletal
258991
258991
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observation of tissue oxygenation levels using near infrared spectroscopy.
Near infrared spectroscopy is a completely non-invasive optical method that utilizes near infrared light to ascertain the average oxygen saturation of haemoglobin in a region of tissue. The method is closely related to standard plethysmographic oxygen saturation measurement(SpO2), and is currently used in cardiac surgery to measure brain tissue oxygenation during cardiopulmonary bypass, and in intensive care. It is also used in sports science to study real-time muscle oxygen kinetics, and is being investigated in a variety of areas.
Group 1 involves patients presenting with grade 3 supracondylar fractures. NIRS monitoring of the injured and uninjured sides is commenced at the end of surgery for up to 48 hours or discharge, in addition to standard post operative monitoring(pain scores, range of motion, swelling).
Group 2 involves patients presenting with suspected compartment syndrome. In these patients a single discrete 2 minute NIRS measurement is made immediately prior to surgery, co-temporaneously with invasive compartment pressure measurement. At surgical fasciotomy, the muscle is assessed for signs of compartment syndrome(swelling, colour, response to stimulation)
The current planned duration is 1 year, with group 1 recruitment of 30 and group 2 recruitment of 10.
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Intervention code [1]
257770
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Not applicable
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Comparator / control treatment
clinical indicators of compartment sydnrome
compartment pressures. A standard assessment includes pain scores, range of motion, pain during active and passive movement, and manual assessment of muscle compartment swelling. Both NIRs and clinical indicators are used on all patients.
As mentioned above there are 2 groups, one with supracondylar fractures and the other with suspected compartment syndrome.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Tissue oxygenation level
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Assessment method [1]
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Timepoint [1]
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From time of operative fixation until hospital discharge in group 1, measured continuously at a 2 second sampling rate, for up to 48 hours or discharge.
At time of surgical intervention for fasciotomy for group 2, as a discrete measurement taken over 2 minutes at a 2 second sampling rate.
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Secondary outcome [1]
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number of group 1 patients developing compartment syndrome. Clinical assessment, described before, is used to detect the development of compartment sydnrome. If suspected, muscle compartment pressures are measured usign an invasive device(Stryker pressure monitor), and fasciotomy is performed, at which time the muscle is directly inspected for colour, swelling and response to stimulation, allowing a definitive diagnosis of compartment syndrome to be made.
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Assessment method [1]
268702
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Timepoint [1]
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Continuous clinical observation for up to 48 hours post fixation or dischaege from hospital.
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Eligibility
Key inclusion criteria
Grade 3 supracondylar fracture for group 1
Clinically suspected compartment syndrome for group 2
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Minimum age
2
Years
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
volar forearm skin damage preventing probe attachment
Jaundice
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
26/02/2010
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Actual
26/02/2010
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Date of last participant enrolment
Anticipated
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Actual
30/11/2011
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Date of last data collection
Anticipated
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Actual
30/11/2011
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Sample size
Target
30
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Accrual to date
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Final
29
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
258235
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Hospital
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Name [1]
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Children's Hospital at Westmead Volunteer fund
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Address [1]
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Hawkesbury road
Westmead
2145
NSW
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Country [1]
258235
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Australia
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Primary sponsor type
Hospital
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Name
The Children's Hospital at Westmead
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Address
Hawkesbury Road
Westmead
2145
NSW
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Country
Australia
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Secondary sponsor category [1]
257402
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None
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Name [1]
257402
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Address [1]
257402
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Country [1]
257402
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
260216
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The Children's Hospital at Westmead HREC
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Ethics committee address [1]
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Hawkesbury road Westmead 2145 NSW
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
260216
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Approval date [1]
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26/02/2009
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Ethics approval number [1]
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08/CHW/117
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Summary
Brief summary
Compartment syndrome occurs when swelling in a muscle interferes with the blood supply to that muscle. The syndrome happens most often in fractures, and after bone operations, and can lead to damage to the muscle and nerves of the limb affected. We are interested in using a new technology that is designed to look at the blood oxygen levels in tissue (in this case muscle). The technology uses probes attached to a machine. The probes are placed on the skin, and shine light into the muscle. The light is not damaging to the tissue. We would like to know more about the oxygen levels of muscles in compartment syndrome in children. All children 0 to 18 years of age can participate. They cannot participate if they have jaundice, or broken skin where the probes may be placed. For those presenting with suspected compartment syndrome, when the child comes to theatre, once they are asleep, we will place a probe on the skin over the muscle. We will do this on the affected and the unaffected side. We will also do a standard compartment pressure measurement simultaneously. The probe will be left on for 2 minutes in theatre, and then removed. For those presenting with a supracondylar fracture, the probes will be placed on the injured, and uninjured sides and left on for 48 hours or until hospital discharge. The monitor has not yet been shown to help in this problem, and we will not use the values to alter treatment in any way. We hope that the results of this study will help us to detect compartment syndrome early on, and allow quicker treatment, in those children who develop it.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Dr Justin Skowno
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Address
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Department of Anaesthesia, The Children's Hospital at Westmead, Hawkesbury Road, Westmead, 2145, New South Wales, Australia.
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Country
30690
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Australia
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Phone
30690
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+61298450000
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Fax
30690
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Email
30690
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[email protected]
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Contact person for public queries
Name
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Dr Justin Skowno
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Address
13937
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Department of Paediatric Anaesthesia
The Children's Hospital at Westmead
Hawkesbury Road
Westmead
2145
NSW
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Country
13937
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Australia
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Phone
13937
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+61298450000
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Fax
13937
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Email
13937
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[email protected]
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Contact person for scientific queries
Name
4865
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Dr Justin Skowno
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Address
4865
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Department of Paediatric Anaesthesia
The Children's Hospital at Westmead
Hawkesbury Road
Westmead
2145
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Country
4865
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Australia
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Phone
4865
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+61298450000
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Fax
4865
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Email
4865
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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