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Trial registered on ANZCTR
Registration number
ACTRN12611000340932
Ethics application status
Approved
Date submitted
30/03/2011
Date registered
31/03/2011
Date last updated
24/07/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Can a measurement called pleth variability index (PVI) be used to guide clinicians in administrating fluids to patients undergoing general anaesthesia?
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Scientific title
Does pleth variability index predict fluid responsiveness in mechanically ventilated patients during general anaesthesia for non-cardiac surgery?
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Secondary ID [1]
259887
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Nil
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Universal Trial Number (UTN)
U1111-1120-4374
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Trial acronym
PVI Fluid Responsiveness
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fluid responsiveness
265483
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Condition category
Condition code
Anaesthesiology
265633
265633
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0
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Anaesthetics
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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
Pleth variability index (PVI) is measured before and after volume expansion with 500 mL of intravenous colloid. The measurements are done before induction of general anaesthesia when a patient presents for their surgery.
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Intervention code [1]
264310
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Not applicable
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Comparator / control treatment
Stroke volume index measured by oesophageal Doppler monitor in each patient simultaneously, before and after volume expansion
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Pleth variability index (PVI) is measured with a device called Masimo Rainbow SET Pulse CO-Oximetry. Hemodynamic variables before and after volume expansion are compared using a paired t-test. Patients are allocated to 2 groups according to the percentage change in stroke volume index (SVI) measured by oesophageal Doppler monitor after volume expansion: responders are defined as change in SVI of greater or equal to 10% and non-responders as change in SVI of less than 10%. The differences between responders and non-responders were evaluated using the Student’s t-test or the Mann-Whitney U-test, as appropriate. A receiver operating characteristic (ROC) curve for PVI was generated and the optimal cut-off value was determined by the highest Youden index (calculated as: sensitivity + specificity – 1). The Spearman rank method was used to test correlation. P-values of <0.05 were considered significant.
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Assessment method [1]
262424
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Timepoint [1]
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Secondary outcome [1]
273748
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Perfusion index, derived from Masimo Rainbow SET Pulse CO-Oximetry
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Assessment method [1]
273748
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Timepoint [1]
273748
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Secondary outcome [2]
273774
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Heart rate, derived from Masimo Rainbow SET Pulse CO-Oximetry
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Assessment method [2]
273774
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Timepoint [2]
273774
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Secondary outcome [3]
273775
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Blood pressure, measured by a non-invasive or an invasive blood pressure monitoring device
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Assessment method [3]
273775
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Timepoint [3]
273775
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Secondary outcome [4]
273776
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Cardiac index, derived from oesophageal Doppler monitor
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Assessment method [4]
273776
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Timepoint [4]
273776
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Secondary outcome [5]
273777
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Corrected flow time (FTc), derived from oesophageal Doppler monitor
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Assessment method [5]
273777
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Timepoint [5]
273777
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Baseline and 1 min, 2 min, and 3 min after fluid challenge, which consists of 500 mL of intravenous colloid
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Eligibility
Key inclusion criteria
Non-cardiac surgical patients requiring general anaesthesia, tracheal intubation and mechanical ventilation
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Minimum age
No limit
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Maximum age
No limit
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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
Patients with arrhythmia (including atrial fibrillation), ischaemic heart disease, cardiac failure (including left and right ventricular dysfunctions), and any contraindications to oesophageal probe insertion (e.g. oesophageal varices)
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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
1/09/2010
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Actual
3/09/2010
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Date of last participant enrolment
Anticipated
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Actual
21/12/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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St. Vincent's Hospital
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Address [1]
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Victoria Parade
Fitzroy
Victoria 3065
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Country [1]
264773
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Australia
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Primary sponsor type
Hospital
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Name
St. Vincent's Hospital
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Address
Victoria Parade
Fitzroy
Victoria 3065
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
263888
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Address [1]
263888
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Country [1]
263888
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
266752
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Research Governance Unit
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Ethics committee address [1]
266752
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St. Vincent's Hospital PO Box 2900 Fitzroy Victoria 3065
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Ethics committee country [1]
266752
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Australia
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Date submitted for ethics approval [1]
266752
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Approval date [1]
266752
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15/07/2010
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Ethics approval number [1]
266752
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HREC-D 057/10
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Summary
Brief summary
Aim: The aim of this project is to investigate whether pleth variability index (PVI), derived from the Masimo Rainbow (Registered Trademark) SET Pulse CO-Oximetry, can predict fluid responsiveness in mechanically ventilated patients during general anaesthesia for non-cardiac surgery. Significance: The significance of assessing PVI is that it is completely non-invasive (it only requires a probe on the finger), it provides a dynamic indicator of fluid responsiveness, and the PVI is displayed as a continuously monitored number, which makes it simple and user-friendly. Hypothesis: The main hypothesis is that PVI can accurately and consistently predict fluid responsiveness in mechanically ventilated patients during general anaesthesia following a standard fluid challenge. Objective: The main objective is to assess the accuracy and consistency of PVI as an indicator of assessing fluid responsiveness, when measured against the more well-established oesophageal Doppler/fluid challenge method. This will determine whether PVI can be used reliably as an indicator of fluid responsiveness. Methods: In this observational study, a total of 30 participants will be assessed as being fluid responsive or fluid non-responsive according to stroke volume changes (measured via the minimally invasive oesophageal Doppler monitor) following the administration of a standard fluid challenge. The two main measurements including PVI and stroke volume index will be recorded along with other variables. Using appropriate statistical analysis, we will determine the consistency and accuracy of PVI in detecting fluid responsiveness. Likely benefit of the research: The significance of assessing PVI in the current study is that it may provide a non-invasive and continuous way of determining which patients are likely to respond and thus benefit from fluid therapy, a measurement that previously requires much more invasive techniques.
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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 Andy Siswojo
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Address
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St. Vincent's Hospital Victoria Parade Fitzroy Victoria 3065
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Country
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Australia
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Phone
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+613 9288 2211
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Fax
32414
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Email
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[email protected]
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Contact person for public queries
Name
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Andy Siswojo
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Address
15661
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St. Vincent's Hospital
Victoria Parade
Fitzroy
Victoria 3065
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Country
15661
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Australia
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Phone
15661
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+613 9288 2211
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Fax
15661
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Email
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[email protected]
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Contact person for scientific queries
Name
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Andy Siswojo
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Address
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St. Vincent's Hospital
Victoria Parade
Fitzroy
Victoria 3065
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Country
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Australia
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Phone
6589
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+613 9288 2211
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Fax
6589
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Email
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[email protected]
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No information has been provided regarding IPD availability
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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