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Trial registered on ANZCTR
Registration number
ACTRN12616000818437
Ethics application status
Approved
Date submitted
16/06/2016
Date registered
22/06/2016
Date last updated
24/02/2022
Date data sharing statement initially provided
4/03/2021
Date results provided
24/02/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Monitoring breathing in children during anaesthesia: The Electrical Impedance Tomography study
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Scientific title
Assessment of lung homogeneity with Electrical Impedance Tomography (EIT) in neonates and small infants during mechanical ventilation in theatre:
a prospective observational cohort study
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Secondary ID [1]
289474
0
None
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Universal Trial Number (UTN)
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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:
Neonatal Ventilation
299155
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Lung Homogeneity
299156
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Condition category
Condition code
Anaesthesiology
299175
299175
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0
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Other anaesthesiology
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Respiratory
299176
299176
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0
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Normal development and function of the respiratory system
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Intervention/exposure
Study type
Observational
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Patient registry
False
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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
We will place the electrical impedance tomography (EIT) belt around the participant's chest. We will record EIT measurements for 2 minutes pre-anaesthesia, for 2 minutes at the start of anaesthesia and for 2 minutes at 30 minute intervals until the end of anaesthesia and 2 minutes post-anaesthesia. Patients are followed up until they are discharged from the recovery unit.
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Intervention code [1]
295057
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
298658
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The primary outcome is the tidal volume homogeneity (VT homogeneity) which is calculated using several variables:
- CoV >2%
- %VT in the dependent (or right) hemithorax >10%
- Change in %atelectasis >5%
- VT >2mL/kg
- Cdyn >0.1mL/kg/cmH2O
This outcome is assessed using EIT and the Florian monitor.
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Assessment method [1]
298658
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Timepoint [1]
298658
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At the conclusion of anaesthesia.
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Secondary outcome [1]
324860
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Correlation between incidence of postoperative respiratory complications (observed from anaesthesia monitor) and presence of ventilation inhomogeneity (assessed by EIT and Florian monitor).
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Assessment method [1]
324860
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Timepoint [1]
324860
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At the conclusion of anaesthesia.
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Eligibility
Key inclusion criteria
1. Neonates and small infants aged less than or equal to 1 year of age
2. Children scheduled for general anaesthesia that requires endotracheal intubation with a cuffed tube
3. Children scheduled for procedures that require them to be in a supine position
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Minimum age
No limit
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Maximum age
1
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
1. Children in whom the placement of EIT belt at the standard position (nipple level) would interfere with surgical care: for example cardiac and thoracic surgery
2. Children with known pulmonary disease
3. Children who have previously been mechanically ventilated
4. Children with <32 weeks completed gestational age at birth
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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
As this is an observational descriptive study, the sample size is largely driven by what is logistically feasible and sufficient to allow for the patterns to be determined for more directed sample size calculations in future studies. Initially we wish to aim for recruiting 30 subjects.
Although the pattern of VT homogeneity is well described in the infant requiring ICU support, it is known to be highly variable and the pattern in healthy infants undergoing an anaesthetic is unknown. Consequently, primary analysis will be limited to simple descriptive statistics. The following would be considered a clinically meaningful change in each parameter:
CoV >2%
%VT in the dependent (or right) hemithorax
>10% Change in %atelectasis
>5% VT >2mL/kg
Cdyn >0.1mL/kg/cmH2O
Depending on the frequency of inhomogeneity we may choose to perform regression analysis to explore the association/correlation between risk factors and lung inhomogeneity. If the frequency is low, then there may be insufficient data for such an analysis. In this case we may consider recruiting more children to enable this analysis.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
Already had sufficient data
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Date of first participant enrolment
Anticipated
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Actual
31/03/2016
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Date of last participant enrolment
Anticipated
31/05/2021
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Actual
1/05/2018
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Date of last data collection
Anticipated
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Actual
1/05/2018
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Sample size
Target
40
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Accrual to date
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Final
30
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
5991
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The Royal Childrens Hospital - Parkville
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Recruitment postcode(s) [1]
13413
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
293836
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Hospital
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Name [1]
293836
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Department of Anaesthesia and Pain Management, The Royal Children's Hospital
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Address [1]
293836
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Department of Anaesthesia and Pain Management
The Royal Children's Hospital
Flemington Road
Parkville VIC 3052
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Country [1]
293836
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Children's Hospital
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Address
The Royal Children's Hospital
Flemington Road
Parkville VIC 3052
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Country
Australia
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Secondary sponsor category [1]
292671
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None
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Name [1]
292671
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Address [1]
292671
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Country [1]
292671
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295264
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The Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [1]
295264
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The Royal Children's Hospital Flemington Road Parkville VIC 3052
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Ethics committee country [1]
295264
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Australia
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Date submitted for ethics approval [1]
295264
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07/01/2016
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Approval date [1]
295264
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28/01/2016
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Ethics approval number [1]
295264
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36008A
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Summary
Brief summary
Mechanical ventilation is often required to support respiratory function but it can cause lung injury. This risk is well understood in the Intensive Care Unit setting where mechanical ventilation is often required for long periods of time but the impact of short exposure to mechanical ventilation during anaesthesia is unknown. Some populations, in particular neonates and small infants, are at greater risk of this potential detrimental effect. One of the principal factors related to ventilator induced lung injury is the inhomogeneity of lung ventilation. To evaluate lung homogeneity, imaging techniques are usually used, although these are often invasive, intermittent and time consuming. Recently a new technology, called Electrical Impedance Tomography (EIT), has been developed. EIT is a non-invasive, radiation-free monitoring tool that allows real-time continuous imaging of ventilation at the bedside, measuring the impedance of the thorax through a belt placed around patient's chest. This study will use EIT to define the patterns of tidal ventilation within the chest and determine whether mechanical ventilation during general anaesthesia increases the risk of lung inhomogeneity in neonates and small infants. We also hope to determine if there is a correlation between the degree of lung inhomogeneity and different aspects of mechanical ventilation. These results could improve our knowledge about the impact of mechanical ventilation on the neonatal lung and help us to find best management for neonatal ventilation during an anaesthetic.
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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
51702
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Dr Bae Corlette
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Address
51702
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The Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
51702
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Australia
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Phone
51702
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+61 3 9345 4901
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Fax
51702
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Email
51702
0
[email protected]
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Contact person for public queries
Name
51703
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Bae Corlette
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Address
51703
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The Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
51703
0
Australia
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Phone
51703
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+61 3 9345 4901
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Fax
51703
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Email
51703
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[email protected]
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Contact person for scientific queries
Name
51704
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Bae Corlette
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Address
51704
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The Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
51704
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Australia
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Phone
51704
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+61 3 9345 4901
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Fax
51704
0
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Email
51704
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Entire database (de-identified data only)
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When will data be available (start and end dates)?
December 2022. No end date determined.
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Available to whom?
Interested parties with projects where the PI agree that the data set would be used appropriately.
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Available for what types of analyses?
Any purpose for which the PI agrees that the data set would be used appropriately.
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How or where can data be obtained?
Dr Bae Corlette:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10892
Study protocol
[email protected]
10893
Informed consent form
[email protected]
10894
Ethical approval
[email protected]
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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