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Trial registered on ANZCTR
Registration number
ACTRN12616001136493
Ethics application status
Approved
Date submitted
18/08/2016
Date registered
19/08/2016
Date last updated
16/06/2021
Date data sharing statement initially provided
21/11/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Ventilation status of sedated patients in the cardiac catheterisation laboratory
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Scientific title
Ventilation status of sedated patients in the cardiac catheterisation laboratory
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Secondary ID [1]
289955
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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:
Sedation-induced respiratory depression
299941
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Respiratory
299971
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Cardiac
299972
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Condition category
Condition code
Anaesthesiology
299842
299842
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0
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Anaesthetics
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Respiratory
299863
299863
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0
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Other respiratory disorders / diseases
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Cardiovascular
299864
299864
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0
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Other cardiovascular diseases
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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
Continuous transcutaneous carbon dioxide measurements will be recorded from patients undergoing procedures with conscious sedation, starting before conscious sedation is induced (for measurement of baseline transcutaneous carbon dioxide) and ceasing at the end of the procedure. These measurement will not be available for clinicians monitoring patients (nurses and cardiologists) and will be used purely for analysis.
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Intervention code [1]
295644
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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]
299321
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Transcutaneous carbon dioxide level during sedation (OAA/S level 4 or less) using the Sentec Digital Monitoring System with VSign 2 sensor.
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Assessment method [1]
299321
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Timepoint [1]
299321
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Continuous measurements taken every second, which commence approximately 10 minutes prior to the start of the procedure and are ceased at the end of the procedure.
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Primary outcome [2]
299322
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Change in transcutaneous carbon dioxide level from baseline whilst sedated (defined as OAA/S 4 or less) using the Sentec Digital Monitoring System with VSign 2 sensor.
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Assessment method [2]
299322
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Timepoint [2]
299322
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Continuous measurements taken every second, which commence approximately 10 minutes prior to the start of the procedure and are ceased at the end of the procedure
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Primary outcome [3]
299323
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Peak transcutaneous carbon dioxide level whilst sedated (defined as OAA/S 4 or less) using the Sentec Digital Monitoring System with VSign 2 sensor.
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Assessment method [3]
299323
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Timepoint [3]
299323
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Continuous measurements taken every second, which commence approximately 10 minutes prior to the start of the procedure and are ceased at the end of the procedure
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Secondary outcome [1]
326835
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Incidence of transcutaneous carbon dioxide level >50mmHg whilst sedated (defined as OAA/S 4 or less) using the Sentec Digital Monitoring System with VSign 2 sensor.
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Assessment method [1]
326835
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Timepoint [1]
326835
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Continuous measurements taken every second, which commence approximately 10 minutes prior to the start of the procedure and are ceased at the end of the procedure.
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Secondary outcome [2]
326836
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Duration of transcutaneous carbon dioxide level >50mmHg whilst sedated (defined as OAA/S 4 or less) using the Sentec Digital Monitoring System with VSign 2 sensor.
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Assessment method [2]
326836
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Timepoint [2]
326836
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Continuous measurements taken every second, which commence approximately 10 minutes prior to the start of the procedure and are ceased at the end of the procedure.
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Eligibility
Key inclusion criteria
Patients undergoing an elective procedure with conscious sedation (intravenous midazolam or midazolam and fentanyl) without an anaesthetist present in a cardiac catheterisation laboratory
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Minimum age
18
Years
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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
1. less than 18 years of age
2. cognitively impaired (due to inability to provide informed consent); or
3. unable to understand and speak English (due to inability to provide written informed consent).
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
Descriptive statistics will be used to calculate mean, standard deviation (or median and interquartile range) and 95% confidence intervals of pre-sedation TcCO2 as well as changes in TcCO2 that occur after sedation is administered. Multiple regression will be used to identify associations between ventilation status (measured as the mean tcCO2 whilst OAA/S score 4 or less) and participant and procedural characteristics.
Sample size considerations
A formal sample size calculation is not required for the primary outcome of this study, which is to describe changes in TcCO2 during sedation. It is generally recommended that 10 observations per variable are required for multivariate statistical analysis. We plan to recruit a sample of at least 100 participants in order to examine associations between ten pre-selected variables and post-sedation mean TcCO2 levels. The variables include: age, gender, BMI, sleep apnoea/obesity hypoventilation syndrome status, presence of COPD, smoking status, history of benzodiazepine/opiod use, total dose of opioids and total dose of midazolam, supplemental oxygen use and clinician interventions to support ventilation (realigning airway, verbal/physical stimulation to increase level of consciousness).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
17/08/2016
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Date of last participant enrolment
Anticipated
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Actual
15/06/2018
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Date of last data collection
Anticipated
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Actual
15/06/2018
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Sample size
Target
100
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Accrual to date
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Final
78
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
6496
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John Flynn - Gold Coast Private Hospital - Tugun
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Recruitment hospital [2]
7201
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
14060
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4224 - Tugun
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Recruitment postcode(s) [2]
14964
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4102 - Woolloongabba
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Funding & Sponsors
Funding source category [1]
294334
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University
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Name [1]
294334
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QUT School of Nursing Seeding Grant
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Address [1]
294334
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QUT
60 Musk Ave
Kelvin Grove QLD 4059
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Country [1]
294334
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Australia
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Primary sponsor type
University
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Name
Queensland University of Technology
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Address
Queensland University of Technology
60 Musk Ave
Kelvin Grove QLD 4059
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Country
Australia
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Secondary sponsor category [1]
293171
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None
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Name [1]
293171
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Address [1]
293171
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Country [1]
293171
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295754
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Greenslopes Research and Ethics Committee
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Ethics committee address [1]
295754
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Greenslopes Private Hospital Newdegate St Greenslopes QLD 4120
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Ethics committee country [1]
295754
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Australia
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Date submitted for ethics approval [1]
295754
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Approval date [1]
295754
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14/06/2016
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Ethics approval number [1]
295754
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16/35
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Summary
Brief summary
Respiratory depression is more likely to be detected during sedation when capnography is used. However, sedation-induced respiratory depression is commonly transient and does not always cause patient harm. Randomised controlled trials have produced conflicting results regarding whether capnography improves patient safety when used during sedation. Further research is required to determine whether applying capnography to the conscious sedation context is warranted. One considerable difficulty in designing a trial to determine whether a specific intervention improves the safety of conscious sedation is that adverse sedation events that pose potential risks to patient safety, such as hypoxaemia, should be so rare that it would not be feasible to recruit the required number of participants. In contrast, the number of participants required to detect a clinically significant difference in ventilation status during conscious sedation, as measured by transcutaneous carbon dioxide concentration (TcCO2), would be feasible to recruit in the context of a clinical trial. However, in order to calculate a sample size for such a trial, the expected control group TcCO2 needs to be identified. In this study, continuous TcCO2 measurements will be recorded from patients undergoing procedures with conscious sedation, starting before conscious sedation is induced (for measurement of baseline TcC02) and ceasing at the end of the procedure.
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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
68338
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Dr Aaron Conway
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Address
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Institute of Health and Biomedical Innovation
Queensland University of Technology
60 Musk Ave
Kelvin Grove QLD 4059
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Country
68338
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Australia
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Phone
68338
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+61731386124
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Fax
68338
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Email
68338
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[email protected]
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Contact person for public queries
Name
68339
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Aaron Conway
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Address
68339
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Institute of Health and Biomedical Innovation
Queensland University of Technology
60 Musk Ave
Kelvin Grove QLD 4059
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Country
68339
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Australia
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Phone
68339
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+61731386124
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Fax
68339
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Email
68339
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[email protected]
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Contact person for scientific queries
Name
68340
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Aaron Conway
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Address
68340
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Institute of Health and Biomedical Innovation
Queensland University of Technology
60 Musk Ave
Kelvin Grove QLD 4059
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Country
68340
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Australia
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Phone
68340
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+61731386124
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Fax
68340
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Email
68340
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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)?
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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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