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Trial registered on ANZCTR
Registration number
ACTRN12617000953336
Ethics application status
Approved
Date submitted
26/06/2017
Date registered
4/07/2017
Date last updated
8/06/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Modelling and measuring anaesthetic gas uptake by the lung
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Scientific title
Measurement of the partial pressure cascade for anaesthetic agents during inhalational anaesthesia for cardiac surgery
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Secondary ID [1]
292291
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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:
Lung uptake of anaesthetic gases
303811
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Inhalational anaesthesia
303812
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Condition category
Condition code
Anaesthesiology
303178
303178
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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
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
The partial pressure cascade for sevoflurane and desflurane will be measured in patients undergoing inhalational general anaesthesia for cardiac surgery. Measurements of inspired, end-tidal, arterial and mixed venous partial pressure of anaesthetic agent and oxygen and CO2 will be made at one time point during the pre-cardiopulmonary bypass phase. Calculation of pulmonary deadspace and shunt will be done as indices of ventilation perfusion scatter in all patients. In a further group of 10 patients ventilation perfusion scatter will be formally quantified uisng the mIGET.
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Intervention code [1]
298465
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Not applicable
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Comparator / control treatment
Patients act as their own controls
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
302566
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The Alveolar deadspace fraction for the anaesthetic agents will be measured from the alveolar-arterial gradient via the Bohr-Enghoff equation, and compared to that calculated in the traditional way using simultaneous PCO2 measurements.
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Assessment method [1]
302566
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Timepoint [1]
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60 minutes post induction of anaesthesia or the nearest point where stability of cardiovascular and measured variables is maintained for at least 5 minutes.
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Secondary outcome [1]
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Relationship of A-a differences and pulmonary deadspace to V/Q scatter measured using the MIGET
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Assessment method [1]
336377
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Timepoint [1]
336377
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60 minutes post induction of anaesthesia or the nearest point where stability of cardiovascular and measured variables is maintained for at least 5 minutes.
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Eligibility
Key inclusion criteria
Patients undergoing coronary artery bypass surgery
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Minimum age
18
Years
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Maximum age
85
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
Patients unable to provide informed consent
Women who are pregnant
Patients with cognitive impairment
Patients with moderately or severely impaired respiratory function on history and examination (FEV1 or FVC < 50% predicted)
Patients with morbid obesity (Body mass index (BMI) > 40 kg/m2)
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
Mean alveolar deadspace for CO2 will be compared with that for volatile agent.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/01/2019
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Actual
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Date of last participant enrolment
Anticipated
31/12/2020
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Actual
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Date of last data collection
Anticipated
31/12/2020
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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)
VIC
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Recruitment hospital [1]
8453
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Austin Health - Austin Hospital - Heidelberg
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Recruitment postcode(s) [1]
16528
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3084 - Heidelberg
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Funding & Sponsors
Funding source category [1]
296835
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Charities/Societies/Foundations
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Name [1]
296835
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ANZCA Research Foundataion
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Address [1]
296835
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ANZCA
Ulimaroa
630 St Kilda Rd
Melbourne 3004
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Country [1]
296835
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Australia
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Primary sponsor type
Hospital
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Name
Austin Health
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Address
Studley Rd
Heidelberg
VIC 3084
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Country
Australia
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Secondary sponsor category [1]
295829
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None
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Name [1]
295829
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Address [1]
295829
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Country [1]
295829
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298067
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Austin Health
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Ethics committee address [1]
298067
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StudleyRd Heidelberg 3084
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Ethics committee country [1]
298067
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Australia
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Date submitted for ethics approval [1]
298067
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28/07/2016
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Approval date [1]
298067
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21/10/2016
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Ethics approval number [1]
298067
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DT 16/419
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Summary
Brief summary
We will collect observational data on patients undergoing cardiac surgery under general anaesthesia with volatile agent maintenance (sevoflurane or desflurane). We will collect simultaneous samples of end-tidal gas concentrations, and arterial and mixed venous blood samples for partial pressure measurement for O2 and CO2, and anaesthetic gases, as we done in several previous studies), along with measurements of alveolar ventilation, and of pulmonary blood flow using bolus thermodilution. We will study 10 patients with sevoflurane and 10 patients with desflurane. Samples will be collected once in the pre-cardiopulmonary bypass period and once post-cardiopulmonary bypass. In a further group of 10 patients we will also perform the Multiple Inert Gas Elimination Technique (MIGET). This is the gold standard method for measuring precise distributions of V/Q ratios in patients. We have developed and validated an adaptation of the MIGET for use in ventilated patients under general anaesthesia. The V/Q distributions generated will be used for application within the model, to obtain precise measurements of shunt fraction and alveolar deadspace. These models will allow us the plot the precise pattern of distribution of anaesthetic gas uptake across the lungs in these patients. An index of severity of V/Q scatter will be obtained by calculations of shunt fraction and alveolar deadspace using the traditional 3-compartment Riley model, from the Shunt equation and the Bohr-Enghoff equation. Parallel calculations of shunt fraction and alveolar deadspace will be made using measurements of volatile agent for comparison.
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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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A/Prof Philip Peyton
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Address
75882
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Dept of Anaesthesia
Austin Health
Studley Rd
Heidelberg 3084
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Country
75882
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Australia
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Phone
75882
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+61 3 94965000
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Fax
75882
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Email
75882
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[email protected]
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Contact person for public queries
Name
75883
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Philip Peyton
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Address
75883
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Dept of Anaesthesia
Austin Health
Studley Rd
Heidelberg 3084
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Country
75883
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Australia
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Phone
75883
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+61 3 94965000
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Fax
75883
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Email
75883
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[email protected]
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Contact person for scientific queries
Name
75884
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Philip Peyton
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Address
75884
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Dept of Anaesthesia
Austin Health
Studley Rd
Heidelberg 3084
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Country
75884
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Australia
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Phone
75884
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+61 3 94965000
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Fax
75884
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Email
75884
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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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