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Trial registered on ANZCTR
Registration number
ACTRN12618001644257p
Ethics application status
Submitted, not yet approved
Date submitted
17/09/2018
Date registered
4/10/2018
Date last updated
4/10/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Hemodynamic effects of warm vs cold resuscitation fluid in critically ill patients
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Scientific title
A randomized control study to examine the hemodynamic effects of resuscitation fluid temperature (warm vs room temperature) in critically ill patients
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Secondary ID [1]
295061
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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:
hypotension
308906
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shock
308908
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Condition category
Condition code
Cardiovascular
307811
307811
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0
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Other cardiovascular diseases
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Emergency medicine
307812
307812
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0
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Resuscitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intensive Care patients meeting a predetermined criteria to receive a fluid bolus will be randomised into intervention (warmed) or control (room temperature) groups.
Patients in intervention group will receive a 500ml bolus of 4% albumin intravenously over 15 minutes, given through a fluid warmer at 38 degrees Celsius.
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Intervention code [1]
301893
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Treatment: Other
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Comparator / control treatment
Intensive Care patients meeting a predetermined criteria to receive a fluid bolus will be randomised into intervention (warmed to 38 degrees Celsius) or control (room temperature 23 degrees Celsius) groups.
Patients in control group will receive a 500ml bolus of 4% albumin intravenously over 15 minutes, given at room temperature.
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Control group
Active
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Outcomes
Primary outcome [1]
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To measure the difference in change in stroke volume via transthoracic echocardiogaphy following room temperature vs warmed fluid bolus
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Assessment method [1]
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Timepoint [1]
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30 minutely from administration of fluid bolus, for 2 hours.
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Secondary outcome [1]
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Stroke work as calculated by stroke volume multiplied by central aortic pressure
Stroke volume will be measured by echocardiography. Central aortic pressure will be calculated indirectly using radial arterial waveform.
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Assessment method [1]
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Timepoint [1]
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [2]
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Systemic vascular resistance. Calculated from echocardiographically measured cardiac output, mean arterial pressure and central venous pressure.
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Assessment method [2]
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Timepoint [2]
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [3]
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Heart rate as measured by ECG, pulse oximeter and arterial blood pressure monitor.
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Assessment method [3]
350415
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Timepoint [3]
350415
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [4]
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Mean arterial pressure as measured by arterial line.
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Assessment method [4]
350416
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Timepoint [4]
350416
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [5]
350417
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body temperature as measured by temperature probe
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Assessment method [5]
350417
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Timepoint [5]
350417
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [6]
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Urine output measured hourly via indwelling urinary catheter bag
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Assessment method [6]
350418
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Timepoint [6]
350418
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [7]
350419
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Vasoactive agent requirement as recorded in standard ICU observation chart, the dose per hour of vasoactive agent required to maintain a target mean arterial pressure will be recorded.
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Assessment method [7]
350419
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Timepoint [7]
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30 minutely for 2 hours from initiation of fluid bolus
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Secondary outcome [8]
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Blood lactate levels
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Assessment method [8]
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Timepoint [8]
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30 minutely for 2 hours from initiation of fluid bolus
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Eligibility
Key inclusion criteria
• Admitted to ICU
• Age 18 years or older
• Meeting clinical criteria for fluid bolus administration (one of the following):
o MAP <65mmHg
o HR >100bpm
o Urine output <0.5ml/kg/hr
o Lactate levels of >3mmol/dL
o Cardiac index <2.5L/min/m2
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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
• Active bleeding requiring transfusion
• Haemoglobin level <70g/L
• Patients in whom death is considered imminent (within 24 hours)
• Receiving continuous renal replacement therapy (CRRT)
• Active temperature control
• Pregnancy
• Malignant hyperthermia
• Planned exit from ICU during 2 hour monitoring period
• Inability to obtain satisfactory echocardiographic images for cardiac output measurement
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Outcomes will be compared after log transformation where appropriate. Comparisons will be made using t-test and analysis of variance for repeated measures or Wilcoxon rank-signed test and Kruskal-Wallis according to the underlying distribution for continuous data and Chi-square for categorical data. Analysis will be an on intention-to-treat basis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
4/02/2019
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Actual
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Date of last participant enrolment
Anticipated
3/08/2020
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Actual
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Date of last data collection
Anticipated
3/08/2020
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Actual
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Sample size
Target
54
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
11614
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Flinders Medical Centre - Bedford Park
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Recruitment postcode(s) [1]
23658
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5042 - Bedford Park
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Funding & Sponsors
Funding source category [1]
299643
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Charities/Societies/Foundations
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Name [1]
299643
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Intensive Care Foundation
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Address [1]
299643
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Level 2/10 Ievers Terrace, Carlton VIC 3053
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Country [1]
299643
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Australia
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Primary sponsor type
Hospital
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Name
Flinders Medical Centre
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Address
Flinders Dr, Bedford Park SA 5042
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Country
Australia
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Secondary sponsor category [1]
300232
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None
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Name [1]
300232
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Address [1]
300232
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Country [1]
300232
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
300540
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Southern Adelaide Clinical Human Research Ethics Committee
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Ethics committee address [1]
300540
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Flinders Medical Centre 1 Flinders Drive BEDFORD PARK SA 5042
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Ethics committee country [1]
300540
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Australia
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Date submitted for ethics approval [1]
300540
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17/09/2018
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Approval date [1]
300540
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Ethics approval number [1]
300540
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Summary
Brief summary
Low blood pressure is a common problem in critically ill patients. It is often associated with compromised organ blood flow, leading to organ dysfunction. Administration of fluids into a vein is a common method to treat low blood pressure, which aims to increase blood volume to improve organ blood flow. The effect of fluid temperature on blood pressure and cardiac output is largely unknown. In healthy volunteers, it was found that room temperature fluids led to a bigger increase in blood pressure than warmed fluids, but caused a decrease in cardiac output. This was thought to be due to reflexive constriction of blood vessels in response to cold. A decrease in cardiac output may in turn cause lowered organ blood flow. This study aims to compare the effect of room temperature and warmed fluid therapy on cardiac output and blood pressure, in critically ill patients. We postulate warmed fluids may lead to better increase in cardiac output, compared to room temperature fluids. If this is true, warmed fluid therapy may become standard to improve organ blood flow in critically ill patients.
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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 Simon Tan
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Address
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Intensive and Critical Care Unit, Flinders Medical Centre, Flinders Dr, Bedford Park SA 5042
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Country
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Australia
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Phone
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+61421347522
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Fax
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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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Simon Tan
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Address
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Intensive and Critical Care Unit, Flinders Medical Centre, Flinders Dr, Bedford Park SA 5042
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Country
83999
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Australia
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Phone
83999
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+61421347522
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Fax
83999
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Email
83999
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[email protected]
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Contact person for scientific queries
Name
84000
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Simon Tan
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Address
84000
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Intensive and Critical Care Unit, Flinders Medical Centre, Flinders Dr, Bedford Park SA 5042
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Country
84000
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Australia
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Phone
84000
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+61421347522
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Fax
84000
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Email
84000
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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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