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Trial registered on ANZCTR
Registration number
ACTRN12620000262909
Ethics application status
Approved
Date submitted
10/02/2020
Date registered
27/02/2020
Date last updated
27/02/2020
Date data sharing statement initially provided
27/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Stomach distension with high flow nasal oxygen therapy. A volunteer study
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Scientific title
Gastric insufflation with high flow nasal oxygen therapy. A volunteer study
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Secondary ID [1]
300497
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Nil Known
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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:
Gastric insufflation
316179
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High flow nasal oxygen therapy
316180
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Gastrointestinal system
316307
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Gastric distension
316308
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Condition category
Condition code
Oral and Gastrointestinal
314472
314472
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
When the participants are ready, a baseline ultrasound estimate of the stomach volume estimate is done. Thereafter, oxygen will be delivered through a high-flow nasal cannula. This will be accomplished using the Optiflow THRIVE device (Opti-Flow, Auckland, New Zealand). Flow rate through the cannula will be commenced at 30 L/min and fractional inspired oxygen concentration will be set at 100%. The flow will be gradually increased and maintained at 60-70L/min during the study. The flow rate could be decreased up to 30 L/min if higher flow rate is not tolerated.
A set of ultrasound measurements looking for gastric distension and stomach volume will be made at 10 min intervals till 30 minutes of HFNC delivery. Measurements will be obtained between peristaltic contractions when the stomach is resting. A set of three measurements will be made for each outcome variable and the mean value would be recorded. The HFNC will be ceased at 30 minutes and the participants are allowed to rest for another 30 minutes. During this time, they are not allowed to eat or drink. Another set of scans and measurements of stomach volume and distension will be obtained 30 minutes after ceasing HFNC. Peripheral oxygen saturation (SPO2) will be monitored throughout the study.
The intervention will be carried out by anaesthesiologists and it will be performed in the post anaesthesia care unit where appropriate facilities are available to conduct the study.
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Intervention code [1]
316805
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Treatment: Other
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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]
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Incidence of gastric distension, defined by distended antrum with air content that blurs the posterior wall (described as comets tail artefact). Recorded as Yes/No
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Assessment method [1]
322802
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Timepoint [1]
322802
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10 minutes
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Primary outcome [2]
322803
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Incidence of gastric distension, defined by distended antrum with air content that blurs the posterior wall (described as comets tail artefact). Recorded as Yes/No
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Assessment method [2]
322803
0
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Timepoint [2]
322803
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20 minutes
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Primary outcome [3]
322804
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Incidence of gastric distension, defined by distended antrum with air content that blurs the posterior wall (described as comets tail artefact). Recorded as Yes/No
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Assessment method [3]
322804
0
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Timepoint [3]
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30 minutes
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Secondary outcome [1]
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Change in the gastric antral area compared to baseline using ultrasound estimates
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Assessment method [1]
379838
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Timepoint [1]
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10 minutes, 20 minutes, 30 minutes and 60 minutes
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Secondary outcome [2]
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Dryness of mouth: Yes/NO
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Assessment method [2]
379839
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Timepoint [2]
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60 minutes
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Secondary outcome [3]
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d) Volunteer comfort: 5-point Likert scale (completed 5 min after the study)
Very comfortable (5), mildly uncomfortable (4), moderately uncomfortable (3), very uncomfortable (2), intolerable (1)
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Assessment method [3]
379840
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Timepoint [3]
379840
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60 minutes
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Secondary outcome [4]
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Dryness of Nose: Yes/NO
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Assessment method [4]
380194
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Timepoint [4]
380194
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60 minutes
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Secondary outcome [5]
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Sensation of
Nausea: Yes/No
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Assessment method [5]
380195
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Timepoint [5]
380195
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60 minutes
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Secondary outcome [6]
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Vomiting: Yes/NO
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Assessment method [6]
380196
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Timepoint [6]
380196
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60 minutes
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Secondary outcome [7]
380197
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Bloating of the stomach: Yes/No
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Assessment method [7]
380197
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Timepoint [7]
380197
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60 minutes
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Eligibility
Key inclusion criteria
Healthy non-pregnant volunteers 18-70 yrs, both males and females
No significant organ impairment
No language barrier
Fasted for 6 hours for solids and liquids. Sips of water allowed till 2 hours of the study enrolment
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
History of severe gastro oesophageal reflux disease, hiatus hernia, previous gastro-oesophageal or duodenal surgery
Those who are on medications affecting gastric motility
History of nasal blockage or congestion
Participants unable to consent
Diabetes mellitus
Morbid obesity >40 BMI
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
Single group
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Other design features
Voluntary study on a convenience sample of volunteers
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
6/03/2020
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Actual
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Date of last participant enrolment
Anticipated
30/08/2020
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Actual
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Date of last data collection
Anticipated
30/08/2020
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Actual
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Sample size
Target
15
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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]
15829
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The Queen Elizabeth Hospital - Woodville
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Recruitment postcode(s) [1]
29272
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5011 - Woodville
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Funding & Sponsors
Funding source category [1]
304915
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Hospital
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Name [1]
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Department of Anaesthesia, The Queen Elizabeth Hospital, Woodvill, SA
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Address [1]
304915
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The Queen Elizabeth Hospital
28 Woodville Road
Woodville
SA 5011
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Country [1]
304915
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Australia
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Primary sponsor type
Hospital
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Name
The Queen Elizabeth Hospital
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Address
28 Woodpile Road, Woodville, SA 5011
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Country
Australia
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Secondary sponsor category [1]
305260
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None
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Name [1]
305260
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Address [1]
305260
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Country [1]
305260
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305322
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [1]
305322
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Royal Adelaide Hospital Clinical Trial Centre Level 3, Wayfiner 3D460.02 Port Road Adelaide SA 5000
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Ethics committee country [1]
305322
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Australia
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Date submitted for ethics approval [1]
305322
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12/10/2019
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Approval date [1]
305322
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29/12/2019
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Ethics approval number [1]
305322
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Q20190410
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Summary
Brief summary
High flow nasal cannula (HFNC) has been shown to provide better oxygenation compared to the venturi face mask and low flow nasal cannula during intravenous sedation for both bronchoscopy and dental procedures . Though there are no major effects reported with this device, gastric distension is a theoretical possibility. Continuous high flow together with the ability to create low levels of positive airway pressure can potentiate gastric distension. When gastric distension occurs, it causes an increase in the secretion of gastric acid through vagal response. Hence, there is a potential for increased gastric volume and secretions, along with an elevated intraluminal pressure. This may increase the risk of pulmonary aspiration of gastric contents. Data is lacking as to quantify this issue in clinical practice. The aim of this study is to assess gastric insufflation and volume in healthy volunteers after application of HFNC. We hypothesise that the application of high flow nasal oxygen will not result in gastric distension. Measurements will be made of the incidence of gastric insufflation before and after the application of HFNC. When the participants are ready, a baseline ultrasound estimate of the stomach volume estimate is done. Thereafter, oxygen will be delivered through a high-flow nasal cannula. This will be accomplished using the Optiflow THRIVE device (Opti-Flow, Auckland, New Zealand). Flow rate through the cannula will be commenced at 30 L/min and fractional inspired oxygen concentration will be set at 100%. The flow will be gradually increased and maintained at 60-70L/min during the study. The flow rate could be decreased up to 30 L/min if higher flow rate is not tolerated. A set of ultrasound measurements looking for gastric distension and antral area will be made at 10 minutes intervals till 30 minutes of HFNC delivery. Measurements will be obtained between peristaltic contractions when the stomach is resting. A set of three measurements will be made for each outcome variable and the mean value would be recorded. The HFNC will be ceased at 30 minutes and the participants are allowed to rest for another 30 minutes. During this time, they are not allowed to eat or drink. Another set of scans and measurements will be obtained 30 minutes after ceasing HFNC.
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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 Venkatesan Thiruvenkatarajan
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Address
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Staff Specialist
Department of Anaesthesia, The Queen Elizabeth Hospital
28 woodville Road,
Woodville South 5011, Adelaide, South Australia
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Country
99994
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Australia
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Phone
99994
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+61 08 82226640
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Fax
99994
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Email
99994
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[email protected]
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Contact person for public queries
Name
99995
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Venkatesan Thiruvenkatarajan
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Address
99995
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Staff Specialist
Department of Anaesthesia, The Queen Elizabeth Hospital
28 woodville Road,
Woodville South 5011, Adelaide, South Australia
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Country
99995
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Australia
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Phone
99995
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+61 08 82226640
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Fax
99995
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+61 08 82226640
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Email
99995
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[email protected]
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Contact person for scientific queries
Name
99996
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Venkatesan Thiruvenkatarajan
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Address
99996
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Staff Specialist
Department of Anaesthesia, The Queen Elizabeth Hospital
28 woodville Road,
Woodville South 5011, Adelaide, South Australia
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Country
99996
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Australia
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Phone
99996
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+61 08 82226640
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Fax
99996
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Email
99996
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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)?
Yes
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What data in particular will be shared?
Non identifiable study results
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When will data be available (start and end dates)?
Beginning 3 months and following 5 years after publication
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Available to whom?
Anyone who wishes to access it
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Available for what types of analyses?
For approved study proposals and for general information to the public
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How or where can data be obtained?
By contacting the principal investigator through Phone
Phone number: 0061 08 8222 6640
Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, SA 5011
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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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