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Trial registered on ANZCTR
Registration number
ACTRN12621000215820
Ethics application status
Approved
Date submitted
17/12/2020
Date registered
3/03/2021
Date last updated
3/03/2021
Date data sharing statement initially provided
3/03/2021
Date results provided
3/03/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Impaired right ventricular deformation to predict acute kidney injury in patients having heart surgery
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Scientific title
Right ventricular strain calculated using perioperative trans-oesophageal echocardiography to predict acute kidney injury in patients receiving cardiopulmonary bypass for cardiothoracic surgery
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Secondary ID [1]
302501
0
Nil known
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Universal Trial Number (UTN)
U1111-1259-3667
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Trial acronym
RVS-HIS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Right ventricular strain
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cardiopulmonary bypass
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Heart surgery
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Acute kidney injury
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Condition category
Condition code
Anaesthesiology
317317
317317
0
0
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Anaesthetics
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Cardiovascular
317318
317318
0
0
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Diseases of the vasculature and circulation including the lymphatic 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
This study is a retrospective analysis of previously captured echocardiographic images of the right ventricle obtained from peri-operative trans-oesophageal echocardiography at the completion of cardiothoracic surgery once patients have been separated from cardiopulmonary bypass. These images are used to determine a numerical value for right ventricular strain. The source of images is from the database of trans-oesophageal echocardiography images obtained as part of the normal care of patients that have undergone cardiac surgery requiring cardiopulmonary bypass at Fiona Stanley Hospital, Perth, WA, Australia between 3rd February 2020 to 3rd August 2020.
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Intervention code [1]
318793
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Not applicable
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Comparator / control treatment
There is no control, this is a retrospective analysis taken from images that have already been captured.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The development of acute kidney injury as defined by the KDIGO guideline on acute kidney injury identified from the outcomes database that is kept as part of the audit procedure at Fiona Stanley Hospital. This database contains all outcome data for patients undergoing cardiac surgery at Fiona Stanley Hospital. This trial will be using worst acute kidney injury in the first 3 days following cardiac surgery using the KDIGO guideline.
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Assessment method [1]
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Timepoint [1]
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Acute kidney injury on the day following heart surgery (as defined by the KDIGO guidelines)
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Secondary outcome [1]
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Oxygen requirement – PaO2/FiO2 ratio
This is defined as the worst PaO2/FiO2 ratio in the three days following cardiac surgery. The data is collected from the cardiac outcomes database for Fiona Stanley hospital.
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Assessment method [1]
387689
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Timepoint [1]
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Oxygen requirement – PaO2/FiO2 ratio
This is defined as the worst PaO2/FiO2 ratio in the three days following cardiac surgery. The data is collected from the cardiac outcomes database for Fiona Stanley hospital.
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Secondary outcome [2]
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Conscious level
This is defined as worst GCS score in the three days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Assessment method [2]
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Timepoint [2]
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This is defined as worst GCS score in the three days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Secondary outcome [3]
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Liver function – Bilirubin values at day 5 post op
This is defined as highest bilirubin score in the five days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Assessment method [3]
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Timepoint [3]
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Liver function – Bilirubin values at day 5 post op
This is defined as highest bilirubin score in the five days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Secondary outcome [4]
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Vasopressor/ inotropic requirements
o Requirement and agent when leaving theatre (low cut off threshold of 5mcg/minute Noradrenaline)
o Requirement at 6 hours into ICU stay
This is defined as worst inotrope score in the three days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Assessment method [4]
391242
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Timepoint [4]
391242
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Vasopressor/ inotropic requirements
o Requirement and agent when leaving theatre (low cut off threshold of 5mcg/minute Noradrenaline)
o Requirement at 6 hours into ICU stay
This is defined as worst inotrope score in the three days following cardiac surgery. This information is collected as part of the outcomes auditing at Fiona Stanley Hospital and the source will be this database.
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Secondary outcome [5]
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RV Strain
Peri-operative RV strain values obtained by TOE images in anaesthetised patients immediately prior to cardiac surgery are not well known. This study will result in a set of values for strain that may be related to outcome.
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Assessment method [5]
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Timepoint [5]
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Given that strain values will be taken from TOE images obtained from the pre-knife to skin scans in anaesthetised patients immediately prior to cardiac surgery the timepoints will be Day0 (prior to surgery)
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Eligibility
Key inclusion criteria
o Are greater than 18 years old
o Have received cardiothoracic surgery involving cardiopulmonary bypass at Fiona Stanley Hospital in 2020
o Have received a transoesophageal echo as part of their usual care.
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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
No images available as determined by the two trained echocardiographers.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
4/01/2021
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Date of last participant enrolment
Anticipated
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Actual
29/01/2021
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Date of last data collection
Anticipated
31/03/2021
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Actual
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Sample size
Target
250
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Accrual to date
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Final
263
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
31658
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6150 - Murdoch
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Heart and Lung Research Institute Western Australia
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Address [1]
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5 Robin Warren Dr, Murdoch WA 6150, Australia
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Country [1]
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Australia
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Funding source category [2]
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Hospital
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Name [2]
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Fiona Stanley Hospital
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Address [2]
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11 Robin Warren Dr, Murdoch WA 6150, Australia
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Country [2]
306930
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Heart and Lung Research Institute Western Australia
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Address
Harry Perkins Institute
5 Robin Warren Dr, Murdoch WA 6150, Australia
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Country
Australia
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Secondary sponsor category [1]
307489
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Charities/Societies/Foundations
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Name [1]
307489
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Spinnaker Health Research Foundation
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Address [1]
307489
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Fiona Stanley Hospital
11 Robin Warren Dr, Murdoch WA 6150, Australia
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Country [1]
307489
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Warren Pavey
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Address [1]
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Fiona Stanley Hospital
8 Robin Warren Dr, Murdoch WA 6150, Australia
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Country [1]
281625
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Australia
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Other collaborator category [2]
281626
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Individual
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Name [2]
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Dr Mick Scerri
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Address [2]
281626
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Fiona Stanley Hospital
8 Robin Warren Dr, Murdoch WA 6150, Australia
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Country [2]
281626
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Metropolitan Health Service- Health Research Ethics Comittee
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Ethics committee address [1]
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South Metropolitan Health Service Fiona Stanley Hospital, Education Building Level 2 11 Robin Warren Drive Murdoch WA 6150
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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28/09/2020
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Approval date [1]
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28/10/2020
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Ethics approval number [1]
307076
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Summary
Brief summary
This research project is investigating how a right ventricular strain, also known as deformation, obtained during trans-oesophageal echocardiography, may be used to predict kidney failure in patients who are placed on cardiopulmonary bypass for heart and lung surgery. Right ventricular strain may be calculated from echocardiographic images, already taken during heart surgery. Trans-oesophageal ultrasound is an established bedside ultrasound investigation that is used on most patients having heart and lung surgery. Recent technological advancements have allowed us to look at the heart in more detail with the aim of improving the outcomes of these patients. Kidney failure is a major problem after heart and lung surgery and increases post-operative mortality. It also results in longer hospital stays, invasive investigations, invasive treatments, and may result in the patient needing long term dialysis and transplantation. Our understanding of how right ventricular strain relates to kidney dysfunction is currently very poor. This research project will improve our understanding and our aim is that this will enable us to direct treatments to preserve kidney function in at risk patients and improve the burden of kidney failure on the patients affected and on the hospitals taking care of them.
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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 Richard Hunt
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Address
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Fiona Stanley Hospital
8 Robin Warren Dr, Murdoch WA 6150, Australia
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Country
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Australia
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Phone
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+61491669568
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Fax
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Email
105946
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[email protected]
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Contact person for public queries
Name
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Richard Hunt
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Address
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Fiona Stanley Hospital
8 Robin Warren Dr, Murdoch WA 6150, Australia
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Country
105947
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Australia
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Phone
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+61 491669568
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Fax
105947
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Email
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[email protected]
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Contact person for scientific queries
Name
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Richard Hunt
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Address
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Fiona Stanley Hospital
8 Robin Warren Dr, Murdoch WA 6150, Australia
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Country
105948
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Australia
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Phone
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+61491669568
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Fax
105948
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Email
105948
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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?
Demographic, primary and secondary outcome data will be shared if requested.
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When will data be available (start and end dates)?
Immediately following publication, no end date.
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Available to whom?
Access will be granted on a case-by-case basis at the discretion of the Primary Sponsor.
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Available for what types of analyses?
To achieve the aims in the approved proposal
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How or where can data be obtained?
Access will be subject to approvals by Principal Investigator (
[email protected]
)
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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.
Download to PDF