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Trial registered on ANZCTR
Registration number
ACTRN12621000840886
Ethics application status
Approved
Date submitted
17/05/2021
Date registered
1/07/2021
Date last updated
14/07/2024
Date data sharing statement initially provided
1/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The Cardiac Return Assist Blanket (CRAB) safely increases central venous pressure.
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Scientific title
Evaluating the cardiovascular effects of the Compressive Redistribution Air Blanket (CRAB) on healthy volunteers
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Secondary ID [1]
304234
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None
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Universal Trial Number (UTN)
U1111-1267-4979
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Trial acronym
CRAB
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Central venous pressure
321942
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Condition category
Condition code
Anaesthesiology
319673
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is a first clinical trial on this new device. The objective is to find the relationship between CRAB Pressure and rise in CVP and to document the comfort / safety of the CRAB. In addition, it will be compared to current standard of care which increase CVP, the straight leg raise and Trendelenburg position.
Twenty healthy volunteers will arrive fasted (from midnight) on the morning of the study.
They will have a midline line catheter inserted by an experienced expert, under ultrasound guidance in an arm vein with the catheter tip being placed in a central vein to monitor the central venous pressure.
The CRAB is an inflatable bag - that will be strapped around the participant and bed by 4 large velcro straps. The top of the CRAB will be at the level of the xiphisternum.
The interventions will be performed by an anaesthetist with an assistant in the room.
The Intervention consists of a cycles of the CRAB being inflated for 2 minutes, then deflated for 2 minutes. The CRAb pressures during the 4 CRAB Cycles will be 10,20,30 and 40 cmH2O and deflation pressure will be zero. 2 further cycles of intervention will be performed with Straight leg elevation for 2 minutes, and 15 degrees Trendelenberg position. During the interventions the participants will be monitored with CVP, ECG, BP & SaO2, and asked to assessment the comfort after each inflation. This initial intervention will take 24 minutes.
After the initial invention cycles the CRAB will be removed from the participant and they will fed with a sandwich and 2 glasses of a drink of their choice.
They will also have 1 litre of CSL through their Midline catheter over a 30 minute period.
The intervention protocol as listed above will then be repeated. 24minutes.
At the completing of the second intervention protocol - the CRAB will be removed, The Midline Catheter removed (while lying flat) and the participant will need to wait 15 minutes before leaving.
Total time from Start (insertion of midline catheter) to Finish(going home) 2.5- 3 hours
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Intervention code [1]
320572
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Treatment: Devices
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Comparator / control treatment
The primary outcome of this trial is to quantify the relationship between CRAB Pressure and rise in CVP. Therefore each participant will be their own control. The 2min of No Pressure in the CRAB will give the baseline CVP, compared against the CVP while the CRAB is pressurised.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in Central Venous Pressure for varying pressures in the CRAB. (10,20,30&40cm H2O)
This will assessed by a pressure transducers connected to a midline catheter positioned in a central vein.
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Assessment method [1]
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Timepoint [1]
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The Central venous pressure (CVP) will be monitored constantly (for 24 min) throughout every cycle of the interventions.. The baseline CVP will be the CVP just prior to each 2 minute intervention (inflation of the CRAB, Straight leg raise or Trendelenberg position). The change in CVP will be defined as the Change in CVP from baseline CVP to the maximal CVP during the 2 minutes of each intervention.
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Secondary outcome [1]
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Participant comfort after each cycle of interventions.
It will be measured with a Visual Analogue Score (VAS) 0-10 Comfort, Tolerability, difficulty breathing
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Assessment method [1]
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Timepoint [1]
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The Comfort / Complications will be assess after each series of interventions.
It will be measured twice - after the fasting cycle of interventions, and after the hydrated cycle of interventions.
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Secondary outcome [2]
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Blood Pressure (BP) change during each intervention.
It will be measure using a constant non invasive Finger BP monitor.
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Assessment method [2]
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Timepoint [2]
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The BP will be monitored constantly (for 24 min) throughout every cycle of the interventions.. The baseline BP will be the BP just prior to each 2 minute intervention (inflation of the CRAB, Straight leg raise or Trendelenberg position). The change in BP will be defined as the Change in BP from baseline BP to the maximal BP during the 2 minutes of each intervention.
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Secondary outcome [3]
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Heart Rate (HR)change during each intervention.
Measure with a Pulse oximeter.
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Assessment method [3]
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Timepoint [3]
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The HR will be monitored constantly (for 24 min) throughout every cycle of the interventions.. The baseline HR will be the HR just prior to each 2 minute intervention (inflation of the CRAB, Straight leg raise or Trendelenberg position). The change in HR will be defined as the Change in HR from baseline HR to the maximal HR during the 2 minutes of each intervention.
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Secondary outcome [4]
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Oxygen Saturation (SaO2) change during each intervention.
Measure with a Pulse oximeter.
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Assessment method [4]
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Timepoint [4]
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The (SaO2) will be monitored constantly (for 24 min) throughout every cycle of the interventions.. The baseline SaO2 will be the SaO2 just prior to each 2 minute intervention (inflation of the CRAB, Straight leg raise or Trendelenberg position). The change in SaO2 will be defined as the Change in SaO2 from baseline SaO2 to the lowest SaO2 during the 2 minutes of each intervention.
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Secondary outcome [5]
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Participant tolerability
It will be measured with a Visual Analogue Score (VAS) 0-10 for Tolerability.
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Assessment method [5]
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Timepoint [5]
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It will be measured twice - after the fasting cycle of interventions, and after the hydrated cycle of interventions.
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Secondary outcome [6]
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Difficulty Breathing
It will be measured with a Visual Analogue Score (VAS) 0-10 for Difficulty Breathing.
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Assessment method [6]
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Timepoint [6]
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It will be measured twice - after the fasting cycle of interventions, and after the hydrated cycle of interventions.
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Secondary outcome [7]
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Pain
It will be measured with a Visual Analogue Score (VAS) 0-10 for Pain
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Assessment method [7]
397127
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Timepoint [7]
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It will be measured twice - after the fasting cycle of interventions, and after the hydrated cycle of interventions
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Eligibility
Key inclusion criteria
Healthy ASA 1 & 2 participants.
ASA 1 - A normal healthy patient eg Healthy, non-smoking, no or minimal alcohol use
ASA 2 - A patient with mild systemic disease eg Mild diseases only without substantive functional limitations. Current smoker, social alcohol drinker, pregnancy, obesity (30<BMI<40), well-controlled DM/HTN, mild lung disease
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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
Pregnant
Abdominal surgery in last 6 months.
Cardiac Disease – Ischemic heart disease, Valvular disease, arrythmias, history of recurrent vasovagals (faints).
Respiratory Disease – (Symptoms controlled mild asthma is OK)
Any significant medical conditions
Prescription medication for the cardiovascular or respiratory system.
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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
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Statistics : Continuous outcome measures will be summarised using means, standard deviations, medians and ranges..
Sample Size : There have been no previous investigation of this product to have an expected mean and standard deviation change in CVP for any CRAB Pressure.
A sample size of 20 has been chosen as =
This is a commonly the size for "phase 1" simple interventional trials.
The intervention is highly unlikely to cause harm so there is minimal risk associated with this number.
The primary endpoints is the change in CVP. 20 participants with 5 CRAB data points (0,10,20,30,40 cmH2O) should allow precise determination of the mean change in CVP for each 10cmH2O of CRAB pressure.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
16/07/2022
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Actual
31/07/2022
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Date of last participant enrolment
Anticipated
30/11/2022
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Actual
3/09/2022
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Date of last data collection
Anticipated
30/11/2022
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Actual
3/09/2022
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Sample size
Target
20
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Accrual to date
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Final
16
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment postcode(s) [1]
34060
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6009 - Nedlands
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Coco Industries Pty Ltd
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Address [1]
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18 Jameson St
Swanbourne 6010
Western Australia
Australia
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Country [1]
308612
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Coco Industries Pty Ltd
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Address
18 Jameson St
Swanbourne 6010
Western Australia
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
309480
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Address [1]
309480
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Country [1]
309480
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308544
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Sir Charles Gairdner and Osborne Park Health Care Group HREC
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Ethics committee address [1]
308544
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SCGH HREC Level 2, A Block, QEII Medical Centre Hospital Avenue Nedlands 6008 Western Australia
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Ethics committee country [1]
308544
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Australia
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Date submitted for ethics approval [1]
308544
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11/06/2021
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Approval date [1]
308544
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15/06/2022
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Ethics approval number [1]
308544
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Summary
Brief summary
The Compressive Redistribution Air Blanket (CRAB) is a recent invention with a primary aim of treating adrenaline resistant anaphylactic shock. Improved understanding of adrenaline resistant anaphylactic shock suggests the primary cause of hypotension is the venodilation, not vasodilation. Venodilation decreases Central Venous Pressure (CVP) resulting in poor cardiac filling and poor cardiac output. Adrenaline is a potent vasoconstrictor but does not significantly effect venodilation. When the CRAB is inflated to the pressures of just 20-40cm H2O the venous system in the abdomen and legs will be compressed and it is believed this will increase the central venous pressure, increase venous return to heart and restore blood pressure. This is a phase 1 clinical trial. The objective is to document the comfort / safety of the CRAB and find the relationship between CRAB Pressure and rise in CVP. In addition, it will be compared to current standard of care which increase CVP, the straight leg raise and Trendelenburg position. Twenty healthy volunteers will arrive fasted on the day of the study and have a midline line catheter inserted under ultrasound guidance in an arm vein to monitor the central venous pressure. A series of 2 minute inflations at 10,20,30 and 40 cmH2O and deflations will be monitored with CVP, ECG, BP & SaO2, and an assessment of comfort after each inflation. The protocol will be repeated after food, drink and IV hydration.
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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 Christopher Mitchell
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Address
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Anaesthetic Department
Sir Charles Gairdner Hospital
Hospital Drive
Nedlands 6008
Western Australia
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Country
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Australia
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Phone
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+61 0427 425854
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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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Christopher Mitchell
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Address
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Anaesthetic Department
Sir Charles Gairdner Hospital
Hospital Drive
Nedlands 6008
Western Australia
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Country
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Australia
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Phone
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+61 0427 425854
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Fax
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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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Christopher Mitchell
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Address
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Anaesthetic Department
Sir Charles Gairdner Hospital
Hospital Drive
Nedlands 6008
Western Australia
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Country
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Australia
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Phone
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+61 0427 425854
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Fax
111084
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Email
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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)?
No
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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
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11686
Study protocol
382006-(Uploaded-17-05-2021-17-52-22)-Study-related document.doc
11687
Informed consent form
382006-(Uploaded-17-05-2021-17-53-04)-Study-related document.docx
11688
Other
Investigator Brochure Information
382006-(Uploaded-17-05-2021-17-54-15)-Study-related document.docx
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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