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Trial registered on ANZCTR
Registration number
ACTRN12622001214729
Ethics application status
Approved
Date submitted
31/08/2022
Date registered
9/09/2022
Date last updated
9/09/2022
Date data sharing statement initially provided
9/09/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Body temperature and shivering during caesarean sections
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Scientific title
Accurate measurement of core body temperature and shivering occurrence in emergency caesarean sections compared to elective caesarean sections
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Secondary ID [1]
307884
0
None
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Universal Trial Number (UTN)
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Trial acronym
TEMS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hypothermia
327515
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Hyperthermia
327516
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Shivering
327517
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Condition category
Condition code
Reproductive Health and Childbirth
324624
324624
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0
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Childbirth and postnatal care
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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 core temperature will be recorded continuously throughout the caesarean section (CS) journey with a 3M™ Bair Hugger™ core Temperature Monitoring System (BHTMS). The BHTMS has a sensor that is attached to the forehead. BHTMS will be applied in the holding bay while waiting for CS for elective CS patients and either in the birthing suite or at the time of arrival in operating theatre for emergency CS patients.
The first temperature logged by the BHTMS will be recorded as the patient’s baseline temperature. Core temperature monitoring with BHTMS is continued in operating theatre during caesarean section and in recovery room.
The overall duration of monitoring will be approximately 6 hours from the time of applying BHTMS to leaving the recovery room.
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Intervention code [1]
324344
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Not applicable
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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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Core temperature change from the baseline at the onset of shivering (shivering threshold delta: difference in core temperature between baseline and the onset of shivering) between elective vs emergency caesarean section.
Core temperature is monitored by BHTMS and recorded in a logger attached to BHTMS. Data of the core temperature will be extracted via USB of the logger after the case. The onset of shivering is recorded by a research member or anaesthetist on a data sheet.
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Assessment method [1]
332441
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Timepoint [1]
332441
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The time of the shivering onset
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Secondary outcome [1]
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1. Maximum change in core temperature from the baseline between elective vs emergency caesarean section.
Core temperature is monitored by BHTMS and recorded in a logger attached to BHTMS. Data of the core temperature will be extracted via USB of the logger after the case.
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Assessment method [1]
413511
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Timepoint [1]
413511
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The time of lowest core temperature and highest core temperature during the caesarean section.
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Secondary outcome [2]
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2. Maximum change in core temperature between those who shivered vs those who did not shiver, and elective vs emergency caesarean section.
Core temperature is monitored by BHTMS and recorded in a logger attached to BHTMS. Data of the core temperature will be extracted via USB of the logger after the case.
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Assessment method [2]
413667
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Timepoint [2]
413667
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The time of the maximum difference (increase or decrease) of core temperature from that of base line.
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Eligibility
Key inclusion criteria
• Elective caesarean section under subarachnoid block (spinal/combined spinal and epidural anaesthesia)
• Intrapartum emergency caesarean section under epidural anaesthesia
• Age 18 or above
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Patient refusal
• Inability to consent
• ASA 3 or over
• Morbidly obese (BMI 50 or over)
• Category 1 or “Code Blue” emergency caesarean section (due to an “urgent threat to the life of the woman or the fetus” as per RANZCOG)
• Antepartum haemorrhage requiring blood transfusion
• Active warming with air forced blanket and/or fluid warmer are planned to use from the beginning of the caesarean section
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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
Prospective
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Statistical methods / analysis
Our primary endpoint is the core temperature change from the baseline at the onset of shivering (shivering threshold delta). The pilot data completed by C. Mullington (co-investigator) showed that the mean core temperature changes at onset of shivering from baseline were -0.62 °C (SD 0.12) in elective CS and -0.03 °C (SD 0.15) in emergency CS.
We powered our study to detect a true difference in mean shivering threshold delta between emergency caesarean group and elective caesarean group of 0.25 °C which is clinically significant. Further, we assumed a pooled standard deviation of 0.5 °C as the bigger population variance is expected with larger and more diverse sample. The study therefore requires a sample size of: 85 for each group (elective and emergency CS), a total sample size of 170 to achieve a power of 90% and a level of significance of 5% (two sided). We aim to recruit total 200 patients (100 for elective and 100 for emergency CS).
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/01/2023
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Actual
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Date of last participant enrolment
Anticipated
29/09/2023
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Actual
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Date of last data collection
Anticipated
29/09/2023
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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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]
38392
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6150 - Murdoch
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Recruitment outside Australia
Country [1]
24990
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United Kingdom
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State/province [1]
24990
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London
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Fiona Stanley Hospital
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Address [1]
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11 Robin Warren Dr, Murdoch WA 6150
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Country [1]
312157
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Australia
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Primary sponsor type
Hospital
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Name
Fiona Stanley Hospital
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Address
11 Robin Warren Dr, Murdoch WA 6150
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Country
Australia
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Secondary sponsor category [1]
313684
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Hospital
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Name [1]
313684
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St Mary's Hospital
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Address [1]
313684
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Praed Street, London W2 1NY
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Country [1]
313684
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United Kingdom
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311548
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South Metropolitan Health Service
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Ethics committee address [1]
311548
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11 Robin Warren Dr, Murdoch WA 6150
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Ethics committee country [1]
311548
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Australia
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Date submitted for ethics approval [1]
311548
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Approval date [1]
311548
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11/07/2022
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Ethics approval number [1]
311548
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RGS0000005199
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Summary
Brief summary
Some women have a caesarean section (abbreviated as CS) to have a baby. The safest anaesthetic for this is with an injection in the mother’s back to make her numb from her breasts down which is called epidural or spinal anaesthesia. CS can be categorised as elective (planned) or emergency (unplanned). Elective CS takes place before the onset of labour (uterine contraction), whereas most emergency CS occurs after labour has started. Hypothermia (a low body temperature) is a common problem during elective CS and consequently active warming is recommended. By contrast, hyperthermia (a high body temperature) is a side effect of epidural pain relief during labour and therefore it is possible that hyperthermia is the dominant problem during emergency CS. The temperature changes during emergency CS are not fully understood. It is important to study temperature changes during CS because hypothermia and hyperthermia can cause problems for her or the baby. Some mothers shiver during CS which is an unpleasant side effect that makes it difficult for mothers to hold their babies and breastfeed shortly after birth. What we know so far is shivering during elective CS is caused by hypothermia and is effectively treated with active warming. During emergency CS, however, shivering occurs at normal or increased body temperatures and therefore active warming is likely inappropriate. At present, body temperature is not routinely checked during CS and therefore it is not possible to tailor temperature regulation strategies to individuals’ needs. In this multicentre cohort study, we will investigate how patterns of body temperature change differ between elective and emergency CSs, and how this relates to shivering. We anticipate that this study will highlight the need to routinely measure body temperature during CS and will be a steppingstone towards personalised temperature management strategies during spinal and epidural anaesthesia.
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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 Yayoi Ohashi
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Address
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Fiona Stanley Hospital
11 Robin Warren Dr, Murdoch WA 6150
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Country
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Australia
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Phone
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+61429047777
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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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Yayoi Ohashi
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Address
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Fiona Stanley Hospital
11 Robin Warren Dr, Murdoch WA 6150
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Country
121499
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Australia
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Phone
121499
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+61429047777
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Fax
121499
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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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Yayoi Ohashi
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Address
121500
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Fiona Stanley Hospital
11 Robin Warren Dr, Murdoch WA 6150
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Country
121500
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Australia
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Phone
121500
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+61429047777
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Fax
121500
0
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Email
121500
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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
There is no plan to share the IPD.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
17075
Study protocol
384610-(Uploaded-31-08-2022-16-04-45)-Study-related document.pdf
17076
Informed consent form
384610-(Uploaded-06-09-2022-07-27-40)-Study-related document.pdf
17077
Ethical approval
384610-(Uploaded-31-08-2022-16-06-17)-Study-related document.pdf
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