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Trial registered on ANZCTR
Registration number
ACTRN12607000436471
Ethics application status
Approved
Date submitted
15/02/2007
Date registered
29/08/2007
Date last updated
29/08/2007
Type of registration
Retrospectively registered
Titles & IDs
Public title
Cerebral Oximetry in Cardiac Surgery
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Scientific title
Using Cerebral oximetry (INVOS 5100) during cardiopulmonary bypass in patients requiring elective isolated coronary artery bypass graft surgery to improve neuropsychological outcomes or composite clincal outcomes (composite endpoint based on the presence of 30-day mortality or a major morbidity (permanent stroke, renal dysfunction or failure, cardiac surgery reoperation, prolonged ventilation, deep sternal wound infection)).
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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:
Patients cerebral oxygenation during cardiopulmonary bypass
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
4 groups, with blinded or unblinded operator with respect to cerebral oximetry monitor and unblinded operator with respect to rewarming rate. Group 1: Standard rewarming with blinded near infrared spectroscopy (control)
Group 2: Standard rewarming with interventional near infrared spectroscopy
Group 3: Slow rewarming with blinded near infrared spectroscopy
Group 4: Slow rewarming with interventional near infrared spectroscopy
Cerebral monitoring occurs from time immediately prior to intubation to the time the patient is extubated (12-15 hr).
Standard rewarming is when the patient is rewarmed at a maximum rate of 1 degree per minute, slow rewarming is when the patient is rewwarmed at a maximum rate 0.5C per minute. INVOS Cerebral Oximeter interventions include increasing flow, gas sweep rates, cardiac output, oxygen saturation and hematocrit.
Blinded near infrared spectroscopy is when the perfusionist is unaware of what the spectrocopy results are during the oepration (equivalent to current practice), interventional is when the perfusionist uses the interventiones noted above to manage the perfusion based upon the near infra red spctrcopy results.
The device is called teh INVOS cerebral oximeter, details are avaialble on the follwoing website http://www.somanetics.com/invos.htm. INVOS means "In-Vivo Optical Spectroscopy".
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
Group 1: Standard rewarming with blinded near infrared spectroscopy (control)
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Control group
Active
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Outcomes
Primary outcome [1]
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Neuropsychological outcome measures (including Employment Status; Edinburgh Handedness; Orientation;California Verbal Learning Test-II; Purdue Pegboard ; Verbal Fluency (COWAT); Trails Making Test A & B; Symbol Digit; Boston Naming Test short form: or Cognitive Drug Research test battery)
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Assessment method [1]
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Timepoint [1]
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Reported prior to discharge and 6,12 and 24 month postoperatively. For patients who do not complete neuropsychological assessments, the combined clinical endpoint will serve as primary outcome (a composite endpoint based on the presence of 30-day mortality or a major morbidity (permanent stroke, renal dysfunction or failure, cardiac surgery reoperation, prolonged ventilation, deep sternal wound infection) determined at discharge.
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Secondary outcome [1]
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Secondary outcomes 1: combined clinical endpoint, a composite endpoint based on the presence of 30-day mortality or a major morbidity (permanent stroke, renal dysfunction or failure, cardiac surgery reoperation, prolonged ventilation, deep sternal wound infection) occurring during the period of hospitalisation.
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Assessment method [1]
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Timepoint [1]
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30 day or until end of hospitalisation
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Secondary outcome [2]
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In addition Short Portable Mental Status Questionnaire, Medical Outcome Short Form 36 Health Survey, Delerium Symptom Interview, Depression Anxiety Sress Scale, Mood Anxiety Sress-Questionairre, Mini International Neuropsychiatirc Interview and a clinical assessment are performed at discharge, 6, 12 and 24 months.
A clinical assessment is the routine morbidity and health examination that is performed on all patients prior to discharge.
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Assessment method [2]
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Timepoint [2]
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Prior to discharge.
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Eligibility
Key inclusion criteria
The patient sample: will consist of participants of both gender, requiring elective isolated coronary artery bypass graft surgery at Flinders Medical Centre;
The patient is willing to participate and has signed a consent form.
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Minimum age
18
Years
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Maximum age
Not stated
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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
English not first language;
Previous cerebrovascular disease including CVA, RIND, or TIA anytime prior to planned surgery;
Emergency and urgent coronary artery surgery
Previous open heart surgery
History of neurological disease/insult
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Study design
Purpose of the study
Prevention
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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)
1. sealed opaque envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
2. Simple randomisation by using a randomization table created by a computer software (i.e., computerised sequence generation).
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Surgeon who performs the operation is blinded to the oximetry; data collector (medical officer) is blinded to the both the oximetry and teh rewarming strategy. The perfusionist is unblinded to the randomisation, as is the trial co-ordinator.
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
3/04/2003
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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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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National Heart Foundation
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Address [1]
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Country [1]
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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
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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]
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none
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Flinders Medical Centre
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Ethics committee address [1]
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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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Approval date [1]
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19/02/2007
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Ethics approval number [1]
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105-067
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Summary
Brief summary
Cardiac surgery is a very common procedure for the treatment of coronary artery disease, however it is not without side effects. Some of these complications, such as stroke, are overtly debilitating, whilst others such as mood changes are less obvious, but still affect daily activities. The aetiology of these complications remains unclear. We believe that they arise from many different causes, some of which relate to the cardiopulmonary bypass machine that is used to support patients during heart surgery. We propose to investigate a device that will help us determine if the brain is being correctly protected during heart surgery using cardiopulmonary bypass. We plan to utilise this device to continuously monitor the amount of oxygen that is supplied to the brain during heart surgery. In addition, we will combine monitoring of the brain with therapeutic strategies designed to limit the exposure of the brain to potentially harmful events. Ultimately this information could be used to reduce the incidence of postoperative brain complications.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Robert A Baker
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Address
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Flinders Medical Centre
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Country
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Australia
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Phone
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61884042015
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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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Robert A Baker
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Address
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Flinders Medical Centre
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Country
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Australia
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Phone
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61884042015
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Fax
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Email
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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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