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Trial registered on ANZCTR
Registration number
ACTRN12610000139077
Ethics application status
Approved
Date submitted
8/02/2010
Date registered
10/02/2010
Date last updated
11/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
The influence of differing inspired oxygen concentrations on platelet function in a model of lower limb ischaemic reperfusion injury
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Scientific title
A trial of patients with a lower limb arterial tournique and whether an increase in inspired oxygen concentration at the time of reperfusion has any effect on platelet activation, as assessed by flow cytometry and thromboelastography
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Secondary ID [1]
1394
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None
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Universal Trial Number (UTN)
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Trial acronym
SLIPPER
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ischaemic reperfusion injuries
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Condition category
Condition code
Blood
256928
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0
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Clotting disorders
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Anaesthesiology
256929
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0
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Anaesthetics
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Anaesthesiology
256930
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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
After randomization to a fractional inspired oxygen concentration of either 0.3, 0.5 or 0.8, the fractional inspired oxygen concentration is altered accordingly from 0.3 at the time of reperfusion. This is achieved by altering oxygen concentration on the ventilator. This is a one off treatment started 10 minutes before tourniquet release and continued until 24 hours after tourniquet release.
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Intervention code [1]
255987
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Treatment: Other
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Comparator / control treatment
Keeping the fractional inspired oxygen concentration at 0.3 at the time of reperfusion. This is a one off treatment started 10 minutes before tourniquet release and continued until 24 hours after tourniquet release.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Change in platelet activation as assessed by flow cytometry (degree of change unknown)
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Assessment method [1]
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Timepoint [1]
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pre induction, 10 mins pre tourniquet deflation, immediately pre tourniquet deflation, 5 mins post tourniquet, 30 mins and 24 hours post tourniquet deflation
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Secondary outcome [1]
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Change in platelet activation as assessed by thromboelastography (degree of change unknown)
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Assessment method [1]
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Timepoint [1]
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pre induction, 10 mins pre tourniquet deflation, immediately pre tourniquet deflation, 5 mins post tourniquet, 30 mins and 24 hours post tourniquet deflation
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Eligibility
Key inclusion criteria
1. Adult patients undergoing lower limb surgery that requires the use of a tourniquet for more than 45 minutes
2. American Society of Anaesthesiology (ASA) grade 1 or 2
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Minimum age
18
Years
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Maximum age
80
Years
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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
1. Patients taking any antiplatelet medication 2. Confirmed coagulation disorder (pathological or drug induced) 3. Platelet count less then 80 x 109/l 4. Blood urea greater than 8.0 mmol/L 5. Systemic infection 6. Confirmed systemic Inflammatory diseases 7. Documented pregnancy 8. Documented malignancy 9. Trauma other than the ipsilateral lower limb 10. Multiple tourniquet episodes 11. Likely intraoperative O2 requirement > 30%
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Study design
Purpose of the study
Treatment
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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)
Identified from theatre lists. Written informed consent as per ethical guidelines. Allocation concealment by sealed opaque envelopes. Patients blinded to intervention.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random number generator using 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
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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
15/02/2010
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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
45
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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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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Royal Perth Hospital Medical Research Fundation
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Address [1]
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Royal Perth Hospital, Wellington street Campus, Perth 6000 WA
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Perth Hospital
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Address
Royal Perth Hospital, Wellington street Campus, Perth 6000 WA
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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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Address [1]
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Country [1]
255803
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Perth Ethics Committee
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Ethics committee address [1]
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Royal Perth Hospital, Wellington street Campus, Perth 6000 WA
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
258541
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Approval date [1]
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08/02/2010
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Ethics approval number [1]
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EC2009/127
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Summary
Brief summary
Evidence exists that surgery conducted with the use of a tourniquet results in blood being more prone to clotting. This phenomena starts whilst the tourniquet is inflated and increases when the tourniquet is deflated. Platelets are thought to be central to this process. Activation of the platelets may in part be due to products produced by the oxygen deprived tissue secondary to the use of the tourniquet. Some evidence exists that these products can be modified by altering the concentration of inspired oxygen at the time of reperfusion. However, whether altering the inspired concentration of oxygen influences platelet function remains unexplored. We plan to investigate whether changes in the inspired oxygen concentration alter platelet function in a model of ischaemic reperfusion injury. This is of clinical interest because ischaemic reperfusion injuries are encountered commonly in surgical practice. Examples include revascularisation of limbs in vascular surgery, organ transplantation, crush injuries etc. Maintenance of normal blood clotting is vital to clinical outcome.
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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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Dr Manuel Wenk
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Address
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Department of Anaesthesia and Pain Medicine
Royal Perth Hospital,
Wellington Street Campus,
Perth 6000
WA
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Country
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Australia
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Phone
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+61 8 9224 1036
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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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Dr Manuel Wenk
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Address
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Department of Anaesthesia and Pain Medicine
Royal Perth Hospital,
Wellington Street Campus,
Perth 6000
WA
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Country
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Australia
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Phone
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+61 8 9224 1036
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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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