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Trial registered on ANZCTR
Registration number
ACTRN12611000817943
Ethics application status
Approved
Date submitted
12/07/2011
Date registered
4/08/2011
Date last updated
4/08/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effects of inverse ratio pressure- controlled ventilation on the gas exchange in patients undergoing robot assisted prostatectomy
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Scientific title
The effects of inverse ratio pressure- controlled ventilation on the gas exchange in patients undergoing robot assisted prostatectomy
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Secondary ID [1]
262614
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nil
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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:
prostate cancer
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robot-assisted prostatectomy
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Condition category
Condition code
Cancer
268438
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0
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Prostate
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Anaesthesiology
268439
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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
Patients will be ventilated with tidal volume 7 ml/kg, inspiratory to expiratory ratio (I:E) of 1:2 in a pressure-controlled mode (PCM)(initial ventilation). After abdominal insufflations of CO2, mechanical ventilation by pressure-controlled mode (PCM) with 5 cmH2O PEEP and I:E of 2:1 will be applied to them during abdominal insufflation of carbon dioxide gas in Trendelenberg position (intervention). The inspiratory pressure will be set to deliver a tidal volume of 7 ml/kg during PCM. After desufflation of abdominal gas, the ventilation will returne to an initial ventilation method of PCM.
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Intervention code [1]
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Treatment: Surgery
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
Patients will be ventilated with tidal volume 7 ml/kg, inspiratory to expiratory ratio (I:E) of 1:2 in a pressure-controlled mode (PCM) , then after abdominal insufflations of CO2, mechanical ventilation by pressure-controlled mode (PCM) with 5 cmH2O PEEP and I:E of 1:2 will be applied to them during abdominal insufflation of carbon dioxide gas. The inspiratory pressure was set to deliver a tidal volume of 7 ml/kg during PCM. After desufflation of abdominal gas, the ventilation returned to an initial ventilation method of PCM.
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Control group
Active
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Outcomes
Primary outcome [1]
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airway pressures (peak and mean airway pressure and total PEEP) will be measured by continuous expiratory air sampling, using a mainstream sensor (CO2 SMO PLUS 8100, Novametrix Medical System Inc., Wallingford, CT) placed in-line between endotracheal tube and the Y-piece using S/5 monitor (Datex-Engstrom, Helsinki, Finland).
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Assessment method [1]
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Timepoint [1]
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before Trendelenberg position (Tini), every 30 min when receiving a mechanical ventilation with PCM having a different I: E ratio (T30, T60, T90,..) until end of abdominal CO2 gas insufflation, and 20 min after return to basal ventilation with abdominal desufflation (Tend)
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Primary outcome [2]
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Arterial blood gas analysis.
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Assessment method [2]
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Timepoint [2]
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before Trendelenberg position (Tini), every 30 min when receiving a mechanical ventilation with PCM having a different I: E ratio (T30, T60, T90,..) until end of abdominal CO2 gas insufflation, and 20 min after return to basal ventilation with abdominal desufflation (Tend)
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Primary outcome [3]
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lung compliance will be monitored by continuous expiratory air sampling, using a mainstream sensor (CO2 SMO PLUS 8100, Novametrix Medical System Inc., Wallingford, CT) placed in-line between endotracheal tube and the Y-piece using S/5 monitor (Datex-Engstrom, Helsinki, Finland).
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Assessment method [3]
269358
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Timepoint [3]
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before Trendelenberg position (Tini), every 30 min when receiving a mechanical ventilation with PCM having a different I: E ratio (T30, T60, T90,..) until end of abdominal CO2 gas insufflation, and 20 min after return to basal ventilation with abdominal desufflation (Tend)
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Secondary outcome [1]
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radial arterial pressure (pulse wave analysis)
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Assessment method [1]
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Timepoint [1]
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before Trendelenberg position (Tini), every 30 min when receiving a mechanical ventilation with PCM having a different I: E ratio (T30, T60, T90,..) until end of abdominal insufflation of CO2 gas, and 20 min after return to basal ventilation with abdominal desufflation (Tend)
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Secondary outcome [2]
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heart rate through electrocardiogram
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Assessment method [2]
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Timepoint [2]
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before Trendelenberg position (Tini), every 30 min when receiving a mechanical ventilation with PCM having a different I: E ratio (T30, T60, T90,..) until end of abdominal insufflation of CO2 gas, and 20 min after return to basal ventilation with abdominal desufflation (Tend)
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Eligibility
Key inclusion criteria
American Society of Anesthesiologists physical status 1,2 patients undergoing elective robot-assisted prostatectomy
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Minimum age
45
Years
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Maximum age
75
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
heart failure (defined as New York Heart Association classification more than 3), coronary artery disease, and obstructive pulmonary disease, defined as forced expiratory volume for 1 min below 80%
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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
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
7/06/2011
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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
42
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Korea, Republic Of
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State/province [1]
3706
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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jie ae kim
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Address [1]
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Jie Ae Kim, M.D., Ph.D., Associate professor in Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of medicine, 50, Irwon-dong, Gangnam-gu, Seoul, Korea 135-710
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Country [1]
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Korea, Republic Of
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Primary sponsor type
Individual
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Name
jie ae kim
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Address
Jie Ae Kim, M.D., Ph.D., Associate professor in Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of medicine, 50, Irwon-dong, Gangnam-gu, Seoul, Korea 135-710
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Country
Korea, Republic Of
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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]
266474
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Samsung Medical Centre Human Research Ethics Committee
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Ethics committee address [1]
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Samsung Medical Center, Sungkyunkwan University school of medicine, 50, Irwon-dong, Gangnam-gu, Seoul, Korea 135-710
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Ethics committee country [1]
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Korea, Republic Of
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Date submitted for ethics approval [1]
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25/04/2011
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Approval date [1]
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02/06/2011
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Ethics approval number [1]
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2011-04-014-001
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Summary
Brief summary
In patients undergoing robot-assisted prostatectomy, positive end- expiratory pressure (PEEP) has been increasingly used to compensate decreased lung compliance. However, airway pressure is another obstacle to apply sufficient PEEP with adequate tidal volume. Prolongation of inspiration time with low level PEEP could provide additive alveolar recruitment effect avoiding increase in the peak airway pressure. This study intended to compare the gas exchange between conventional and inverse ratio ventilation in robot-assisted prostatectomy patients receiving mechanical ventilation by pressure-controlled mode (PCM).
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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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jie ae kim
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Address
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Associate professor in Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of medicine, 50, Irwon-dong, Gangnam-gu, Seoul, Korea 135-710
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Country
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Korea, Republic Of
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Phone
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+82 2 3410 2470
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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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jie ae kim
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Address
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Associate professor in Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University school of medicine, 50, Irwon-dong, Gangnam-gu, Seoul, Korea 135-710
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Country
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Korea, Republic Of
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Phone
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+82 2 3410 2470
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Fax
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Email
7041
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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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