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Trial registered on ANZCTR
Registration number
ACTRN12612000539831
Ethics application status
Approved
Date submitted
9/05/2012
Date registered
22/05/2012
Date last updated
10/11/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Cerebral Oximetry to Reduce Peri-operative Morbidity: A Pilot Study
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Scientific title
The use of cerebral oximetry to reduce the incidence of peri-operative morbidity and mortality in elderly patients undergoing lower limb arthroplasty or bowel resection.
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Secondary ID [1]
280463
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Nil
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Universal Trial Number (UTN)
U1111-1130-5874
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Trial acronym
CORM Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Peri-operative morbidity
286438
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Condition category
Condition code
Anaesthesiology
286695
286695
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0
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Anaesthetics
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intra-operative cerebral oximetry.
Cerebral oximetry is a non-invasive method for measuring the oxygenation of brain tissue. It is based on the principle of near-infrared reflactance spectroscopy (NIRS), and works in a similar way to the pulse oximeter.
The anaesthetist will be given instructions on how to apply the cerebral oximeter to the participant’s forehead, and how to turn on the monitor and store a baseline cerebral saturation value. They will then open the envelope which will contain the randomisation allocation. If the participant is in the control group (group C) the monitor will be covered throughout the case, and turned off prior to leaving the operating theatre.
If the participant is allocated to the intervention group (group I), the anaesthetist will monitor the cerebral saturation throughout the operation. They will be instructed to aim to keep the cerebral saturation within 25% of the patient’s baseline value. The anaesthetist will be provided with a list of suggested methods to improve cerebral saturation e.g. management of blood pressure, oxygenation or carbon dioxide tension. The use of these interventions, as well as the choice and timing of interventions will be entirely the choice of the anaesthetist. All suggested interventions are part of routine anaesthetic management. At the conclusion of the operation the monitor will be turned off prior to leaving the operating theatre.
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Intervention code [1]
284825
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Prevention
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Comparator / control treatment
Blinded use of cerebral oximeter (anaesthetist unable to see cerebral oxygen saturation value).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Incidence of any complication in first five days following surgery.
Pre-defined Complications:
Acute myocardial infarction
Cardiac arrest
Re-intubation
Acute pulmonary oedema
Pulmonary embolus
Stroke
Systemic inflammation
Wound infection
Unplanned return to operating room
Acute renal impairment
Unplanned ICU admission
Death
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Assessment method [1]
287093
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Timepoint [1]
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5 days
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Secondary outcome [1]
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Incidence of individual specified complications.
Pre-defined Complications:
Acute myocardial infarction
Cardiac arrest
Re-intubation
Acute pulmonary oedema
Pulmonary embolus
Stroke
Systemic inflammation
Wound infection
Unplanned return to operating room
Acute renal impairment
Unplanned ICU admission
Death
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Assessment method [1]
297353
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Timepoint [1]
297353
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5 days
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Secondary outcome [2]
297354
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30-day mortality
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Assessment method [2]
297354
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Timepoint [2]
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30 days
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Secondary outcome [3]
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Length of hospital stay
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Assessment method [3]
297355
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Timepoint [3]
297355
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At discharge
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Secondary outcome [4]
297356
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Incidence of cerebral desaturation (using cerebral oximeter)
Cerebral desaturation is defined as a fall in the cerebral saturation more than 25% below the participant's own baseline. All cerebral saturation data is stored and can be analysed offline.
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Assessment method [4]
297356
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Timepoint [4]
297356
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Intra-operative
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Secondary outcome [5]
297357
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Total duration of cerebral saturation < 75% baseline (using cerebral oximeter).
Cerebral desaturation is defined as a fall in the cerebral saturation more than 25% below the participant's own baseline. All cerebral saturation data is stored and can be analysed offline.
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Assessment method [5]
297357
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Timepoint [5]
297357
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Intra-operative
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Eligibility
Key inclusion criteria
1. Adult patients (age > 70 years)
2. Total knee or hip joint replacement, or bowel resection surgery.
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Minimum age
70
Years
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Maximum age
No limit
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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. Emergency or unplanned surgery.
2. Inability to provide informed consent for participation.
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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)
Eligible patients will be identified and approached at the pre-admission clinics. If the patient is deemed to be able to give informed consent they will be provided with information about the study as well as the PICF. Patients who choose to participate may be enrolled as an outpatient or on the day of surgery.
Participants are under anaesthesia for the duration of the intervention period and will not be made aware of their assigned group. Allocation is by sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomly assigned to one of two groups using a random number allocation system with permuted blocks.
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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
Completed
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Date of first participant enrolment
Anticipated
5/03/2012
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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
40
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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]
285221
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Hospital
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Name [1]
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Austin Health
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Address [1]
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Department of Anaesthesia
Austin Health
Studley Rd
Heidelberg VIC 3084
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Country [1]
285221
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Australia
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Funding source category [2]
285222
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Commercial sector/Industry
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Name [2]
285222
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Covidien
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Address [2]
285222
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Covidien
6135 Gunbarrel Ave
Boulder, CO 80301
USA
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Country [2]
285222
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United States of America
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Primary sponsor type
Hospital
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Name
Austin Health
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Address
145 Studley Road
Heidelberg VIC 3084
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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]
284093
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Address [1]
284093
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Country [1]
284093
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287228
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Austin Health Non-drug Study Advisory Committee
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Ethics committee address [1]
287228
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Research Ethics Unit Henry Buck Building 145 Studley Road Austin Hospital, Heidelberg VIC 3084
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Ethics committee country [1]
287228
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Australia
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Date submitted for ethics approval [1]
287228
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Approval date [1]
287228
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21/02/2012
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Ethics approval number [1]
287228
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04513
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Summary
Brief summary
Cerebral oximetry is a clinical monitor which is used routinely for heart surgery patients at Austin Health. When the device is used, a sensor is applied to the forehead and safe near-infrared light is shone through the skull. The reflected light gives information about the level of oxygen in the brain. Previous research has shown that using this monitor can reduce the risk of complications after heart surgery. Other clinical research has shown that complications after surgery are more common as people get older. In one large study it was shown that complications occur in one fifth of patients over the age of 70. The complications studied included heart attack, major breathing complications, stroke, infections, kidney failure, being admitted to the intensive care unit, or death. The aim of this study is to find out whether using a cerebral oximeter during other types of surgery can reduce the rate of complications for patients over the age of 70. There is currently no research evidence to show whether this is the case. 40 patients over the age of 70 will be asked to participate in this study. These patients will all be having joint replacement or bowel surgery. All the participants will have a cerebral oximeter monitor applied at the start of the anaesthetic. For half the participants the anaesthetist will no be able to see the numbers on the monitor. In the other half, the anaesthetist will be asked to monitor the levels of oxygen in the brain, and to try to keep them close to (within 25% of) the participant’s starting level. This is done by methods which are part of normal anaesthetic care. For example, the anaesthetist makes small changes to the amount of anaesthetic, or to the blood pressure. There is no other change to the operation, anaesthetic, or hospital care. The number and types of complications which occur in each of these two groups will be compared. This study will determine if using the cerebral oximeter results in fewer complications. The results of this small study may help to design larger research studies in the future.
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Trial website
None
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
34155
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Address
34155
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Country
34155
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Phone
34155
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Fax
34155
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Email
34155
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Contact person for public queries
Name
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Dr Dean Cowie
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Address
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Department of Anaesthesia
Austin Health
Studley Rd
Heidelberg VIC 3084
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Country
17402
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Australia
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Phone
17402
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+61 3 94963227
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Fax
17402
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Email
17402
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[email protected]
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Contact person for scientific queries
Name
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Dr Dean Cowie
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Address
8330
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Department of Anaesthesia
Austin Health
Studley Rd
Heidelberg VIC 3084
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Country
8330
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Australia
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Phone
8330
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+61 3 94963227
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Fax
8330
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Email
8330
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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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