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Trial registered on ANZCTR
Registration number
ACTRN12612001007820
Ethics application status
Approved
Date submitted
13/09/2012
Date registered
19/09/2012
Date last updated
23/11/2018
Date data sharing statement initially provided
23/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The Effect of Changes in Cardiac Output on Sevoflurane Delivery in the Aisys Anaesthetic Machine.
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Scientific title
The Effect of Changes in Cardiac Output on Sevoflurane Delivery in the Aisys Anaesthetic Machine in patients undergoing off-pump coronary artery bypass surgery (OPCAB).
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Secondary ID [1]
281207
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None
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Universal Trial Number (UTN)
U1111-1134-5513
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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:
Cardiac output changes during anaesthesia.
287395
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Anaesthesia during off-pump coronary artery bypass surgery (OPCAB)
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Condition category
Condition code
Anaesthesiology
287737
287737
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0
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Anaesthetics
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Cardiovascular
287758
287758
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0
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Coronary heart disease
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Surgery
287759
287759
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0
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Other surgery
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Intervention/exposure
Study type
Observational
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Patient registry
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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
An observational study to determine whether changes in anaesthetic agent delivery, using End-Tidal control (ETc), can be used as an indicator of cardiac output changes. We are monitoring changes in inspired concentration to determine whether these changes may provide an accurate indicator of cardiac output changes, before, during and immediately following periods of cardiac manipulation during OPCAB. We are particularly interested to see if monitoring the inspired concentration can detect cardiac output (CO) changes greater than 25%; that is, is there a given percentage fall in inspired sevoflurane that corresponds to a 25% drop in CO? This level of change is about the level of sensitivity of CO estimations using a pulmonary artery catheter and is frequently taken as the standard to which less invasive monitors should perform.
Since we are comparing time periods within single patient treatments, participants are their own control.
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Intervention code [1]
285672
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Not applicable
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Comparator / control treatment
No control.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To determine whether changes in anaesthetic agent delivery can be used as an indicator of cardiac output change during surgery.
Off-pump coronary artery bypass surgery is associated with abrupt changes in cardiac output (CO) as the heart is manipulated. We have observed that with end-tidal control, a feature of the Aisys anaesthetic machine, the target end-tidal level is well maintained but that there are significant changes in the rate of delivery seen with changes in CO. In particular, the inspired concentration now rises and falls in parallel with the end-tidal CO2. We are interested in determining whether there is a given percentage fall in inspired sevoflurane concentration that corresponds to a 25% drop in CO%. We will assess this by observing the Aisys monitor display and the Vigileo CO monitor display; by extracting and examining the data for each case from these machines and by comparing both sets of data against the relevant time periods.
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Assessment method [1]
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Timepoint [1]
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5 minutes before and 1 minute after each manipulation of the heart during cororary artery bypass surgery.
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Secondary outcome [1]
299213
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Nil.
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Assessment method [1]
299213
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Timepoint [1]
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Nil.
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Eligibility
Key inclusion criteria
Patients undergoing off-pump coronary artery bypass surgery (OPCAB) where the anaesthetic technique is based on sevoflurane and where use of flo trac/Vigileo monitors is not contra-indicated.
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Minimum age
18
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
Aged <18 yrs;flo trac/Vigileo not required;
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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
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Recruitment
Recruitment status
Stopped early
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Data analysis
No data analysis planned
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
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Date of first participant enrolment
Anticipated
22/08/2012
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Actual
7/12/2012
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Date of last participant enrolment
Anticipated
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Actual
15/12/2014
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Date of last data collection
Anticipated
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Actual
15/12/2014
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Sample size
Target
40
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Accrual to date
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Final
15
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Recruitment outside Australia
Country [1]
4547
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New Zealand
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State/province [1]
4547
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Canterbury
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Funding & Sponsors
Funding source category [1]
286011
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Self funded/Unfunded
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Name [1]
286011
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Address [1]
286011
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Country [1]
286011
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Primary sponsor type
Individual
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Name
Dr Frances Cammack
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Address
Department of Anaesthesia,Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
New Zealand
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Secondary sponsor category [1]
284813
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Individual
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Name [1]
284813
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Assoc Prof Dr Ross Kennedy
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Address [1]
284813
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Department of Anaesthesia,Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country [1]
284813
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New Zealand
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Secondary sponsor category [2]
284823
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Individual
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Name [2]
284823
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Margie McKellow
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Address [2]
284823
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Department of Anaesthesia,Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country [2]
284823
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New Zealand
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Secondary sponsor category [3]
284824
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Individual
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Name [3]
284824
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Dr Chris Harrison
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Address [3]
284824
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Department of Anaesthesia,Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country [3]
284824
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288034
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
288034
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Health and Disability Ethics Committee PO Box 5013 Wellington 6154
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Ethics committee country [1]
288034
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New Zealand
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Date submitted for ethics approval [1]
288034
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08/06/2012
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Approval date [1]
288034
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18/07/2012
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Ethics approval number [1]
288034
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URA/12/06/024
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Summary
Brief summary
Movement of gases (such as carbon dioxide or inhaled anaesthetic agents) that dissolve in the blood, in and out of the lungs, can indicate blood flow through the lungs. Because lung blood flow changes in parallel with cardiac output, we can measure the levels of these gases in the lungs to obtain information about cardiac output. It is already well known that expired CO2 levels change as cardiac output changes. Our newest anaesthetic machines allow the user to set an expired concentration. The machine then adjusts delivery of the agent to maintain this expired level, with delivery increasing as uptake (& hence lung blood flow) increases and vice versa. We speculate that this system offers a unique opportunity to investigate the relationship between inhaled anaesthetic uptake and cardiac output. During off-pump coronary artery bypass surgery (OPCAB), manipulation of the heart to access the various graft sites causes abrupt changes in cardiac output. These changes occur frequently during OPCAB surgery and produce visible changes in CO2 and anaesthetic agents levels. We monitor cardiac output during OPCAB with a device that provides a continuous measure of cardiac output based on the shape of the pulse waveform. The combination of frequent large changes in cardiac output, a continuous measure of cardiac output and a new way to follow anaesthetic agent uptake gives us the opportunity to explore these relationships.
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Trial website
NA
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Trial related presentations / publications
Not yet.
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Public notes
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Contacts
Principal investigator
Name
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Dr Frances Cammack
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Address
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Department of Anaesthesia
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
34696
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New Zealand
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Phone
34696
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+64 (03) 3640288
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Fax
34696
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+64 (03) 3640289
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Email
34696
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[email protected]
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Contact person for public queries
Name
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Margie McKellow
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Address
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Department of Anaesthesia
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
17943
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New Zealand
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Phone
17943
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+64 (03) 3640288
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Fax
17943
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+64 (03) 3640289
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Email
17943
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[email protected]
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Contact person for scientific queries
Name
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Frances Cammack
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Address
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Department of Anaesthesia
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
8871
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New Zealand
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Phone
8871
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+64 (03) 3640288
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Fax
8871
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+64 (03) 3640289
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Email
8871
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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
Study stopped early. Data collection/analysis not completed.
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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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