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Trial registered on ANZCTR
Registration number
ACTRN12614000182695
Ethics application status
Approved
Date submitted
11/02/2014
Date registered
17/02/2014
Date last updated
21/07/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Critical Evaluation of a Targeted Point of Care (POC) ROTEM (Registered Trademark) and Multiplate (Registered Trademark) Guided Coagulation and Haemostasis Management Programme in Cardiac Surgical Patients
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Scientific title
Critical Evaluation of a Targeted Point of Care (POC) ROTEM (Registered Trademark) and Multiplate (Registered Trademark) Guided Coagulation and Haemostasis Management Programme in Cardiac Surgical Patients
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Secondary ID [1]
284076
0
N/A
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Universal Trial Number (UTN)
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Trial acronym
N/A
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Coagulation and transfusion management in patients undergoing cardiac surgery
291136
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Condition category
Condition code
Blood
291476
291476
0
0
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Clotting disorders
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Surgery
291510
291510
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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
False
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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
ROTEM / Multiplate coagulation assessment and product transfusion protocol.
At 4 predefined time points a ROTEM/Multiplate panel of tests will be analysed:
1. Pre-operatively
2. 30 mins before coming off Cardiopulmonary Bypass
3. 10 mins after coming off CPB and after Protamine
4. On admission to ICU post-operatively
At each of these time points blood product replacement will be guided by the results. There is a predefined and validated algorithm.
In addition further tests will be done 10 minutes after any haemostatic intervention.
Further testing can be done at clinician discretion - i.e. In the presence of on-going bleeding further testing will be performed.
Testing will cease once there is no further evidence of on-going bleeding .
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Intervention code [1]
288768
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Not applicable
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Comparator / control treatment
N/A
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
291452
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Blood and Blood Product Transfusion Rates
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Assessment method [1]
291452
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Timepoint [1]
291452
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1 year
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Secondary outcome [1]
306803
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Blood and Blood Product Cost
This data will be accessed from GCUH Blood Bank database
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Assessment method [1]
306803
0
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Timepoint [1]
306803
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1 year
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Secondary outcome [2]
306804
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Adverse Events Rate - TACO / TRALI / MOF / ARF / Sepsis
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Assessment method [2]
306804
0
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Timepoint [2]
306804
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1 year
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Secondary outcome [3]
306805
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Mortality at 30 / 60 / 90 days
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Assessment method [3]
306805
0
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Timepoint [3]
306805
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1 year
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Secondary outcome [4]
306806
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Disturbances in Fibrogen and Platelet contribution to coagulation in the preoperative period.
This is assessed by analysing the results of ROTEM/Multiplate tests.
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Assessment method [4]
306806
0
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Timepoint [4]
306806
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1 year
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Secondary outcome [5]
306807
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Cardiac Functional Outcome:
Functional outcome - NYHA Class
Cardiac Function - Echocardiography at 6 weeks post-operatively
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Assessment method [5]
306807
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Timepoint [5]
306807
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1 year
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Eligibility
Key inclusion criteria
All patients undergoing cardiac surgery
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Minimum age
18
Years
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Maximum age
100
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
Age < 18 years
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
De-identified data will be obtained from hospital managed patient records and results will be amalgamated into a customised secure excel spreadsheet. Prior to analysis data will be assessed for normality using Kolmogorov-Smirnov and Shapiro-Wilk tests. Blood test results at different time points will be analysed using repeated measures ANOVA and Bonferroni post hoc test. The association between pre/peri-operative carboxy-haemoglobin and total bilirubin with post-operative cardiac function will be determined using either Pearson or Spearman’s rank correlation. T-tests will test the effect of baseline (high or low) carboxy-haemoglobin/total bilirubin concentrations on event rates per person years (readmission, arrhythmia etc).
A prospective sample size calculation was performed based on decreased Fibrinogen level experienced post cardiac surgery for a desired power of 90% and a alpha of 5% a minimum total subject sample size of 26 patients is estimated. To ensure validity we propose to recruit a minimum of 100 patients.
Statistical Package for the Social Sciences (SPSS) will be used to perform the statistical analysis.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/04/2014
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Actual
29/06/2015
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Date of last participant enrolment
Anticipated
1/03/2017
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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
200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
2077
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Gold Coast Hospital - Southport
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Recruitment postcode(s) [1]
7769
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4215 - Southport
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Funding & Sponsors
Funding source category [1]
288708
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Hospital
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Name [1]
288708
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Gold Coast University Hospital
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Address [1]
288708
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1 Hospital Boulevard
Southport
QLD
4215
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Country [1]
288708
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Australia
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Primary sponsor type
Hospital
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Name
Gold Coast University Hospital Critical Care Research Group
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Address
1 Hospital Boulevard
Southport
QLD
4215
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Country
Australia
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Secondary sponsor category [1]
287410
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None
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Name [1]
287410
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Address [1]
287410
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Country [1]
287410
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290544
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Gold Coast University Hospital HREC
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Ethics committee address [1]
290544
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1 Hospital Boulevard Southport QLD 4215
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Ethics committee country [1]
290544
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Australia
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Date submitted for ethics approval [1]
290544
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12/02/2014
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Approval date [1]
290544
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26/03/2014
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Ethics approval number [1]
290544
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EC00160
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Summary
Brief summary
There is an increasing body of evidence that the adoption of point of care (POC) guided coagulation and haemostatic management algorithms in the cardiac surgical patient population results in improved outcomes. We aim to critically evaluate our POC programme at the Gold Coast University Hospital (GCUH). In addition, we aim to evaluate the prognostic importance of baseline and perioperative humeral factors relating to haem catabolism (bilirubin/carboxy haemoglobin) in modulating haemostatic function and predicting post-operative outcomes in patients undergoing cardiac surgery
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Trial website
N/A
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Trial related presentations / publications
N/A
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Public notes
N/A
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Contacts
Principal investigator
Name
46182
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Dr James Winearls
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Address
46182
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Gold Coast University Hospital
1 Hospital Boulevard
Southport
QLD
4215
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Country
46182
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Australia
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Phone
46182
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+61756875684
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Fax
46182
0
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Email
46182
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[email protected]
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Contact person for public queries
Name
46183
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James Winearls
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Address
46183
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Gold Coast University Hospital
1 Hospital Boulevard
Southport
QLD
4215
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Country
46183
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Australia
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Phone
46183
0
+61756875684
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Fax
46183
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Email
46183
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[email protected]
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Contact person for scientific queries
Name
46184
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James Winearls
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Address
46184
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Gold Coast University Hospital1 Hospital Boulevard
Southport
QLD
4215
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Country
46184
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Australia
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Phone
46184
0
+61756875684
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Fax
46184
0
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Email
46184
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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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