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Trial registered on ANZCTR
Registration number
ACTRN12617000306314
Ethics application status
Approved
Date submitted
29/12/2016
Date registered
27/02/2017
Date last updated
27/02/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Oxygen concentrations and responses of the immune system in surgery
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Scientific title
Does variation of inspired oxygen concentration at the time of
reperfusion of the lower limb during elective knee surgery alter oxidative stress and immune activation
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Secondary ID [1]
290810
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Nil Known
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Universal Trial Number (UTN)
U1111-1191-2111
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Trial acronym
ORIS-II
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Surgery
301465
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Reperfusion
301466
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Condition category
Condition code
Anaesthesiology
301184
301184
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0
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Anaesthetics
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Surgery
301823
301823
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Alteration of inspired oxygen concentration prior to release of tourniquet. These patients are undergoing general anaesthesia and routinely receive oxygen administration at a concentration of 0.3 following anaesthesia induction up to 30 minutes prior to release of the lower limb tourniquet . The inspired oxygen concentration will be changed to either FiO2 = 0.3, 0.5 or 0.8 30 minutes prior to release of the tourniquet and this concentration will be continued until the end of surgery.
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Intervention code [1]
296734
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Treatment: Drugs
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Comparator / control treatment
Control group comprised FiO2 of 0.3
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Control group
Active
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Outcomes
Primary outcome [1]
300607
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Plasma concentrations Isofurans
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Assessment method [1]
300607
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Timepoint [1]
300607
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T1 Baseline sample, prior to anaesthesia induction
T2 Immediately prior to a change in oxygen concentration, 30 minutes prior to deflation of the tourniquet
T3 5 minutes after T2
T4 10 minutes after T2
T5 20 minutes after T2
T6 Immediately prior to deflation of the tourniquet
T7 5 minutes following deflation of the tourniquet
T8 120 minutes following deflation of the tourniquet
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Secondary outcome [1]
330402
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Concentrations of lymphocyte subpopulations on whole blood;
The subpopulations are :
B cells, T cells, CD4 , CD8 cells, Natural killer cells and naieve b cells
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Assessment method [1]
330402
0
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Timepoint [1]
330402
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35 minutes following tourniquet release
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Eligibility
Key inclusion criteria
Adult patients undergoing Knee Replacement surgery requiring the use of a tourniquet for more than 60 minutes
ASA 1 - 3
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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
Systemic infection Immunosuppressive medication
Extensive tissue trauma Multiple tourniquet episodes
Concurrent NSAID use Chronic opioid abuse, IVDU
Recent MI (< 4 weeks) CRF (creatinine > 125 micromol/l)
Liver failure Obstructive Sleep Apnoea, BMI > 40
Likely intraop O2 requirement > 50 %
or supplemental O2 preoperatively
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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)
Opaue sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer Sequence generation
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Masking / blinding
Open (masking not 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
Phase 4
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
Mixed models will be employed to analyse changes over time
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
3/02/2012
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Date of last participant enrolment
Anticipated
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Actual
22/10/2014
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Date of last data collection
Anticipated
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Actual
22/10/2014
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment postcode(s) [1]
14940
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6000 - Perth
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Funding & Sponsors
Funding source category [1]
295239
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Hospital
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Name [1]
295239
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Royal Perth Hospital
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Address [1]
295239
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Wellington Street
Perth, WA 6000
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Country [1]
295239
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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
Wellington Street
Perth
WA, 6000
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Country
Australia
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Secondary sponsor category [1]
294066
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None
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Name [1]
294066
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None
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Address [1]
294066
0
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Country [1]
294066
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296578
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Royal perth Hospital HREC
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Ethics committee address [1]
296578
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Royal Petrh Hospital Wellington Street Perth WA, 6000
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Ethics committee country [1]
296578
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Australia
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Date submitted for ethics approval [1]
296578
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08/12/2008
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Approval date [1]
296578
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10/10/2011
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Ethics approval number [1]
296578
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EC 2008/211
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Summary
Brief summary
Surgery for many procedures involving the leg requires the surgeons to stop the blood flow for a variable period of time. During this period certain changes occur in the leg. When the blood supply is restored, these changes result in a very strong stimulus to the immune system. Some of these changes are beneficial, promoting healing of wounds and repair of damaged tissues. Some of these changes, however, can cause depression of the immune system and make infections more likely. During surgery, the anaesthetist administers anaesthetic drugs, and oxygen. The amount of oxygen that is given varies according to a number of factors. There is some evidence that the amount of oxygen in the body at the time of restoring blood supply to a limb may be of importance. This importance is in terms of the damage that may occur during surgery and the recovery from the surgery. We do not know how much oxygen is good or bad when the blood supply is restored, and we would like to perform a study looking at this question. At all times in this study, patients will receive at least more than the minimum amount of oxygen that is necessary for all of the bodies organs to function entirely normally, and make a complete recovery from anaesthesia and surgery. Study protocol After randomisation to one of the three groups, patients will receive a standardised general anaesthetic based upon the gas “Sevoflurane”. All patients will receive 30% oxygen during the surgery, up until the time of restoring blood supply to the leg. At that point patients in one of three groups will receive either a). 30% oxygen before the blood supply is restored and continued until the end of surgery -(Conventional Care) b). 30% oxygen before the blood supply is restored and then 50 % until the end of surgery c). 30% oxygen before the blood supply is restored and then 80 % until the end of surgery - all of the above are in addition to the usual standard anaesthetic care. A small ( 3 ml. ) sample of blood will be taken at ten separate times up until 2 hours after the blood supply is restored. The study period then ends for each patient at that point. In summary, our hypothesis is that different concentrations of oxygen will produce changes in biochemistry that we wish to measure. These changes will help us to identify which is the best oxygen concentration to give to patients who are having this type of surgery.
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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
71354
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Prof Tomas Corcoran
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Address
71354
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Department of Anaesthesia and Pain Medicine
Royal Perth Hospital
Wellington Street
Perth
WA, 6000
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Country
71354
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Australia
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Phone
71354
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+61414791151
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Fax
71354
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Email
71354
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[email protected]
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Contact person for public queries
Name
71355
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Tomas Corcoran
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Address
71355
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Department of Anaesthesia and Pain Medicine
Royal Perth Hospital
Wellington Street
Perth, WA, 6000
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Country
71355
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Australia
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Phone
71355
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+61414791151
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Fax
71355
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Email
71355
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[email protected]
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Contact person for scientific queries
Name
71356
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Tomas Corcoran
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Address
71356
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Department of Anaesthesia and Pain Medicine
Royal Perth Hospital
Wellington Street
Perth, WA, 6000
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Country
71356
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Australia
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Phone
71356
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+61414791151
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Fax
71356
0
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Email
71356
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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
Source
Title
Year of Publication
DOI
Embase
Increased inspired oxygen concentration does not adversely affect oxidative stress and the resolution of inflammation during reperfusion in patients undergoing knee replacement surgery.
2021
https://dx.doi.org/10.1080/10715762.2020.1868451
N.B. These documents automatically identified may not have been verified by the study sponsor.
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