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Trial registered on ANZCTR
Registration number
ACTRN12619000471189
Ethics application status
Approved
Date submitted
18/03/2019
Date registered
21/03/2019
Date last updated
4/06/2019
Date data sharing statement initially provided
21/03/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of the effects of arterial blood pressure and cardiac output based hemodynamic management on cognitive function in elderly patients undergoing spinal surgery: A Randomized Clinical Trial.
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Scientific title
Comparison of the effects of arterial blood pressure and cardiac output based hemodynamic management on cognitive function in patients over 60 years old undergoing spinal surgery: A Randomized Clinical Trial.
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Secondary ID [1]
297594
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none
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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:
Spinal surgery
311853
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Condition category
Condition code
Anaesthesiology
310449
310449
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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
We will make cardiac output and stroke volume measurement during surgery with FloTrac pulse conture cardiac output sensor ( Edwards Lifesciences, Irvine, CA, USA) using right or left radial artery cannulation. Hemodynamic management will be made according to Cardiac index value. We will aim to maintain Cardiac index value within ± 20% of the baseline value that measured before anesthesia induction.
Intervention is the measurement of cardiac index and management of hemodynamics of patients according to the cardiac index value. The intervention will start before surgery and will continue until surgery finished. The intervention will be made by one of the researchers.
Treatment of inadequate cardiac index will be included infusion of crystalloid solution, administration of bolus ephedrine sulfate (5mg) and noradrenaline infusion with start dose of 0.02 mcg/kg/min (if the infusion of crystalloid and administration of ephedrine will be insufficient)
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Intervention code [1]
313828
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Treatment: Other
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Comparator / control treatment
We will make Invasive arterial pressure measurement during surgery using right or left radial artery cannulation. Hemodynamic management will be made according to mean arterial pressure and systolic arterial pressure values. We will aim to maintain mean arterial pressure and systolic arterial pressure values within ± 20% of the baseline values that measured before anesthesia induction.
The difference from the intervention group is that we only measure arterial pressure not cardiac index and we will make hemodynamic management according to mean arterial pressure in control group.
Treatment of inadequate mean arterial pressure will be included infusion of crystalloid solution, administration of bolus ephedrine sulfate (5mg) and noradrenaline infusion with start dose of 0.02 mcg/kg/min (if the infusion of crystalloid and administration of ephedrine will be insufficient)
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Control group
Active
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Outcomes
Primary outcome [1]
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Montreal Cognitive Assessment (cognitive function test) test will apply patients one day before surgery and seven days after surgery.
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Assessment method [1]
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Timepoint [1]
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one day before surgery
seven day after surgery
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Secondary outcome [1]
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Comparison of the cerebral oxygen saturation during surgery between groups as assessed by INVOSâ„¢ 5100C Cerebral/Somatic Oximeter.
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Assessment method [1]
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Timepoint [1]
367721
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during surgery
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Eligibility
Key inclusion criteria
1-age equal or over 60 years
2-patients who undergo spinal surgery
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Minimum age
60
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-not have epilepsy
2-not undergo brain surgery before
3-not have carotid stenosis
4-not have hydrocephalus
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
15/04/2019
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Actual
15/04/2019
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Date of last participant enrolment
Anticipated
30/06/2019
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Actual
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Date of last data collection
Anticipated
8/07/2019
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Actual
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Sample size
Target
60
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Accrual to date
30
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Final
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Recruitment outside Australia
Country [1]
21324
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Turkey
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State/province [1]
21324
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istanbul
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Funding & Sponsors
Funding source category [1]
302143
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University
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Name [1]
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Istanbul medical faculty
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Address [1]
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istanbul medical faculty,Department of Anesthesiology ,turgut ozal cad. no: 12, 34104 istanbul
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Country [1]
302143
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Turkey
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Primary sponsor type
University
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Name
Istanbul medical faculty
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Address
istanbul medical faculty,Department of Anesthesiology ,turgut ozal cad. no: 12, 34104 istanbul
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Country
Turkey
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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]
301978
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Country [1]
301978
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Committee of Istanbul Medical Faculty
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Ethics committee address [1]
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Ethics Committee of Istanbul Medical Faculty, turgut ozal cad. no: 12, 34104 istanbul
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Ethics committee country [1]
302822
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Turkey
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Date submitted for ethics approval [1]
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12/03/2019
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Approval date [1]
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15/03/2019
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Ethics approval number [1]
302822
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2019/361
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Summary
Brief summary
We hypothesize that cardiac index based hemodynamic management can provide better postoperative cognitive function compared with arterial pressure-based hemodynamic management in elderly patients. Also, we expect cerebral oximetry desaturation will be less in the cardiac index group. Montreal Cognitive Assessment (cognitive function test) test will apply patients one day before surgery and seven days after surgery. Patients will be randomized to either a Cardiac index group (We will aim to maintain Cardiac index value within ± 20% of the baseline value that measured before anesthesia induction) or an arterial pressure group (Hemodynamic management will be made according to mean arterial pressure and systolic arterial pressure values. We will aim to maintain mean arterial pressure and systolic arterial pressure values within ± 20% of the baseline values that measured before anesthesia induction). In both group, entropy (depth of anesthesia) and cerebral oximeter will be measured. Anesthesia level will be adjust according to state entropy value. Target value is 40 to 60. In both groups, researchers who follow patients and record hemodynamic data will be blind to cerebral oximetry monitorization. Cerebral oximetry will be recorded by another researcher.
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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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A/Prof achmet ali
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Address
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istanbul medical faculty,Department of Anesthesiology ,turgut ozal cad. no: 12, 34104 istanbul
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Country
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Turkey
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Phone
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+902124142000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
91515
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achmet ali
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Address
91515
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istanbul medical faculty,Department of Anesthesiology ,turgut ozal cad. no: 12, 34104 istanbul
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Country
91515
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Turkey
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Phone
91515
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+902124142000
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Fax
91515
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Email
91515
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[email protected]
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Contact person for scientific queries
Name
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achmet ali
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Address
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istanbul medical faculty,Department of Anesthesiology ,turgut ozal cad. no: 12, 34104 istanbul
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Country
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Turkey
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Phone
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+902124142000
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Fax
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Email
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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
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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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