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Trial registered on ANZCTR
Registration number
ACTRN12614000292673
Ethics application status
Approved
Date submitted
12/03/2014
Date registered
20/03/2014
Date last updated
12/10/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Cerebral near-infrared spectroscopy monitoring in infants during the peri-operative period: a prospective observational cohort study
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Scientific title
Infants undergoing near-infrared spectroscopy monitoring to measure cerebral deoxygenation during surgery
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Secondary ID [1]
284254
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None
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Universal Trial Number (UTN)
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Trial acronym
The NIRS study: oxygen monitoring of children during surgery
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cerebral deoxygenation
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Neurodevelopmental outcome
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Condition category
Condition code
Anaesthesiology
291737
291737
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0
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Anaesthetics
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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
Cerebral near-infared spectroscopy (NIRS) monitoring during surgery. In the study two NIRS sensors will be placed on the participants' foreheads to measure cerebral deoxygenation. We will place the NIRS sensors pre-operatively and record NIRS measurements pre, intra and post operatively until the participant fully awakes. We will be enrolling children who are expected to undergo surgery of at least 30 minutes duration.
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Intervention code [1]
288961
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Not applicable
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Cerebral oxygenation levels
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Assessment method [1]
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Timepoint [1]
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Perioperative period (pre, intra and post-operatively).
We will record the NIRS for a short period pre-operatively (5-10 minutes) while the participant is awake and resting quietly. We will record NIRS post-operatively until the participant fully awakes (or up to a maximum of 30 minutes).
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Secondary outcome [1]
307265
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Blood pressure readings will be recorded using a manual sphygomanometer pre and post-operatively. We will use an automatic sphygomanometer to record blood pressure intraoperatively. Where possible, we will also record intra-arterial blood pressure to allow high frequency analysis.
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Assessment method [1]
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Timepoint [1]
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Several blood pressure readings will be recorded over a 5-10 minute period pre-operatively when the child is awake and resting. Blood pressure readings will be recorded every 2.5 minutes pre-operatively. We will also collect blood pressure readings post-operatively until the child fully awakes (or up to a maximum of 30 minutes).
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Eligibility
Key inclusion criteria
Infants aged less than 6 months of age (corrected) scheduled for anaesthesia that is expected to last longer than 30 minutes duration.
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Minimum age
1
Days
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Maximum age
6
Months
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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. Children where application of the NIRS would be impractical: for example surgery on the head or neck of the child.
2. Children scheduled for cardiac surgery
3. Children with known major cardiovascular shunting
4. Children with known neurological abnormalities
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Study design
Purpose
Screening
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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
The sample size is largely driven by what is logistically feasible. Initially we wish to aim for recruiting 240 subjects.
The first analysis is simply to identify the recruitment rate and note difficulties in placing the NIRS and obtaining artifact free data. Theatre is an electronically “busy” environment so it is important to establish that we can record substantial amounts of artifact free recording before planning larger studies. The next analysis is to record the frequency of deoxygenation. Depending on the frequency of deoxygenation we should be able to perform regression analyses to explore the association between risk factors and deoxygenation.
In a subset of children we shall have high fidelity invasive blood pressure data. In these children we shall collect data that may be used in future to determine greater details about the relationship between blood pressure and NIRS to help identify autoregulatory thresholds.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/04/2014
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Actual
15/07/2014
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Date of last participant enrolment
Anticipated
30/04/2016
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Actual
31/05/2016
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Date of last data collection
Anticipated
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Actual
31/05/2016
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Sample size
Target
240
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Accrual to date
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Final
215
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [2]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [3]
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Princess Margaret Hospital - Subiaco
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Recruitment postcode(s) [1]
7864
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3052 - Parkville
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Recruitment postcode(s) [2]
9486
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2145 - Westmead
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Recruitment postcode(s) [3]
9487
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6008 - Subiaco
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Funding & Sponsors
Funding source category [1]
288880
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Hospital
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Name [1]
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
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Address [1]
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Flemington Road
Parkville
VIC 3052
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Australian & New Zealand College of Anaesthetists
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Address [2]
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117 Alexander St., Crows Nest NSW 2065
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Country [2]
294696
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Children's Hospital Melbourne
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Address
Flemington Road
Parkville
VIC 3052
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Country
Australia
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Secondary sponsor category [1]
287573
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Charities/Societies/Foundations
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Name [1]
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Murdoch Childrens Research Insitute
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Address [1]
287573
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Flemington Road
Parkville
VIC 3052
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Country [1]
287573
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290709
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Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [1]
290709
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Flemington Road Parkville VIC 3052
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Ethics committee country [1]
290709
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Australia
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Date submitted for ethics approval [1]
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12/03/2014
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Approval date [1]
290709
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18/06/2014
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Ethics approval number [1]
290709
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34055A
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Summary
Brief summary
Surgery and anaesthesia in infants is associated with a small but definite increased risk of brain injury. The reasons for this are very unclear. One reason may be that the infant does not receive enough oxygen to the brain during the operation. This in turn may be because the blood pressure is not optimal – the blood pressure often falls during anaesthesia in infants. This study hopes to use a new technology known as NIRS (near infrared spectroscopy) to try and see which infants are at risk and why. NIRS consists of a device that shines a red light through the infant’s skull into their brain. The amount of light reflected back gives an indication of how much oxygen is in the brain tissue. In this study we shall attach the NIRS to infants having routine surgery to see if the brain oxygen levels fall and what tends to make the levels fall. We also hope to be able to compute how blood pressure is related to levels of brain oxygen in infants during surgery. Eventually we hope this technology will help develop techniques to ensure brain oxygen levels are kept optimal and hopefully the risk of brain injury reduced.
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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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Prof Andrew Davidson
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Address
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
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Australia
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Phone
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+61393455233
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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
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Suzette Sheppard
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Address
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
46903
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Australia
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Phone
46903
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+61393455233
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Fax
46903
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Email
46903
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[email protected]
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Contact person for scientific queries
Name
46904
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Andrew Davidson
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Address
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Department of Anaesthesia and Pain Management
Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
46904
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Australia
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Phone
46904
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+61393455233
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Fax
46904
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+61393456003
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Email
46904
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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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