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Trial registered on ANZCTR
Registration number
ACTRN12618000351213
Ethics application status
Approved
Date submitted
14/11/2017
Date registered
8/03/2018
Date last updated
19/03/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Tidal Volume Challenge During Neurosurgery for Assessing Fluid Responsiveness. A Interventional Prospective Trial
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Scientific title
Tidal Volume Challenge During Neurosurgery for Assessing Fluid Responsiveness. A Interventional Prospective Trial of Patients Scheduled for Supine Surgery
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Secondary ID [1]
293354
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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:
Tidal Volume Challenge
305469
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Hypovolemia
Hemodynamic Instability
305470
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Anesthesia
Neurosurgery
305471
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fluid responsiveness
tidal volume challenge
fluid responsiveness
305472
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stroke volume variation
pulse pressure variation
305475
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Condition category
Condition code
Surgery
304730
304730
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0
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Other surgery
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Cardiovascular
305570
305570
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0
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Normal development and function of the cardiovascular system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The TVC has been proposed as novel hemodynamic test to assess fluid responsiveness in ICU patients. TVC consists in the transient increase of Tidal Volume from 6ml/kg to 8ml/kg for 1 minute. The TVC-related changes of stroke volume variation (SVV) and pulse pressure variation (PPV) are highly predictive of fluid responsiveness. The aim of the present study is to assess TVC reliability in a population of neurosurgical patients scheduled for supine surgery.
Brief description of TVC:
1) TVC is a transient increase in the Tidal Volume used to ventilate the patient from 6 to 8 ml/kg of predicted body weight
2) The duration is 1 minute
3) The attending anesthetist will modify the setting of the ventilation in operating room
4) The decision of administer fluids because of transient hypotension (defined as a reduction of >20% of systolic blood pressure recorded at the beginning of the operation) is the indication to perform first the TVC
5) Only the first fluid challenge will be recorded. The frequency of administration will be decided by the attending anesthetist according to the occurrence of hemodynamic instability, for the entire duration of the operation.
The end-expiratory occlusion test is a hemodynamic test aiming to assess fluid responsiveness by means of a interruption of mechanical ventilation. In order to compare TVC with EEO, the EEO will be also performed in all the patients at predefined time points (before and after TVC, when the patient is ventilated with 6ml/kg and 8 lm/kg respectively).
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Intervention code [1]
299610
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Early detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The receiver operating characteristic curve of SVV variation after TVC application
A patient will be consider responder for a cardiac index increase of at least 15%.
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Assessment method [1]
303941
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Timepoint [1]
303941
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Immediately following fluid challenge infusion
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Primary outcome [2]
304693
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The receiver operating characteristic curve of PPV variation after TVC application
A patient will be consider responder for a cardiac index increase of at least 15%.
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Assessment method [2]
304693
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Timepoint [2]
304693
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Immediately following fluid challenge infusion
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Secondary outcome [1]
340520
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To compare the area under the Receiver operating characteristic (ROC) curve of TVC and EEO
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Assessment method [1]
340520
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Timepoint [1]
340520
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Immediately following fluid challenge infusion
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Eligibility
Key inclusion criteria
Elective neurosurgical patients requiring invasive arterial monitoring
Need of fluid challenge as required by the attending anesthetist
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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
Any cardiac arrhythmia
Consent denied
Instable intracranial pressure or emergency surgical treatment
Spinal shock
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
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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
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Actual
16/01/2018
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Date of last participant enrolment
Anticipated
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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
50
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Accrual to date
20
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Final
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Recruitment outside Australia
Country [1]
9355
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Italy
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State/province [1]
9355
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Funding & Sponsors
Funding source category [1]
297979
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University
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Name [1]
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Azienda Ospedaliero Universitaria Maggiore della Carita
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Address [1]
297979
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Corso Mazzini n. 18
28100 Novara
Italy
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Country [1]
297979
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Italy
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Primary sponsor type
University
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Name
Azienda Ospedaliero Universitaria Maggiore della Carita
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Address
Corso Mazzini n. 18
28100 Novara
Italy
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Country
Italy
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Secondary sponsor category [1]
297047
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None
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Name [1]
297047
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Address [1]
297047
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Country [1]
297047
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299020
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Comitato Etico Interaziendale Novara
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Ethics committee address [1]
299020
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Corso Mazzini, 18 - 28100 Novara - Italy
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Ethics committee country [1]
299020
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Italy
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Date submitted for ethics approval [1]
299020
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30/10/2017
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Approval date [1]
299020
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15/12/2017
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Ethics approval number [1]
299020
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Summary
Brief summary
TVC has never been tested in surgical populations. We aim to perform a clinical study to assess TVC reliability in supine surgical patients. The TVC has been proposed as novel hemodynamic test to assess fluid responsiveness in ICU patients. TVC consists in the transient increase of Tidal Volume from 6ml/kg to 8ml/kg for 1 minute. The TVC-related changes of stroke volume variation (SVV) and pulse pressure variation (PPV) are highly predictive of fluid responsiveness. The aim of the present study is to assess TVC reliability in a population of neurosurgical patients scheduled for supine 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
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Dr ANTONIO MESSINA
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Address
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AOU MAGGIORE DELLA CARITA' - INTENSIVE CARE UNIT; Corso Giuseppe Mazzini 18; Novara, Italy, 28100
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Country
79010
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Italy
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Phone
79010
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+3903213733380
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Fax
79010
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Email
79010
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[email protected]
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Contact person for public queries
Name
79011
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ANTONIO MESSINA
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Address
79011
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AOU MAGGIORE DELLA CARITA' - INTENSIVE CARE UNIT; Corso Giuseppe Mazzini 18; Novara, Italy, 28100
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Country
79011
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Italy
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Phone
79011
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+3903213733380
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Fax
79011
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Email
79011
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[email protected]
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Contact person for scientific queries
Name
79012
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ANTONIO MESSINA
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Address
79012
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AOU MAGGIORE DELLA CARITA' - INTENSIVE CARE UNIT; Corso Giuseppe Mazzini 18; Novara, Italy, 28100
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Country
79012
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Italy
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Phone
79012
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+3903213733380
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Fax
79012
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Email
79012
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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
Tidal volume challenge to predict fluid responsiveness in the operating room: An observational study.
2019
https://dx.doi.org/10.1097/EJA.0000000000000998
N.B. These documents automatically identified may not have been verified by the study sponsor.
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