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Trial registered on ANZCTR
Registration number
ACTRN12619000530123
Ethics application status
Approved
Date submitted
1/04/2019
Date registered
3/04/2019
Date last updated
3/04/2019
Date data sharing statement initially provided
3/04/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
A prospective observational pilot study into the renal effects of using dexmedetomidine for sedation in intensive care
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Scientific title
A prospective observational pilot study into the renal effects of using dexmedetomidine for sedation in intensive care
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Secondary ID [1]
297840
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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:
Sedation
312214
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Condition category
Condition code
Renal and Urogenital
310758
310758
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0
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Other renal and urogenital disorders
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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
Patients in intensive care receiving dexmedetomidine sedation are observed for a 24 hour period. Arterial blood will be drawn from an existing arterial line and urine will be collected from an existing urinary catheter. This means there will not be any discomfort or inconvenience for the patient. The following samples will be collected:
• 1 ml blood in a safePICO Aspirator syringe
o for pH, pO2, pCO2 & lactate
• 4 ml blood in a lithium-heparin tube
o for metanephrines
• 4 ml blood in an EDTA tube
o for renin
• 2 ml blood in an EGTA tube containing glutathione
o for plasma noradrenaline
• 3 ml blood in an EDTA tube
o for serum cystatin C & plasma cytokines (tumour necrosis factor alpha, interleukin 6 & interleukin 10)
• 2 ml blood in a tube containing EDTA, reduced glutathione and butylated hydroxytoluene
o for plasma free F2-isoprostanes (non-esterified)
• 2 ml urine in a sterile container
o for neutrophil gelatinase-associated lipocalin and F2-isoprostanes
These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started. The total blood volume collected during the study will be 80 ml and the total urine volume will be 10 ml. We will also record the sodium, potassium and creatinine levels at the start and end of the study that are done daily on the ICU as part of routine care.
The continuous assessment of urinary oxygenation will be measured using an oxygen sensor probe developed by Oxford Optronix Ltd., 19-21 East Central, 127 Olympic Avenue, Milton Park, Abingdon, Oxfordshire OX14 4SA, United Kingdom. The sensor is inserted into the urinary catheter so that it remains within the catheter and does not exit the tip. This aims to avoid incorrect measurement of bladder wall oxygen tension instead of true urinary oxygen tension, and also means there will not be any discomfort for the patient. This would provide continuous measurements of the urinary oxygenation. This will be used as a surrogate marker of medullary tissue pO2 and thus, renal oxygenation.
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Intervention code [1]
314076
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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]
319606
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The effect of dexmedetomidine on urinary pO2
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Assessment method [1]
319606
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Timepoint [1]
319606
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The first 24 hours from the patient starting to receive dexmedetomidine
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Secondary outcome [1]
368839
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The effect of dexmedetomidine on blood pH
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Assessment method [1]
368839
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Timepoint [1]
368839
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [2]
368840
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The effect of dexmedetomidine on blood pO2
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Assessment method [2]
368840
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Timepoint [2]
368840
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [3]
368841
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The effect of dexmedetomidine on blood pCO2
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Assessment method [3]
368841
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Timepoint [3]
368841
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [4]
368842
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The effect of dexmedetomidine blood lactate
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Assessment method [4]
368842
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Timepoint [4]
368842
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [5]
368843
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The effect of dexmedetomidine on plasma sodium
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Assessment method [5]
368843
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Timepoint [5]
368843
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [6]
368844
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The effect of dexmedetomidine on plasma potassium
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Assessment method [6]
368844
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Timepoint [6]
368844
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [7]
368845
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The effect of dexmedetomidine on plasma creatinine
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Assessment method [7]
368845
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Timepoint [7]
368845
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [8]
368847
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The effect of dexmedetomidine on plasma metanephrine
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Assessment method [8]
368847
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Timepoint [8]
368847
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [9]
368848
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The effect of dexmedetomidine on plasma renin
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Assessment method [9]
368848
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Timepoint [9]
368848
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [10]
368849
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The effect of dexmedetomidine on plasma noradrenaline
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Assessment method [10]
368849
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Timepoint [10]
368849
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [11]
368850
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The effect of dexmedetomidine on urine neutrophil gelatinase-associated lipocalin (NGAL)
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Assessment method [11]
368850
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Timepoint [11]
368850
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [12]
368851
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The effect of dexmedetomidine on serum cystatin C
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Assessment method [12]
368851
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Timepoint [12]
368851
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [13]
368852
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The effect of dexmedetomidine on plasma tumour necrosis factor alpha
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Assessment method [13]
368852
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Timepoint [13]
368852
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [14]
368948
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The effect of dexmedetomidine on plasma normetanephrine
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Assessment method [14]
368948
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Timepoint [14]
368948
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [15]
368949
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The effect of dexmedetomidine on plasma interleukin 6
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Assessment method [15]
368949
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Timepoint [15]
368949
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Secondary outcome [16]
368950
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The effect of dexmedetomidine on plasma interleukin 10
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Assessment method [16]
368950
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Timepoint [16]
368950
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These samples will be collected prior to the patient receiving dexmedetomidine and at 2, 4, 8 and 24 hours after dexmedetomidine infusion has been started.
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Eligibility
Key inclusion criteria
Patients will be eligible for participation if their treating doctor was already intending to start them on this treatment (dexmedetomidine) for an existing clinical indication.
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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
Patients will be excluded if aged less than 18 years, pregnant, or they have acute or chronic end stage kidney failure and are receiving renal replacement therapy.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
We plan to collect information from the monitor and transfer it to a statistics program to assess values obtained. We plan to use descriptive statistics and graph analysis to assess urinary oxygenation over time in these patients along with the method of generalized estimating equations to analyse the longitudinal data that we will collect. Our main interest will be the change from baseline within each participant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
28/04/2018
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Date of last participant enrolment
Anticipated
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Actual
31/12/2018
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Date of last data collection
Anticipated
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Actual
1/01/2019
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Sample size
Target
12
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Accrual to date
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Final
12
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13522
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Royal Melbourne Hospital - City campus - Parkville
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Recruitment postcode(s) [1]
26141
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3050 - Royal Melbourne Hospital
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Recruitment postcode(s) [2]
26142
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3050 - Parkville
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Funding & Sponsors
Funding source category [1]
302361
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Hospital
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Name [1]
302361
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The Royal Melbourne Hospital ICU Research Fund
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Address [1]
302361
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300 Grattan St
Parkville VIC 3050
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Country [1]
302361
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Melbourne Hospital ICU
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Address
300 Grattan St
Parkville VIC 3050
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Country
Australia
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Secondary sponsor category [1]
302272
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None
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Name [1]
302272
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Address [1]
302272
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Country [1]
302272
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303037
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MELBOURNE HEALTH HUMAN RESEARCH ETHICS COMMITTEE
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Ethics committee address [1]
303037
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300 Grattan St Parkville VIC 3050
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Ethics committee country [1]
303037
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Australia
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Date submitted for ethics approval [1]
303037
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27/06/2017
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Approval date [1]
303037
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16/11/2017
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Ethics approval number [1]
303037
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LNR/17/MH/224
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Summary
Brief summary
Dexmedetomidine is a drug that is commonly used on Intensive Care Units across the world in patients requiring sedation as part of their medical treatment. This research aims to see if this drug is protecting or causing harm to the kidneys. We will do this by using very sensitive techniques that detect kidney function, which are not used in routine clinical practice. There have been a few studies looking at this drug in the past, mainly with people undergoing heart operations. There have also been some studies looking at animals being given this drug for sedation. The results of these have been mixed, meaning that it is unclear what the true effect is of dexmedetomidine on the kidneys. This study hopes to look at a small number of patients who are already receiving this drug as part of their treatment and see what happens to their kidney function after they start receiving it.
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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
92250
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Dr Charlie Harding
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Address
92250
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The Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
92250
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Australia
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Phone
92250
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+61 3 9342 9100
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Fax
92250
0
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Email
92250
0
[email protected]
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Contact person for public queries
Name
92251
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Charlie Harding
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Address
92251
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The Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
92251
0
Australia
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Phone
92251
0
+61 3 9342 9100
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Fax
92251
0
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Email
92251
0
[email protected]
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Contact person for scientific queries
Name
92252
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Charlie Harding
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Address
92252
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The Royal Melbourne Hospital
300 Grattan St
Parkville VIC 3050
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Country
92252
0
Australia
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Phone
92252
0
+61 3 9342 9100
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Fax
92252
0
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Email
92252
0
[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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