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Trial registered on ANZCTR
Registration number
ACTRN12623000741684
Ethics application status
Approved
Date submitted
31/05/2023
Date registered
10/07/2023
Date last updated
10/07/2023
Date data sharing statement initially provided
10/07/2023
Date results provided
10/07/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
Changes in tissue oxygenation in carotid occlusion
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Scientific title
The Relationship Between Cerebral Desaturation and Postoperative Cognitive
Dysfunction in Carotid Endarterectomy Surgery: A Prospective Study
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Secondary ID [1]
309797
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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:
Postoperative Cognitive Dysfunction
330206
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Carotid stenosis
330207
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Condition category
Condition code
Anaesthesiology
327076
327076
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
3
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Target follow-up type
Days
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Description of intervention(s) / exposure
A Standardized Mini Mental Test was administered to determine the baseline cognitive function level of the patients 24 hours before the operation. Patients admitted to the operating room underwent electrocardiography (ECG), peripheral oxygen saturation (SpO2), invasive blood pressure monitoring (radial artery), esophageal temperature measurement, and Near-Infrared Spectroscopy (NIRS) monitoring. Arterial blood pressure (systolic/diastolic/mean), heart rate (HR), oxygen saturation (SatO2), and cerebral tissue oxygen saturation (rSO2) on the operative side and contralateral side were
noted in the case form at baseline (T1), 5 minutes after intubation (T2), before carotid clamping (T3), the 5th (T4) and 10th (T5) minutes after carotid clamping, 5th minutes after unclamping (T6), preextubation (T7), and the end of the operation (T8). Two days
after the operation, the mini-mental test was repeated by the same physician.
Cerebral desaturation was defined as a decrease of 25% or more in the baseline value of near-infrared spectroscopy (NIRS) or an NIRS value below 50%. The patients were divided into two groups: group I included those who experienced cerebral desaturation, and group II consisted of those who did not experience desaturation (normal group). Demographic data, NIRS values, complications, and changes in the mini-mental test were analyzed to determine if there were significant statistical differences between the two groups.
The same physician performed the Standardized Mini Mental Test and took around 20 minutes to complete.
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Intervention code [1]
326226
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Diagnosis / Prognosis
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Intervention code [2]
326227
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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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Brain oxygen rSO2 levels were measured using near-infrared spectroscopy (NIRS) monitor
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Assessment method [1]
334940
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Timepoint [1]
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During the operation and 2 days after the operation
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Secondary outcome [1]
422490
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Intraoperative hemodynamic changes were observed during the cross-clamp bedside hemodynamic monitor.
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Assessment method [1]
422490
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Timepoint [1]
422490
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During the cross-clamp
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Eligibility
Key inclusion criteria
The patients who underwent carotid endarterectomy due to carotid stenosis
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Minimum age
18
Years
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Maximum age
65
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
Patients with communication problems, illiteracy, and inability to
complete the tests successfully, sedative, antidepressant, or antiepileptic medication use,
cerebrovascular or psychiatric diseases, and alcohol or substance dependence were excluded from the study.
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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
Statistical calculations were performed using SPSS 21.0 software (SPSS Inc., IL, USA) for Windows. The data were expressed as mean ± standard deviation (SD), median, and percentage (%). The Kolmogorov-Smirnov test was used to determine the normal distribution. Chi-square and Fisher's exact tests were used for categorical variables in intergroup comparisons, while independent samples t-test and Mann-Whitney U test were used for numerical variables. For repeated measurements, ANOVA (Bonferroni test) was applied. A p-value of <0.05 was considered statistically significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
9/04/2018
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Date of last participant enrolment
Anticipated
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Actual
12/10/2018
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Date of last data collection
Anticipated
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Actual
30/10/2018
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Sample size
Target
75
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Accrual to date
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Final
48
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Recruitment outside Australia
Country [1]
25565
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Turkey
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State/province [1]
25565
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Cengiz Sahutoglu
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Address [1]
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Dr. Cengiz Sahutoglu
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country [1]
313979
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Turkey
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Primary sponsor type
Individual
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Name
Cengiz Sahutoglu
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Address
Dr. Cengiz Sahutoglu
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country
Turkey
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Secondary sponsor category [1]
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Individual
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Name [1]
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Aslan Zafer Atilgan
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Address [1]
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Dr. Aslan Zafer Atilgan
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country [1]
315853
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Turkey
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
313117
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Ege University Faculty of Medicine Clinical Research Ethics Committee
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Ethics committee address [1]
313117
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Ege University Faculty of Medicine Clinical Research Ethics Committee Ege Üniversitesi Tip Fakültesi Dekanligi, 35100, Bornova, Izmir
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Ethics committee country [1]
313117
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Turkey
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Date submitted for ethics approval [1]
313117
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07/04/2017
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Approval date [1]
313117
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06/04/2018
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Ethics approval number [1]
313117
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18-4/36
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Summary
Brief summary
Introduction: Carotid endarterectomy (CEA) is an established surgical procedure for patients with high-grade carotid artery stenosis. Cerebral hypoperfusion after clamping the carotid artery can lead to the development of new strokes or worsen existing damage. Near-infrared spectroscopy (NIRS) provides continuous and non-invasive monitoring of cerebral oxygenation, allowing for early detection of cerebral ischemia due to hypoperfusion in critical patients and a reduction in early complications. Postoperative cognitive dysfunction (POCD) refers to changes in cognitive function following surgery and anesthesia. Methods: In this prospective and observational study, our aim is to evaluate whether cerebral desaturation, as assessed by NIRS, contributes to the occurrence of POCD. Hemodynamic and NIRS assessments were recorded at various time points: baseline, post-intubation, pre-clamping, 5th and 10th minutes after carotid clamping, 5th minutes after unclamping, pre-extubation, and the end of the operation. The Mini-Mental Status Examination was administered to patients on the day before surgery and on the second day after surgery. Results: Cerebral desaturation was observed in 33% of patients. Regional cerebral oxygen saturation (rSO2) showed a slight decrease in the early stages after clamping the carotid artery. During the clamping period, rSO2 values increased, and by the end of the operation, they had returned to baseline or even exceeded baseline levels. We did not identify any cases of POCD during the early postoperative period. Conclusion: NIRS is a practical and effective method for detecting cerebral hypoperfusion. However, based on our study, we were unable to establish a correlation between NIRS values and the occurrence of POCD
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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 Cengiz Sahutoglu
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Address
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Dr. Cengiz Sahutoglu
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country
127054
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Turkey
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Phone
127054
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+905064248814
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Fax
127054
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Email
127054
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[email protected]
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Contact person for public queries
Name
127055
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Aslan Zafer Atilgan
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Address
127055
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Dr. Aslan Zafer Atilgan
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country
127055
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Turkey
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Phone
127055
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+902323902140
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Fax
127055
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Email
127055
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[email protected]
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Contact person for scientific queries
Name
127056
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Aslan Zafer Atilgan
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Address
127056
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Dr. Aslan Zafer Atilgan
Ege University School of Medicine
Department of Anesthesiology and Reanimation
Bornova/Izmir, Turkey
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Country
127056
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Turkey
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Phone
127056
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+902323902140
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Fax
127056
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Email
127056
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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)?
Yes
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What data in particular will be shared?
individual participant data underlying published results only
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When will data be available (start and end dates)?
Immediately following publication, no end date.
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Available to whom?
Anyone who wishes to access it
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access subject to approvals by Principal Investigator
(Aslan Zafer Atilgan:
[email protected]
)
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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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