Cardiac DiseaseNCT03103633
The Effects of Individualized Oxygen Dynamic on Prognosis of Patients With High-risk Cardiac Surgery
A study testing mean artery pressure, bispectral index and Brain oxygen saturation in people with Cardiac Disease and High Risk Sex, run by The First Affiliated Hospital of Anhui Medical University at 1 site in China.
Trial summary
Anesthesia-related factors have been linked to poor perioperative outcomes. Our observational study suggested that the cumulative duration of a triple-low state [intraoperative low mean arterial pressure (MAP), low bispectral index (BIS), and low target effect-site concentration(Ce) ]was associated with poorer 30-day… Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Cardiac Disease, High Risk Sex
- What is being tested?
- mean artery pressure, bispectral index and Brain oxygen saturation
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 286 participants
- Where
- 1 siteChina
- Study dates
- 5 Mar 2017to 30 Jul 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Written informed consent;
- Selective cardiac surgery and general anesthesia patients;
- Age 18-90 yrs;
- Anesthesia Society of American (ASA) Scale II-IV
- European System for Cardiac Operative Risk Evaluation score equal to or greater than 6 or left ventricular ejection fraction lower than 50%
Who cannot join
- Preoperative cardiac ejection fraction<30 %;
- History of anesthesia awareness;
- History or anticipation of difficult intubation;
- Unanticipated intraoperative conditions, including haemorrhage, obstinate resuscitation failure,multiple cardiopulmonary bypass procedures, severe hypotension or hypoxemia;
- long-term preoperative use of anticonvulsant agents, opiates, benzodiazepines or cocaine.
Trial locations and contacts
1 site in 1 country.
China1 site
The First Affiliated Hospital of Anhui Medical University
Hefei, Anhui, 230022
About this study
Official title: Effects of Perioperative Goal-Directed Therapy Based on Individualized Oxygen Balance on Outcomes During High-risk Cardiac Surgery:A Single Center, Prospective,Randomized,Controlled,Double Blinded Study.
Anesthesia-related factors have been linked to poor perioperative outcomes. Our observational study suggested that the cumulative duration of a triple-low state [intraoperative low mean arterial pressure (MAP), low bispectral index (BIS), and low target effect-site concentration(Ce) ]was associated with poorer 30-day mortality.This randomized, prospective study based on individualized Oxygen dynamics is designed to confirm this association in high-risk patients cardiopulmonary bypass (CPB).
- Conditions
- Cardiac Disease, High Risk Sex
- Being tested
- mean artery pressure, bispectral index, Brain oxygen saturation, Controlled
- Keywords
- oxygen dynamics, Prognosis
- Medical subject headings
- Heart Diseases, Unsafe Sex
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
mean artery pressureProcedure or surgery
mean artery pressure declined with less than 20% of baseline
bispectral indexProcedure or surgery
Also called BIS
BIS 45-60 before and after CPB; and BIS 40-45 during CPB
Brain oxygen saturationProcedure or surgery
Brain oxygen saturation declined with less than 20% of baseline
ControlledOther
receiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr.
| Study group | Role | What they receive |
|---|---|---|
| Individualized Goal-Directed Therapy | Experimental | The goal of intervention:mean artery pressure declined with less than 20% of baseline, BIS 45-60 before and after CPB; and BIS 40-45 during CPB, Brain oxygen saturation declined with less than 20% of baseline. Receives: Procedure: mean artery pressure; Procedure: bispectral index; Procedure: Brain oxygen saturation |
| Controlled | Sham comparator | no intervention beside the same monitoring with MAP, BIS and brain oxygen saturation and receiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr. Receives: Other: Controlled |
What is being measured
The primary outcome is the main question the study is designed to answer.
Major postoperative complications(i.e., Rate of low cardiac output syndrome, stroke, myocardial ischemia, infection,reoperation, and need for dialysis)
Number of Participants with major complications extracted after 30-day follow-up
Measured: 30-day after surgery
30-day mortality
Data for duration of postoperative 30-day all-cause mortality
Measured: 30-day after surgery
The change of incidence of postoperative delirium
Through Confusion Assessment Method (CAM)to assess the incidence of the postoperative delirium
Measured: The 1,2,3 day after surgery
1,3,5-year mortality
Data for duration of 1,3,5-year all-cause mortality is extracted after 1-year follow-up
Measured: 1,3,5-year after surgery
Secondary outcomes (4)
postoperative hospital stay
Data for duration of postoperative hospital stay is extracted after 30-day follow-up
Measured: 30-day after surgery
The change of incidence of postoperative cognition dysfunction
The neuropsychological tests performed at the day before the surgery,the 3,7 day after the surgery respectively.
Measured: 1 day before surgery, the 3,7 day after the surgery
The occurrence of cardiovascular events
Data for duration of the occurrence of cardiovascular events is extracted 30-day follow-up
Measured: 30-day after surgery
The incidence of any adverse events
Including kidney or brain related adverse events 30-day after surgery
Measured: 30-day after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Apr 2017
- Study start5 Mar 2017
- Primary completion30 Jun 2018
- Study completion30 Jul 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Cardiac DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Interventional group:MAP declined with less than 20% of baseline, BIS 45-60 before and after CPB; and BIS 40-45 during CPB, Brain oxygen saturation declined with less than 20% of baseline. Control group:no intervention beside the same monitoring with MAP, BIS and brain oxygen saturation and receiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 286 participants (actual)
Sponsor and investigators
- Lead sponsor
- The First Affiliated Hospital of Anhui Medical University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03103633
- Sponsor's protocol ID
- FirstAnhuiM
- Status last verified
- Apr 2017
- First submitted
- 1 Apr 2017
- Last updated
- 25 Mar 2019
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Cheng XQ, Zhang JY, Wu H, Zuo YM, Tang LL, Zhao Q, Gu EW. Outcomes of individualized goal-directed therapy based on cerebral oxygen balance in high-risk patients undergoing cardiac surgery: A randomized controlled trial. J Clin Anesth. 2020 Dec;67:110032. doi: 10.1016/j.jclinane.2020.110032. Epub 2020 Sep 1.
PubMed 32889413
Study at a glance
From the registry record, last updated by the sponsor on 25 Mar 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Perioperative Goal-Directed Therapy Based on Individualized Oxygen Balance on Outcomes During High-risk Cardiac Surgery:A Single Center, Prospective,Randomized,Controlled,Double Blinded Study.
- ClinicalTrials.gov ID
- NCT03103633
- Acronym / sponsor ID
- FirstAnhuiM
- Conditions
- Cardiac Disease, High Risk Sex
- Keywords
- oxygen dynamics, Prognosis
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 286 participants (actual)
- Lead sponsor
- The First Affiliated Hospital of Anhui Medical UniversityUniversity, hospital or other
- Study start
- 5 Mar 2017 (actual)
- Primary completion
- 30 Jun 2018 (actual)
- Study completion
- 30 Jul 2018 (actual)
- First posted
- 6 Apr 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Anesthesia-related factors have been linked to poor perioperative outcomes. Our observational study suggested that the cumulative duration of a triple-low state [intraoperative low mean arterial pressure (MAP), low bispectral index (BIS), and low target effect-site concentration(Ce) ]was associated with poorer 30-day mortality.This randomized, prospective study based on individualized Oxygen dynamics is designed to confirm this association in high-risk patients cardiopulmonary bypass (CPB).
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Interventional group:MAP declined with less than 20% of baseline, BIS 45-60 before and after CPB; and BIS 40-45 during CPB, Brain oxygen saturation declined with less than 20% of baseline. Control group:no intervention beside the same monitoring with MAP, BIS and brain oxygen saturation and receiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr.
| Arm | Type | Receives |
|---|---|---|
| Individualized Goal-Directed Therapy | Experimental | Procedure: mean artery pressure, Procedure: bispectral index, Procedure: Brain oxygen saturationThe goal of intervention:mean artery pressure declined with less than 20% of baseline, BIS 45-60 before and after CPB; and BIS 40-45 during CPB, Brain oxygen saturation declined with less than 20% of baseline. |
| Controlled | Sham comparator | Other: Controlledno intervention beside the same monitoring with MAP, BIS and brain oxygen saturation and receiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr. |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Written informed consent;
- Selective cardiac surgery and general anesthesia patients;
- Age 18-90 yrs;
- Anesthesia Society of American (ASA) Scale II-IV
- European System for Cardiac Operative Risk Evaluation score equal to or greater than 6 or left ventricular ejection fraction lower than 50%
Key exclusion criteria (5 listed)
- Preoperative cardiac ejection fraction<30 %;
- History of anesthesia awareness;
- History or anticipation of difficult intubation;
- Unanticipated intraoperative conditions, including haemorrhage, obstinate resuscitation failure,multiple cardiopulmonary bypass procedures, severe hypotension or hypoxemia;
- long-term preoperative use of anticonvulsant agents, opiates, benzodiazepines or cocaine.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| mean artery pressuremean artery pressure declined with less than 20% of baseline | Procedure or surgery | Individualized Goal-Directed Therapy |
| bispectral indexAlso: BISBIS 45-60 before and after CPB; and BIS 40-45 during CPB | Procedure or surgery | Individualized Goal-Directed Therapy |
| Brain oxygen saturationBrain oxygen saturation declined with less than 20% of baseline | Procedure or surgery | Individualized Goal-Directed Therapy |
| Controlledreceiving standard measures to achieve a heart rate (HR) in the range of 60-100 beats/min, central venous oxygen saturation (Svco2) higher than 70%, lactate level lower than 3 mmol/L, hematocrit value higher than 28%, and urinary output higher than 0.5 mL/kg/hr. | Other | Controlled |
Primary outcome
Major postoperative complications(i.e., Rate of low cardiac output syndrome, stroke, myocardial ischemia, infection,reoperation, and need for dialysis)
Time frame: 30-day after surgery
Number of Participants with major complications extracted after 30-day follow-up
30-day mortality
Time frame: 30-day after surgery
Data for duration of postoperative 30-day all-cause mortality
The change of incidence of postoperative delirium
Time frame: The 1,2,3 day after surgery
Through Confusion Assessment Method (CAM)to assess the incidence of the postoperative delirium
1,3,5-year mortality
Time frame: 1,3,5-year after surgery
Data for duration of 1,3,5-year all-cause mortality is extracted after 1-year follow-up
4 secondary outcomes
postoperative hospital stay
Time frame: 30-day after surgery
The change of incidence of postoperative cognition dysfunction
Time frame: 1 day before surgery, the 3,7 day after the surgery
The occurrence of cardiovascular events
Time frame: 30-day after surgery
The incidence of any adverse events
Time frame: 30-day after surgery
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Mar 2019.
- Derived from this study: PubMed 32889413Cheng XQ, Zhang JY, Wu H, Zuo YM, Tang LL, Zhao Q, Gu EW. Outcomes of individualized goal-directed therapy based on cerebral oxygen balance in high-risk patients undergoing cardiac surgery: A randomized controlled trial. J Clin Anesth. 2020 Dec;67:110032. doi: 10.1016/j.jclinane.2020.110032. Epub 2020 Sep 1.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing mean artery pressure, bispectral index and Brain oxygen saturation in people with Cardiac Disease and High Risk Sex, run by The First Affiliated Hospital of Anhui Medical University at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Major postoperative complications(i.e., Rate of low cardiac output syndrome, stroke, myocardial ischemia, infection,reoperation, and need for dialysis) (time frame: 30-day after surgery). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03103633, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2019; AzTrials last refreshed its copy on 7 Nov 2026.