- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00137527
Brain Oxygenation Monitoring in Patients Undergoing Coronary Artery Bypass Surgery
Prospective, Randomized Trial of Cerebral Oximetry Monitoring in Patients Undergoing Coronary Artery Bypass Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study represents a prospective, randomized assessment of the potential clinical and economic benefit to be derived from the continuous non-invasive monitoring of regional cerebral oxygen saturation (rSO2) during cardiac surgery employing cardiopulmonary bypass (CPB). Previous studies have shown that low rSO2 values obtained during surgery are highly associated with postoperative frontal lobe dysfunction, cognitive declines, disorientation, and other clinical indices of prolonged recovery. Low rSO2 values are thought to reflect the development of tissue hypoxia within susceptible regions of the cerebral cortex during the non-pulsatile perfusion of CPB. Rapid detection and correction of such episodes should help avoid regional hypoxia and its attendant postoperative sequelae. This study will assess neurologic, psychometric, and quality of life markers of brain dysfunction which could result from CPB. Each study patient will be assessed both pre- and postoperatively (pre-hospital discharge and at three months) for neurologic and neurocognitive dysfunction.
Comparison(s): Intervention versus control group. Patients assigned to the intervention rSO2-monitored group will be managed with conservative measures designed to maintain the rSO2 value at, or above, its preoperative value. Such measures include increases in pump flow, blood pressure, anesthetic dose, arterial oxygen tension, carbon dioxide tension, and hematocrit. Those patients in the control group will be managed according to current established practice. Although rSO2 is also recorded in this group, the monitor's readings are blinded.
Study Type
Enrollment
Phase
- Not Applicable
Contacts and Locations
Study Locations
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New Jersey
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Morristown, New Jersey, United States, 07962
- Morristown Memorial Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Primary coronary artery bypass surgery
- Ages 18-90
- Voluntary participation with signed informed consent
Exclusion Criteria:
- An unwillingness to participate in the study
- Inability to obtain informed consent
- Expressive or receptive aphasia
- Inability to correctly perform the neurocognitive tests preoperatively
- Inability to correctly perform the saccadic and anti-saccadic eye movement tests preoperatively
- Non-English speaking candidates
- Patients for whom it is known that follow-up will be improbable
- Previous cardiac surgery
- Concomitant procedures
- Pre-existing psychotic disorders
- Patients with active alcohol (ETOH) abuse requiring emergent surgery
- Patients scoring 2 or higher on the CAGE evaluation
- Mini-Mental State Exam preoperative score of 23 or less
- Severe visual or auditory disorders
- Parkinson's disease
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
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Cognitive function measured by neurocognitive tests administered in the preoperative, immediate postoperative, and three months postoperative periods
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Secondary Outcome Measures
Outcome Measure |
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Relationship of intraoperative risk data to postoperative cognitive function
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: James P Slater, MD, Morristown Memorial Hospital
Publications and helpful links
General Publications
- Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, Mark DB, Reves JG, Blumenthal JA; Neurological Outcome Research Group and the Cardiothoracic Anesthesiology Research Endeavors Investigators. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001 Feb 8;344(6):395-402. doi: 10.1056/NEJM200102083440601. Erratum In: N Engl J Med 2001 Jun 14;344(24):1876.
- Selnes OA, Grega MA, Borowicz LM Jr, Royall RM, McKhann GM, Baumgartner WA. Cognitive changes with coronary artery disease: a prospective study of coronary artery bypass graft patients and nonsurgical controls. Ann Thorac Surg. 2003 May;75(5):1377-84; discussion 1384-6. doi: 10.1016/s0003-4975(03)00021-3.
- Selnes OA, McKhann GM. Neurocognitive complications after coronary artery bypass surgery. Ann Neurol. 2005 May;57(5):615-21. doi: 10.1002/ana.20481.
Study record dates
Study Major Dates
Study Start
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- B03-07-008
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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