Registration Enabling Study of the Safety and Efficacy of the Use of the Navigator Circulatory Management System

A Prospective,Open,Multicentre,RCT to Assess the Safety & Efficacy of Navigator v Conventional Care in Post-op Cardiac Surgery Patients Undergoing CABG &/or Heart Valve Repair/Replacement Utilising Heart Lung Perfusion Pump(The NAV-1 Study)

Sponsors

Lead Sponsor: Applied Physiology Pty Ltd

Collaborator: Trident Clinical Research Pty Ltd

Source Applied Physiology Pty Ltd
Brief Summary

A multicentre, open, RCT to assess the safety and efficacy of the Navigator Guided Circulatory Management System versus conventional care in post-operative cardiac surgery patients. The purpose of the study is to demonstrate that the real time acquisition and subsequent processing and display of data produced by the Navigator guided circulatory management system provides the clinician with appropriate data and guidance to achieve and maintain a prescribed target haemodynamic stability in the post operative patient when compared to conventional care in an Intensive Care Unit setting.

Detailed Description

Protocol No. AP2006-01 Study title: A Prospective, Open, Randomised, Multicentre, Controlled Group Study to Assess the Safety and Efficacy of Navigator versus Conventional Care in Postoperative Cardiac Surgery Patients Undergoing Coronary Bypass Grafting and or Heart Valve Repair or Replacement Utilizing Heart Lung Perfusion Pump. Acronym: NAV 1 Type of study: Device Trial Sponsor: Applied Physiology Pty Ltd Study device: Navigator Guided Circulatory Care Management System Route of Administration: Via Touch Panel Computer, externally connected to the bedside physiological monitor in a critical care environment Study centres: Six Australian centres Study design: Multicentre, open, randomised, controlled group study Total sample size: One hundred completed patients, 50 in each arm Study population: Post operative coronary bypass and heart valve repair or replacement patients admitted to a Cardiac Intensive Care or Intensive Care Unit. Surgery must involve the use of a heart lung perfusion pump and the patient must have a functioning arterial line and Swan Ganz catheter in situ to enable the measurement of Cardiac Output, Mean Arterial Pressure, and Right Atrial Pressure. Study regimen: Following surgery, and after meeting inclusion and exclusion criteria, patients will be randomised on admission to ICU to receive care guided by Navigator or conventional care during their ICU stay while CO is being monitored. All patients will be connected to the Navigator; the screen of the patients in the control group will have the graphical section blank, the right hand side will display actual values of MAP, CO and RAP as slaved from the bedside monitor, along with the patient's screening and randomisation number and initials. The arm of the study to which the patient has been randomised ;control/Navigator, will also be shown. Endpoints: Primary: The primary efficacy endpoint is the average distance to the central point of the target cardiovascular zone over the period the patient is connected to Navigator. Secondary: Secondary endpoints for the trial will be: - Percentage time in the target cardiovascular zone over the period the patient is connected to the Navigator - Clinically significant atrial fibrillation over the period the patient is connected to the Navigator. This is defined as irregular supraventricular rhythm with an absence of discrete P waves lasting more than ten minutes documented and confirmed with an ECG - Multiple organ function, as assessed using the SOFA score, calculated daily - Navigator device related adverse events and device failures Statistical analysis: The primary and secondary endpoints and all safety data will be analysed on the randomised Intention-to-treat population.The ITT population will include all individuals who are randomised. The analysis will compare the primary efficacy endpoint between the two randomised treatment groups using independent t tests. The secondary analyses will compare the secondary endpoints between the two randomised treatment groups using independent t-tests, Chi-square tests and Fisher's exact tests as appropriate. Study Period: From the first pre-surgery screening visit to the post operative follow up visit, approximately six weeks

Overall Status Completed
Start Date 2007-03-01
Completion Date 2008-04-01
Primary Completion Date 2008-04-01
Phase Phase 2
Study Type Interventional
Primary Outcome
Measure Time Frame
Average distance to central point of the target cardiovascular zone while connected to the device Time connected to Navigator device
Secondary Outcome
Measure Time Frame
Percentage time in the target cardiovascular zone while connected to device Time connected to Navigator device
Clinically significant AF while connected to device Time connected to Navigator device
Multiple organ function (SOFA score) From connection to Navigator device to hospital discharge
Device-related adverse events and device failures Time connected to Navigator device
Enrollment 112
Condition
Intervention

Intervention Type: Device

Intervention Name: Navigator

Description: Navigator circulatory mgt system

Arm Group Label: 1

Intervention Type: Other

Intervention Name: Conventional care

Description: Conventional haemodynamic care

Arm Group Label: 2

Eligibility

Criteria:

Inclusion Criteria: 1. Male or female aged 18 years or older 2. Undergoing elective cardiac surgery where surgery involves the use of a heart-lung perfusion pump 3. Will have an arterial line and Swan Ganz catheter in situ 4. Require invasive measurement of Cardiac Output (CO), Mean Arterial Pressure (MAP) and Right Atrial Pressure (RAP) 5. Are able and willing to provide written informed consent to participate in the study Exclusion Criteria: 1. Women who are lactating or pregnant 2. Require Extracorporeal Membrane Oxygenation 3. Present at baseline screening or immediately prior to randomisation in the ICU with atrial fibrillation (irregular supraventricular rhythm, not due to ectopic complexes with an absence of discrete P-waves lasting more than 10 minutes documented and confirmed with an ECG) 4. Intra-operative surgical treatment for atrial fibrillation 5. Surgery for left atrial reduction 6. Patients with left ventricular assist devices 7. Patients with permanent pacemakers in situ 8. Deemed by the investigator to be uncooperative or unsuitable for inclusion into this trial 9. Have a medical condition that in the opinion of the investigator would jeopardise the patient's safety by participating in this trial 10. Current participation in another drug or device study

Gender:

All

Minimum Age:

18 Years

Maximum Age:

N/A

Healthy Volunteers:

No

Overall Official
Location
Facility:
St Vincent's Public Hospital | Sydney, New South Wales, 2010, Australia
Royal North Shore Hospital | Sydney, New South Wales, 2065, Australia
Westmead Private Hospital | Sydney, New South Wales, 2145, Australia
Westmead Public Hospital | Sydney, New South Wales, 2145, Australia
St George Public Hospital | Sydney, New South Wales, 2217, Australia
Monash Medical Centre | Melbourne, Victoria, 3168, Australia
The Alfred Hospital | Melbourne, Victoria, 3181, Australia
Location Countries

Australia

Verification Date

2008-04-01

Responsible Party

Name Title: Vickie Edwards

Organization: Applied Physiology Pty Ltd

Keywords
Has Expanded Access No
Condition Browse
Number Of Arms 2
Arm Group

Label: 1

Type: Active Comparator

Description: Device , Navigator used for guiding haemodynamic care

Label: 2

Type: Placebo Comparator

Description: Conventional care

Acronym NAV-1
Study Design Info

Allocation: Randomized

Intervention Model: Parallel Assignment

Primary Purpose: Treatment

Masking: None (Open Label)

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