- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01002209
Postoperative Hyperbaric Oxygen Treatments to Reduce Complications in Diabetic Patients Undergoing Vascular Surgery (HODiVA)
Postoperative Hyperbaric Oxygen Treatments to Reduce Complications in Diabetic Patients Undergoing Vascular Surgery (HODiVA) - A Double Blind, Randomized Controlled Study
This trial aims to evaluate if hyperbaric oxygen treatment (HBO) given postoperatively is effective in reducing healing time and wound complications after lower extremity bypass surgery in patients with diabetes.
Hypothesis: Postoperative HBO treatment is effective in reducing complications in patients with diabetes undergoing peripheral vascular surgery
Study Overview
Status
Intervention / Treatment
Study Type
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Stockholm, Sweden, 17176
- Karolinska University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients are eligible for inclusion if the following criteria are fulfilled
- Informed consent obtained
- Scheduled for lower extremity open vascular surgery
- Diabetes treated with insulin or oral antidiabetic medicine
- Age ≥ 18 years
Exclusion Criteria:
- Contraindications to HBO therapy
- Pregnancy (women of childbearing potential will undergo pregnancy test before inclusion)
- Patients already in HBO treatment
- Vascular reoperation
- Creatinine > 250 mmol/L
- NYHA class IV heart failure or severe cardiopulmonary disease with desaturation judged to be incompatible with safe HBO/ placebo therapy in a monoplace chamber
- Clinically significant chronic obstructive pulmonary disease.
- Acute sepsis.
- Malignancy or other serious medical condition where it is likely that the patient will significantly deteriorate or not survive within the two years of follow up.
- Simultaneous or previous (within 30 days prior to study entry participation in a clinical study using experimental drugs or devices.
- Mental condition making the subject unable to understand the concepts and risk of the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Sham Comparator: Sham Hyperbaric Oxygen Treatment
|
HBO sham treatment will start on first postoperative day (study day 1). HBO sham treatment will be given twice daily first three days (study day 1-3) and then once daily for up to three days (study day 4-6). The total number of treatments will be at least 6 and at most 9 treatments. Patients who have received at least three days HBO sham treatments and who have a clearly uncomplicated postoperative course will terminate HBO sham treatment on the day of discharge from hospital. For patient blinding purposes, the sham group will breathe air and will be given a brief compression to 1.5 bar at the beginning of each treatment after which the chamber is slowly decompressed to 1.1, 1.2 , 1.3, or 1.4 bar corresponding to 0.23 ,0.25, 0.27, and 0.29 bar inspired oxygen. Two 10 min "airbrakes" will also be included. |
Experimental: Hyperbaric oxygen treatment (HBO)
|
HBO treatment will be given in a monoplace chamber and will start on first postoperative day (study day 1). The HBO group will be treated with 100% oxygen at 2.5 bar for 100 min with two 10 min airbrakes (without mask). HBO treatment will be given twice daily first three days (study day 1-3) and then once daily for up to three days (study day 4-6). The total number of treatments will be at least 6 and at most 9 treatments. Patients who have received at least three days HBO/placebo treatment and who have a clearly uncomplicated postoperative course will terminate HBO/placebo treatment on the day of discharge from hospital. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Time to complete healing of operative wounds
Time Frame: 7-365 days
|
7-365 days
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Number of wound infections at 7 days assessed by ASEPSIS score. A score over 20 will be considered as a wound infection.
Time Frame: 7 days (plus minus 3 days)
|
7 days (plus minus 3 days)
|
Number of wound infections at 30 days assessed by ASEPSIS score. A score over 20 will be considered as a wound infection.
Time Frame: 30 days (plus minus 3 days)
|
30 days (plus minus 3 days)
|
The severity of wound infection defined as by ASEPSIS score: 0-10= satisfactory healing 11-20= disturbed healing 21-30= minor wound infection 31-40= moderate wound infection >40= severe wound infection.
Time Frame: highest score up to 30 days (plus minus 3 days)
|
highest score up to 30 days (plus minus 3 days)
|
A combination of any wound infection and/or unhealed wounds at 30 days (combined endpoint).
Time Frame: 30 days (plus minus 3 days)
|
30 days (plus minus 3 days)
|
SF-36 score
Time Frame: 7, 14, 28, 365 days (plus minus 3 days)
|
7, 14, 28, 365 days (plus minus 3 days)
|
Major amputation or death. This will be assessed as "amputation-free survival". A major amputation is defined as any ipsilateral amputation through or above the ankle.
Time Frame: 0-365 days
|
0-365 days
|
Tissue perfusion and oxygenation on dorsum of foot on operated extremity as assessed by Transcutaneous oximetry during normobaric air breathing and after 6 min normobaric 100% oxygen challenge
Time Frame: day 3-5, 7 and 14, 28, 365 (plus minus 3 days)
|
day 3-5, 7 and 14, 28, 365 (plus minus 3 days)
|
HBO complications (confinement anxiety, barotrauma, oxygen convulsions)
Time Frame: During HBO treatment up to day 6
|
During HBO treatment up to day 6
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jonas Malmstedt, MD, Karolinska Institutet
- Principal Investigator: Folke G Lind, MD, PhD, Karolinska Institutet
- Principal Investigator: Sergiu Catrina, MD, PhD, Karolinska Institutet
- Principal Investigator: Joy Roy, MD, PhD, Karolinska Institutet
- Principal Investigator: Nils Pettersson, MD, PhD, Karolinska Institutet
- Principal Investigator: Bengt M Eriksson, MD, Hyperbaric Medicine, Karolinska Univ Hosp
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
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
- HODIVA
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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