- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01686659
Noninvasive and Continuous Hemoglobin Monitoring for Surgical Blood Management (NACHO)
April 20, 2018 updated by: Society for the Advancement of Blood Management, Inc
This is a multi-center cluster-randomized trial with the following Specific Aims:
- To evaluate if continuous noninvasive hemoglobin monitoring will reduce the RBC transfusions in patients undergoing surgeries associated with a significant risk of bleeding.
- To evaluate if patients monitored with continuous noninvasive hemoglobin experience less frequent complications and shorter hospital stay compared with patients who are not being monitored with continuous noninvasive hemoglobin.
Accordingly, the study hypotheses are defined as follows:
- The primary null hypothesis is that continuous noninvasive hemoglobin monitoring will not reduce the RBC transfusions in patients undergoing surgeries associated with a significant risk of bleeding.
- The secondary hypothesis is that in patients monitored with continuous noninvasive hemoglobin, there will be earlier warning of critical drops in hemoglobin, and thus, there will be less frequent complications compared with patients who are not being monitored with continuous noninvasive hemoglobin.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
This is a matched-pair cluster-randomized controlled trial.
At each participating centers, consenting eligible Anesthesiologists will be grouped into matched pairs based on their practice characteristics and experience (namely, their main surgical service/procedures and their years of experience working as a clinician responsible for making transfusion decisions).
From each pair, Anesthesiologists will be randomly allocated to either treat their patients while having access to data from a continuous noninvasive hemoglobin monitoring device (total hemoglobin [SpHb] and Pleth Variability Index [PVI]) (SpHb group) or without access to SpHb/PVI data, under standard of care (control group).
Regardless of randomization, all patients will be monitored with the device but the data will be blinded and not be available to the Anesthesiologist to be used in the management of the control group.
Only in the SpHb group, the SpHb/PVI data will be provided live to the Anesthesiologist, to be used during management of the patients.
Study Type
Interventional
Enrollment (Anticipated)
470
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Richard Melseth
- Phone Number: 602-343-7458
- Email: rmelseth@sabm.org
Study Contact Backup
- Name: Mazyar Javidroozi, MD, PhD
- Phone Number: 201-894-3917
- Email: mazyarjr@yahoo.com
Study Locations
-
-
-
Angers, France
- Completed
- CHU Angers
-
-
-
-
MI
-
San Donato, MI, Italy
- Completed
- IRCCS Policlinico San Donato
-
-
-
-
Hokkaido
-
Chuo-ku Sapporo, Hokkaido, Japan, 060-8543
- Completed
- Sapporo Medical University School of Medicine
-
-
-
-
California
-
Stanford, California, United States, 94305
- Recruiting
- Stanford University
-
Contact:
- Pedro P Tanaka, MD, PhD
-
Principal Investigator:
- Pedro P Tanaka, MD, PhD
-
-
New York
-
Bronx, New York, United States, 10467
- Completed
- Montefiore Medical Center
-
-
North Carolina
-
Durham, North Carolina, United States, 27710
- Completed
- Duke University Medical Center
-
-
Ohio
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Columbus, Ohio, United States, 43210
- Recruiting
- The Ohio State University Wexner Medical Center
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Contact:
- Sergio Bergese, MD
-
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Washington
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Seattle, Washington, United States, 98122
- Completed
- Swedish Medical Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Adult patients undergoing one of the listed major surgeries associated with possibility of significant blood loss
- Consenting patients who are primarily managed by the consenting Anesthesiologists participating in the study (Not applicable at participating centers which have obtained a waiver of informed consent for the patients from their respective IRB)
- At least one finger available and accessible for performing non-invasive hemoglobin monitoring (preoperative perfusion index greater than 0.5)
Exclusion Criteria:
- Any patients who do not fit the criteria for use of sensor, specifically, any patient with nail polish and/or a nail deformity, or obstructed physical access (e.g. due to bandage) to all fingers that would be used for sensor placement, in a manner that interferes with satisfactory sensor placement
- Any patients being monitored with motor evoked potential devices
- Any patients with a known hemoglobinopathy
- Any patients undergoing Cardio-Pulmonary Bypass (CPB)
- Any patients who cannot be transfused or has refused consent for a blood transfusion
- Patients who are moribund/salvage cases as determined by the participating Anesthesiologist in charge of management of the patient in the operating room
- Patients being treated by any artificial oxygen carriers within 30 days of hospital stay
- Patients who are actively enrolled in or within 30 days of completion of any other study (except for purely observational studies with no intervention)
- Patients being managed outside of an operating room in the participating centers, or in operating room with conditions not conducive to perform and complete the study procedures (including use of the hemoglobin monitoring device)
- Patients younger than 18 years old
- Patients who are pregnant
- Any patients expected to receive transfusion preoperatively
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SpHb Arm
These are the patients whose primary anesthesiologists have been allocated to treat them while having access to data from a continuous noninvasive hemoglobin monitoring device
|
Availability of data from a continuous noninvasive hemoglobin monitoring device (total hemoglobin [SpHb] and Pleth Variability Index [PVI]) to the clinicians in the operating room
Other Names:
|
No Intervention: Control Arm
These are the patients whose primary anesthesiologists have been allocated to treat them without having access to data from a continuous noninvasive hemoglobin monitoring device
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Amount of Intraoperative RBC Transfusion
Time Frame: From the first surgical incision to the wound closure
|
Number of allogeneic RBC units transfused intraoperatively per patient
|
From the first surgical incision to the wound closure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intraoperative RBC Transfusion Rate
Time Frame: From the first surgical incision to the wound closure
|
Occurrence of any allogeneic RBC transfusions intraoperatively
|
From the first surgical incision to the wound closure
|
Amount of Perioperative RBC Transfusion
Time Frame: From time of admission to the hospital to the time of discharge or death whichever sooner (an estimated average of 6 days)
|
Total number of allogeneic RBC units transfused perioperatively during hospital stay
|
From time of admission to the hospital to the time of discharge or death whichever sooner (an estimated average of 6 days)
|
Ischemic Events
Time Frame: From time of surgery to the time of discharge or death whichever sooner (an estimated average of 5 days)
|
Incidence of new (or worsening of pre-existing) ischemic events
|
From time of surgery to the time of discharge or death whichever sooner (an estimated average of 5 days)
|
Mortality
Time Frame: From time of surgery to 30 days after the surgery
|
Any death occuring during surgery or within 30-day period following the surgery
|
From time of surgery to 30 days after the surgery
|
Length of Stay
Time Frame: From time of surgery to time of discharge from hospital (an estimated average of 5 days)
|
Length of post-surgery hospital stay
|
From time of surgery to time of discharge from hospital (an estimated average of 5 days)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Aryeh Shander, MD, Englewood Hospital & Medical Center
- Study Director: Mazyar Javidroozi, MD, PhD, Englewood Hospital & Medical Center
- Study Chair: Aryeh Shander, MD, Englewood Hospital & Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2012
Primary Completion (Anticipated)
December 1, 2018
Study Completion (Anticipated)
June 1, 2019
Study Registration Dates
First Submitted
August 29, 2012
First Submitted That Met QC Criteria
September 12, 2012
First Posted (Estimate)
September 18, 2012
Study Record Updates
Last Update Posted (Actual)
April 23, 2018
Last Update Submitted That Met QC Criteria
April 20, 2018
Last Verified
April 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NACHO
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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