- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02179840
Assessment of Cerebral Microvascular Circulation (CHS-Brain)
January 4, 2019 updated by: University of California, San Francisco
Assessment of Coherent Hemodynamics Spectroscopy (CHS) as a New Tool for Monitoring Cerebral Blood Flow and Autoregulation at the Microvascular Level
One of the fundamental goals of anesthesia care is to optimize tissue perfusion and oxygenation, especially in critically ill patients.
The standard monitors such as blood pressure, heart rate and pulse oximetry do not directly reflect tissue information and can be misleading sometimes.
Coherent hemodynamics spectroscopy (CHS) based on cerebral oximetry is proposed as a continuous and non-invasive tool assessing cerebral microvascular hemodynamics.
The investigators propose this study to explore the validity of CHS via comparison with transcranial Doppler measurement in anesthetized surgical patients.
The hypotheses are: 1) CHS can effectively measure cerebral microvascular hemodynamic changes associated with mechanical ventilation adjustment during anesthesia.
2) CHS can assess functional status of cerebral autoregulation that is altered by hypercapnia and inhalational anesthetic agent.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
One of the essential goals in taking care of anesthetized surgical patients is to maintain adequate tissue perfusion and oxygenation.
This is especially true for vital organs like the brain.
Unfortunately, neither cerebral oxygen consumption nor cerebral oxygen delivery are directly monitored in the clinical setting while this type of information is of particular importance when taking care of patients inflicted with critical neurologic conditions.
In addition, cerebral autoregulation - the mechanism of maintaining a constant cerebral blood flow in the face of arterial blood pressure fluctuation, is also not routinely monitored.
The recent establishment of Coherent Hemodynamics Spectroscopy (CHS) is promising in offering what is needed in this context.
The uniqueness of CHS is that it does not add any additional monitoring modality other than the cerebral oximeter based on near-infrared spectroscopy (NIRS) that is currently used in clinical care.
However, CHS is based on its own innovative algorithm that quantifies microvascular cerebral blood flow and oxygen consumption, separates arterial and venous blood, and assesses functional status of cerebral autoregulation while the conventional cerebral oximeters do not.
The investigators have established collaborations with Dr. Fantini from Tufts University and Dr. Tromberg from Beckman Laser Institute who are both leading scientists in Biophotonics research and development.
Based on the clinical strength at UCSF, it is the investigators collaborative plan to explore the clinical application of CHS in patients with and without intracranial pathophysiologies.
The study protocol has been submitted for review at UCSF.
Study Type
Interventional
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 Locations
-
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California
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San Francisco, California, United States, 94143
- UCSF
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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 to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients are 18 years of age or older
- Relative healthy (ASA I-II)
- Scheduled for elective intra-abdominal surgeries including colorectal, urological and gynecological procedures under general anesthesia with placements of endotracheal tube and radial arterial catheter.
- Paralysis is required for surgery
- A total of 30 patients will be recruited. These 30 patients are randomly divided into 2 groups based on the technique of anesthesia maintenance during surgery. The anesthesia in one group (n=15) is maintained using inhalational agent. The anesthesia in the other group (n=15) is maintained using intravenous agents.
Exclusion Criteria:
- Patients <18 years of age
- ASA physical status ≥III
- Emergent or urgent surgery
- Laparoscopic surgery
- History of pulmonary diseases including COPD
- Asthma
- Restrictive lung disease, etc.
- History of cardiac diseases including symptomatic coronary artery disease, heart failure, arrhythmia, moderate to severe valvular abnormalities, and cardiomyopathies
- History of neurological diseases including carotid artery disease, stroke or TIA, etc.
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 Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Intravenous
Anesthesia is maintained via intravenous agents.
Mechanical ventilation adjustment will be performed.
|
Mechanical ventilation adjustment and study procedure: This is a validation study of the CHS method in assessing cerebral microvascular hemodynamic changes.
Cyclical physiological events such as respiration are essential in CHS methodology.
The previous study shows that the robust measurement of the CHS method occurs at a respiratory rate of about 4-10 breaths per minute.
Therefore, we propose the following respiration adjustment in this study with the consideration that CO2 is a powerful regulator of cerebral blood flow.
Blood gas analysis will be performed during the 1st and 2nd rounds of ventilation adjustment.
|
Active Comparator: Inhalational
Anesthesia is maintained via inhalational agents.
Mechanical ventilation adjustment will be performed.
|
Mechanical ventilation adjustment and study procedure: This is a validation study of the CHS method in assessing cerebral microvascular hemodynamic changes.
Cyclical physiological events such as respiration are essential in CHS methodology.
The previous study shows that the robust measurement of the CHS method occurs at a respiratory rate of about 4-10 breaths per minute.
Therefore, we propose the following respiration adjustment in this study with the consideration that CO2 is a powerful regulator of cerebral blood flow.
Blood gas analysis will be performed during the 1st and 2nd rounds of ventilation adjustment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
cerebral oximetry
Time Frame: 3 minutes following the intervention
|
Cerebral blood flow capillary transit time and cerebral autoregulation
|
3 minutes following the intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Lingzhong Meng, University of California, San Francisco
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
March 1, 2015
Primary Completion (Anticipated)
June 1, 2015
Study Completion (Anticipated)
March 1, 2016
Study Registration Dates
First Submitted
June 23, 2014
First Submitted That Met QC Criteria
July 1, 2014
First Posted (Estimate)
July 2, 2014
Study Record Updates
Last Update Posted (Actual)
January 8, 2019
Last Update Submitted That Met QC Criteria
January 4, 2019
Last Verified
January 1, 2019
More Information
Terms related to this study
Other Study ID Numbers
- CHS-Brain
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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