- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03039881
Evaluation of Non-Invasive Respiratory Volume Monitor
Blinded Observational Study to Evaluate a Non-Invasive Respiratory Volume Monitor in the Post-Anesthesia Care Unit and on the General Hospital Floor
Study Overview
Status
Intervention / Treatment
Detailed Description
Aim and Hypotheses Currently, there is no objective measure of early respiratory indicators for developing respiratory compromise in surgical patients. Current respiratory assessment in non-intubated patients relies on oximetry data and subjective clinical assessment. Pulse oximetry has been extremely helpful in recognizing oxygen desaturations but it is a late indicator of respiratory decline. New advances in technology and digital signal processing have led to the development of an impedance based Respiratory Volume Monitor (RVM). The RVM (ExSpiron™, Respiratory Motion, Inc.; Waltham, MA) has been shown to provide accurate real-time, continuous, non-invasive measurements of tidal volume (TV), minute ventilation (MV) and respiratory rate (RR) in general patient population.
Hypotheses
Primary:
Low minute ventilation (LMV) defined as sustained LMV<40% minute ventilation predicted (MVPRED) based on IBW following opioid administration correlates with adverse clinical outcomes in PACU or on the floor including:
- O2 desaturation, atelectasis, respiratory status requiring advanced monitoring
- respiratory interventions such as O2 administration, continuous positive airway pressure CPAP, BiPAP,
- incidence of ICU transfer and/or increase in PACU and/or general hospital floor (GHF) length of stay (LOS).
Secondary:
- 1. Decreased MV defined as sustained MV<80% MVPRED based on IBW before opioid administration correlates with adverse clinical outcomes as defined above.
- 2. Patients with decreased MV prior to opioid administration will be more likely to develop LMV after standard opioid administration compared to patients with normal MV defined as MV ≥ 81% MVPRED based on ideal body weight (IBW)
Rationale Continuous respiratory monitoring using the ExSpiron System will be particularly beneficial to patients in the post-anesthesia environment. Assessment and management of respiratory function and early intervention when indicated is a multifaceted, complex task often complicated by the lack of a cohesive and continuous monitoring system to guide clinical decisions. The ExSpiron system is designed for these patients and is intended to address some of the limitations of the current generation of hospital monitors and to provide healthcare providers with continuous real-time data regarding the patient's respiratory status. Recent data has shown that stratification of patients based on the RVM's MV as % of predicted MV (MVPRED), prior to opioid dosing has made it possible to identify patients who are at risk for further decreases in MV and opioid-induced respiratory depression (OIRD).
- In the spontaneously breathing, non-ventilated patient, current monitoring devices do not provide continuous, objective non-invasive, continuous real time information of the important respiratory parameters TV, MV & RR.
- Current monitoring of non-intubated patients mostly relies on subjective clinical assessment, oximetry data, and rarely end-tidal carbon dioxide CO2 measurements. In appropriate clinical settings, the ExSpiron system can provide direct quantitative measure of ventilation parameters for use in clinical assessment and trend prediction as well as response to medications and other interventions to allow for more efficient clinical decision making.
- Current technologies do not provide for a continuity of care between the PACU and the general hospital floor.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Adult patients undergoing surgery with general anesthesia and positive pressure ventilation, patient's ≥80 pounds and who are able to give informed consent.
Exclusion Criteria:
- Patients unable to give informed consent. Any patient whose condition or procedure will not allow for placement of the electrode PadSet
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Low minute ventilation
Time Frame: Post-operatively in PACU and general patient' floor up to 24 hours after completion of surgery
|
Low minute ventilation (LMV) defined as sustained LMV<40% minute ventilation predicted (MVPRED) based on IBW following opioid administration correlates with adverse clinical outcomes in PACU and on the floor
|
Post-operatively in PACU and general patient' floor up to 24 hours after completion of surgery
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Iwona Bonney, PhD, Tufts Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
Other Study ID Numbers
- 11544
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
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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