- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04633343
Effects of Different Tidal Volume Ventilation Strategies on Fontan Flow and Hemodynamics
May 22, 2023 updated by: Manchula Navaratnam, Stanford University
In patients with Fontan circulation blood is not pumped to the lungs from a ventricle.
Instead the superior vena cava and inferior vena cava is connected to the pulmonary artery and blood flow to the lungs occurs passively along this Fontan pathway.
This passive blood flow to the lungs occurs best when the patient is breathing on their own (spontaneous ventilation).
However for certain surgeries and procedures patients need to have an endotracheal tube inserted and need to be muscle relaxed and receive positive pressure ventilation.
Prior studies have shown that positive pressure ventilation can reduce blood flow to the lungs and consequently blood returning to the heart resulting in less blood pumped out to the rest of the body (cardiac output).
The purpose of this study is to investigate if changing the volume of the positive pressure ventilation (tidal volume) affects blood flow to the lungs and cardiac output in patients with Fontan circulation.
Study Overview
Status
Completed
Conditions
Detailed Description
If it can be shown that changing the tidal volume does affect the blood flow to the lungs and cardiac output in patients with Fontan circulation the information can be used to learn from this study to optimize the tidal volume ventilation, and therefore pulmonary blood flow and cardiac output when Fontan patients come for general anesthesia.
This is important because the population of patients with Fontan circulation is increasing and an increasing number will present for cardiac and non cardiac surgery when positive pressure ventilation will be required.
They may also spend time on the cardiac intensive care unit on a ventilator and improving our knowledge on how best to ventilate them may help improve their overall hospital outcomes.
Study Type
Interventional
Enrollment (Actual)
12
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
-
-
California
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Stanford, California, United States, 94305
- Stanford University
-
-
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
7 months to 48 years (Child, Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Age 2- 50 years of age
- Patients with Fontan circulation undergoing cardio-thoracic surgery or undergoing cardio-thoracic surgery for completion of Fontan circulation.
Exclusion Criteria:
1. Patients presenting for cardio-thoracic surgery without Fontan circulation or those not coming for completion of Fontan circulation.
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: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Small Volume Breath Group
Small volume breath and fast breathing rate for 5 minutes when the patient is in the Operating room and on mechanical ventilation
|
Small volume breath and fast breathing rate delivered via mechanical ventilator.
|
Experimental: Large Volume Breath Group
Large volume breath and slow breathing rate for 5 minutes when the patient is in the Operating room and on mechanical ventilation.
|
Large volume breath and slow breathing rate delivered via mechanical ventilator.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Transpulmonary gradient
Time Frame: 5 minutes of change in Tidal Volume (high vs low)
|
Effect of tidal volume changes (high vs low) on Transpulmonary gradient as measured as the difference between mean pulmonary artery pressure measured from right internal jugular (Fontan pressure line) and left atrial pressure measured by direct intracardiac pressure line.
Both lines are placed for the scheduled clinical procedure and not solely for the purposes of the research study.
|
5 minutes of change in Tidal Volume (high vs low)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood flow in inferior vena cava (IVC)
Time Frame: 5 minutes of change in Tidal Volume (high vs low)
|
Effect of tidal volume changes (high vs low) on blood flow in inferior vena cava (IVC) as measured by Transesophageal Echocardiography TEE)..
|
5 minutes of change in Tidal Volume (high vs low)
|
Systemic outflow tract stroke distance (velocity time integral)
Time Frame: 5 minutes of change in Tidal Volume (high vs low)
|
Effect of tidal volume changes (high vs low) on systemic outflow tract stroke distance (velocity time integral) as measured by Transesophageal Echocardiography.
(TEE).
|
5 minutes of change in Tidal Volume (high vs low)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Manchula Navaratnam, MD, Stanford University
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 (Actual)
February 22, 2021
Primary Completion (Actual)
August 30, 2022
Study Completion (Actual)
August 30, 2022
Study Registration Dates
First Submitted
November 11, 2020
First Submitted That Met QC Criteria
November 11, 2020
First Posted (Actual)
November 18, 2020
Study Record Updates
Last Update Posted (Actual)
May 24, 2023
Last Update Submitted That Met QC Criteria
May 22, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Other Study ID Numbers
- 58526
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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