- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04747535
Continuous Positive Airway Pressure After Abdominal Surgery
Continuous Positive Airway Pressure After Abdominal Surgery -A Randomized Controlled Trial
This is a randomized controlled trial with an allocation ratio of 1:1. Half the patients are randomized to continuous positive airway pressure (CPAP) and half to routine medical care. Included are one hundred and twenty patients aged 18-80 years plus patients with ongoing CPAP scheduled for abdominal surgery at Umeå university hospital. The primary outcome is oxygen partial pressure (PaO2) measured on postoperative day 2 compared with the day before surgery. Secondary outcomes include diffusion capacity for carbon-monoxide, vital capacity, FEV1 and carbon-dioxide partial pressure (PaCO2) on postoperative day 2 compared with the day before surgery. PaO2 and PaCO2 are recorded from blood gas measurements obtained from the radial artery. Percentage of nocturnal hypoxia defined as the percentage of oxygen saturation during 90% of the second postoperative night. Tolerance to CPAP measured by the number of hours used CPAP. Side effects related to CPAP. All patients are examined with a simplified sleep apnea examination (Noxturnal T3, Res Med) the night before surgery.
Patients in the CPAP treated group are given an auto-CPAP with a minimum pressure of 5 cm and a maximum pressure of 10 cm. They will be treated with CPAP for at least 2 hours immediately after surgery and during the first two postoperative nights. Oxygen is supplied to CPAP if oxygen saturation falls below 90%. Patients in the control group receives standard treatment and supplemental oxygen if oxygen saturation falls below 90%. In a third arm, we will include patients who already are using CPAP at night at home for previously diagnosed obstructive sleep apnea. are instructed to use CPAP for 2 hours immediately after surgery and subsequent nights during hospital stay.
Study Overview
Status
Intervention / Treatment
Detailed Description
Theory Research question: Does nasal CPAP abolish postoperative hypoxia and lung function decline after abdominal surgery?
Methods This is a randomized controlled trial with an allocation ratio of 1:1. Half of the patients are randomized to CPAP and half to routine medical care. Randomization is generated by a computer program and handled by a person outside the study. Randomization procedure is documented by the contact person and in the patient's study protocol.
Include are one hundred and twenty patients age 18-80 years old, scheduled for abdominal surgery at Umeå university hospital. Excluded are patients with American Society of Anesthesia (ASA) class 2-3 and patients with cognitive impairment or dementia, unable to participate. Patients with ongoing CPAP treatment are not randomized. Instead, they form a separate group with ongoing CPAP after surgery
The primary outcome is oxygen partial pressure (PaO2) measured on postoperative day 2 compared with the day before surgery.
Secondary outcomes include diffusion capacity for carbon-monoxide, vital capacity, FEV1 and carbon-dioxide partial pressure (PaCO2) on postoperative day 2 compared with the day before surgery.
PaO2 and PaCO2 are recorded from blood gas measurements obtained from the radial artery. Percentage of nocturnal hypoxia defined as the percentage of oxygen saturation during 90% of the second postoperative night. Tolerance to CPAP measured by the number of hours used CPAP. Side effects related to CPAP.
All patients are examined with a simplified sleep apnea examination (Noxturnal T3, Res Med) the night before surgery.
A need of 35 patients in each arm was estimated to detect a difference in mean (SD) in PaO2 of 1 (1.5) kilo Pascal with a significance of p<0.05 and a power of 80%. Due to dropouts, it is estimated a need to include and randomize 120 patients.
Patients in the CPAP treated group are given an auto-CPAP that can increase the pressure during respiratory arrest (AirSense 10 AutoSet, ResMed Inc) including a silicone nasal mask. It is set with a minimum pressure of 5 cm and a maximum pressure of 10 cm during instruction on the day before surgery. Pressure and mask are tested by trained personnel at the Lung section so that both pressure and mask are comfortable and can be tolerated by the patient. Immediately after surgery they will be given CPAP for at least 2 hours immediately after surgery and during the first two postoperative nights. Oxygen is supplied to CPAP if oxygen saturation falls below 90%.
Patients in the control group receive standard treatment and supplemental oxygen if oxygen saturation falls below 90%
Included in a third arm are patients who already are using CPAP at night at home for previously diagnosed obstructive sleep apnea. They are instructed to use CPAP for 2 hours immediately after surgery and subsequent nights during hospital stay.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Umea
-
Umeå, Umea, Sweden, 901 85
- Dept of Surgery, Inst of Surgical and Perioperative sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults (age 18-80 years) scheduled for elective abdominal surgery
- Must be able to tolerate nasal CPAP
Exclusion Criteria:
- American Society Anesthesia (ASA) Class 3-4.
- Cognitive impairment or dementia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
NO_INTERVENTION: Control
Regular treatment
|
|
EXPERIMENTAL: Auto CPAP
Auto CPAP, AirSense 10 AutoSet, ResMed Inc, max pressure 10 cm water, min pressure 5 cm water
|
AIrSense 10, Auto-CPAP, Minimum pressure 5 cm water, maximum pressure 10 cm water
|
OTHER: CPAP since before
Patients with CPAP since before will all continue using CPAP.
They will not attend the randomization process.
They will be regarded as a separate group.
|
A CPAP the patient uses since before because of previously diagnosed obstructive sleep apnea
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Arterial oxygen partial pressure
Time Frame: Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Difference in PaO2
|
Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Diffusion capacity for carbon monoxide
Time Frame: Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Difference in diffusion capacity
|
Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Forced vital capacity (FVC)
Time Frame: Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Difference in FVC
|
Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Forced expiratory volume in one second (FEV1)
Time Frame: Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Difference in FEV1
|
Difference in change from baseline before surgery to follow-up at postoperative day 2
|
PaCO2
Time Frame: Difference in change from baseline before surgery to follow-up at postoperative day 2
|
Difference in PaCO2
|
Difference in change from baseline before surgery to follow-up at postoperative day 2
|
time of hypoxia with SaO2 <90%
Time Frame: During postoperative night 2
|
Time with hypoxia (SaO2 <90%)
|
During postoperative night 2
|
Side effects of CPAP
Time Frame: From day of surgery to the second postoperative day
|
Type of side effects from CPAP
|
From day of surgery to the second postoperative day
|
CPAP compliance
Time Frame: From day of surgery to the second postoperative day
|
Number of hours using CPAP
|
From day of surgery to the second postoperative day
|
Sleep apnea
Time Frame: From day of surgery to the second postoperative day
|
Effect of CPAP with regard to the occurrence of sleep apnea
|
From day of surgery to the second postoperative day
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Karl A Franklin, Prof, Department of Surgery
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 (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 2020-03408
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.
Clinical Trials on Abdominal Surgery
-
University Hospital MuensterCompletedAbdominal Surgery | Abdominothoracic SurgeryGermany
-
3MRecruitingAbdominal Surgery | Orthopedic Surgery | Vascular Surgery | Cardiovascular SurgeryUnited States
-
York Teaching Hospitals NHS Foundation TrustCompletedColorectal Surgery | Major Abdominal SurgeryUnited Kingdom
-
Technische Universität DresdenRecruiting
-
The Cleveland ClinicRecruiting
-
Washington University School of MedicineTerminatedAbdominal SurgeryUnited States
-
Sameh FathyCompleted
-
Universidade Federal de Santa MariaCompleted
-
The Cleveland ClinicWithdrawnAbdominal Surgery
-
Bayside HealthNational Health and Medical Research Council, AustraliaCompletedAbdominal SurgeryAustralia
Clinical Trials on Auto-CPAP
-
Philips RespironicsCompletedObstructive Sleep ApneaUnited States, Germany
-
Columbia UniversityNational Heart, Lung, and Blood Institute (NHLBI)RecruitingObstructive Sleep Apnea | Interstitial Lung DiseaseUnited States
-
MetroHealth Medical CenterResMed; Great Lakes NeuroTechnologies Inc.TerminatedObstructive Sleep ApneaUnited States
-
University Hospital, GrenobleCoordenação de Aperfeiçoamento de Pessoal de Nível Superior.; ResMed; Agir pour...UnknownSleep Apnea SyndromesFrance
-
University of WashingtonCompletedStroke | Sleep Apnea, ObstructiveUnited States
-
Guangdong Provincial People's HospitalCompletedQuality of Life | Sleep Apnea, Obstructive | Hypertension | Obesity | Diabetes | Fatigue Syndrome, Chronic | Compliance, Patient | Insomnia Chronic | Economic Problems | Health Impairment | HyperdiploidChina
-
State Key Laboratory of Respiratory DiseaseCompletedSleep Apnea, Obstructive | Continuous Positive Airway Pressure | PolysomnographyChina
-
Philips RespironicsMayo Clinic; Brigham and Women's HospitalCompletedObstructive Sleep ApneaUnited States
-
MetroHealth Medical CenterWithdrawnObstructive Sleep ApneaUnited States
-
Fisher and Paykel HealthcareCompleted