- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05011357
Phenylephrine and Pulse Pressure Variability
Effect of Phenylephrine Infusion on Pulse Pressure Variability
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Perioperative fluid administration is a very important issue in modern anesthesia practice. Overzealous intraoperative administration of fluids can lead to cardiac overload thus potentially causing significant morbidity. It has been demonstrated that over 50% of perioperative complications are tied to intraoperative fluid administration and that changing intraoperative fluid management alone has significant positive benefit. Pulse pressure variation (PPV), which quantifies the respiratory variation in beat-to-beat arterial blood pressure, is viewed as a reliable method to assess volume status. Increasing PPV indicates hypovolemia, and a decreasing PPV indicates progression towards euvolemia. However, there are many commonly encountered intraoperative conditions that may make these interpretations of PPV problematic. For example it is commonly accepted in the perioperative community that PPV is interpretable in patients without vasopressor infusion since there is little consensus to the effects of vasopressor therapy on PPV. Hence the proposed study seeks to characterize the PPV response during simulated hypovolemia with and without infusion of phenylephrine, which acts on alpha-1 receptors to increase systemic vascular resistance, and hence blood pressure.
In a patient under general anesthesia, a PPV cut-off of 13% indicates a positive response to fluid administration. However, this cut-off was based on studies that used a wide variety of vasopressor agents with different mechanisms. Furthermore, it is unclear how effective the current threshold is at predicting fluid responsiveness when vasopressors are added during the same operation (i.e. a PPV of 13% without vasopressors likely represents different physiologic conditions compared to a PPV of 13% with vasopressors in the same operation). Hence, understanding how vasopressors such as phenylephrine change PPV and the PPV threshold is very important and represents an important knowledge gap in the practice of anesthesia.
Study Type
Enrollment (Estimated)
Phase
- Early Phase 1
Contacts and Locations
Study Contact
- Name: Noah P Jouett, DO/PhD
- Phone Number: (214) 648-5460
- Email: noah.jouett@utsouthwestern.edu
Study Contact Backup
- Name: David McDonagh, MD
- Phone Number: 214/648-8083
- Email: david.mcdonagh@utsouthwestern.edu
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75231
- Recruiting
- Texas Health Resources
-
Contact:
- Noah P Jouett, DO/PhD
-
Principal Investigator:
- Noah P Jouett, DO/PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 18 to 45 years of age
- Non-obese (Body Mass Index less than 30 kg/m2)
- Baseline systolic blood pressure between 80-140 mmHg
- Baseline diastolic blood pressure <90 mmHg
Exclusion Criteria:
- Participants who have cardiac, vascular, respiratory, neurological and/or metabolic illness
- Current or previous use of anti-hypertensive medications
- Any known history of renal or hepatic insufficiency/disease
- Pregnancy (verified by negative urine test on the experimental days) or breast-feeding
- Current smokers, as well as individuals who regularly smoked within the past 3 years
- Sulfite allergy, as this is a contraindication to intravenous phenylephrine
- Serious mental illness including claustrophobia
- History of use of recreational drugs including cocaine or amphetamines
- Peripheral vascular disease
- Subject on anticoagulant treatment
- Subjects with a baseline systolic blood pressure <80 mmHg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Phenylephrine
Phenylephrine infusion (0.3 mcg/kg/hr)
|
Phenylephrine will be administered as an infusion
Other Names:
|
Placebo Comparator: Control
Saline infusion
|
Saline infusion
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pulse Pressure Variability
Time Frame: Thirty minutes following phenylephrine infusion
|
Quantifying respiratory variation in beat-to-beat arterial blood pressure
|
Thirty minutes following phenylephrine infusion
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Noah Jouett, DO/PhD, University of Texas Southwestern Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Hypotension
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Protective Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Cardiotonic Agents
- Respiratory System Agents
- Sympathomimetics
- Vasoconstrictor Agents
- Mydriatics
- Nasal Decongestants
- Adrenergic alpha-1 Receptor Agonists
- Phenylephrine
- Oxymetazoline
Other Study ID Numbers
- STU-2021-0497
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 drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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