Phenotype Guided Vasoactive Medication During Kidney Transplantation
Intraoperative Circulation Phenotyping to Guide Vasoactive Medication in Kidney Transplant Recipients
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Jennifer L Cutler, M.D.
- Telefonnummer: 310-497-4541
- E-mail: jennifer.cutler@cshs.org
Undersøgelse Kontakt Backup
- Navn: Leon Wang, M.D.
- Telefonnummer: 203-464-8236
- E-mail: leon.wang@cshs.org
Studiesteder
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California
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Los Angeles, California, Forenede Stater, 90048
- Cedars Sinai Medical Center
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Adults aged 18 years or older
- Undergoing kidney transplantation at Cedars-Sinai Medical Center
- Able to provide informed consent
Exclusion Criteria:
- Patients unable to provide informed consent
- Patients with contraindications to protocol vasoactive medications, as determined by the treating anesthesiologist
- Patients in whom required intraoperative monitoring cannot be performed
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Experimental: Phenotype-Guided Vasoactive Protocol
Recipients undergo intraoperative circulation phenotyping using pulse contour monitoring and fluid responsiveness testing.
Vasoactive support is assigned according to phenotype: vasopressin infusion for Hyperdynamic physiology, norepinephrine infusion for Mixed Physiology, calcium chloride and/or low-dose dopamine for Poor Contractility, and fluid-guided support for Normal physiology.
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Recipients undergo intraoperative circulation phenotyping using pulse contour monitoring and flow-pressure coupling testing.
Vasoactive support is assigned according to phenotype: vasopressin infusion for Hyperdynamic physiology, norepinephrine infusion for Mixed Physiology, calcium chloride and/or low-dose dopamine for Poor Contractility, and fluid-guided support for Normal physiology.
Andre navne:
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Positive Flow-Pressure Coupling Proportion in Hyperdynamic Phenotype as measured by pulse contour analysis on the Edwards Hemosphere
Tidsramme: Intraoperative (from induction to end of surgery)
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Proportion of positive flow-pressure coupling responses among recipients classified intraoperatively as Hyperdynamic.
Flow-Pressure coupling is defined as demonstrating both fluid responsiveness and pressure responsiveness following a fluid responsiveness test.
Fluid responsiveness is defined as >= 10% increase in the stroke volume (ml/beat) and pressure responsiveness is defined as >= 15% in the mean arterial pressure (mmHg) 2 minutes after conclusion of the fluid responsiveness test.
Hyperdynamic phenotypes are defined as having the following hemodynamics: CI >4.0 L/min/m², SVRI <1970 dyn·s·cm-⁵/m², and dP/dt >1000 mmHg/s .
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Intraoperative (from induction to end of surgery)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Characterization of flow-pressure coupling in Normal, Mixed Physiology, and Poor-contractility phenotypes as measured with pulse contour analysis on the Edwards Hemosphere
Tidsramme: intraoperative
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Measurement of positive rate of FPC per FRT in all remaining circulatory phenotypes.
These phenotypes are defined by the following hemodynamics: • Normal phenotype: CI 2.5-4.0
L/min/m² and SVRI 1970-2390 dyn·s·cm-⁵/m² ; • Mixed physiology: CI 2.5-4.0
L/min/m², SVRI <1970 dyn·s·cm-⁵/m², and dP/dt <1000 mmHg/s and • Poor Contractility: CI <2.5 L/min/m² and dP/dt <1000 mmHg/s .
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intraoperative
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Analysis of intraoperative cardiac index (CI) measured with pulse contour analysis on the Edwards Hemosphere
Tidsramme: intraoperative
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recording of CI L/min/m² as baseline, and after each FRT
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intraoperative
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Protocol Adherence
Tidsramme: Intraoperative
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Proportion of intraoperative decision points consistent with the phenotype-guided protocol.
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Intraoperative
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Analysis of Intraoperative Systemic vascular resistance index (SVRI) measured with pulse contour analysis on the Edwards Hemosphere
Tidsramme: intraoperative
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Recording of SVRI dyn·s·cm-⁵/m² as baseline, and after each FRT
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intraoperative
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Analysis of Intraoperative mean arterial pressure (MAP) measured with pulse contour analysis on the Edwards Hemosphere
Tidsramme: intraoperative
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recording of MAP mmHg as baseline and after each FRT
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intraoperative
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Analysis of Intraoperative Contractility (dP/dt) measured with pulse contour analysis on the Edwards Hemosphere.
Tidsramme: intraoperative
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Recording of dP/dt mmHg/s as baseline and after each FRT
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intraoperative
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Analysis of Intraoperative EaDyn (PPV/SVV) with pulse contour analysis on the Edwards Hemosphere
Tidsramme: intraoperative
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Recording of EaDyn (PPV/SVV) as baseline and after each FRT
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intraoperative
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Recording of delayed graft function, defined as the need for dialysis within the first week following kidney transplantation
Tidsramme: Postoperative day 0 to postoperative day 7
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Delayed graft function will be recorded as yes or no
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Postoperative day 0 to postoperative day 7
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Peptidhormoner
- Neuropeptider
- Peptider
- Aminosyrer, peptider og proteiner
- Oligopeptider
- Nervevævsproteiner
- Proteiner
- Organiske kemikalier
- Kulbrinter
- Kulbrinter, cyklisk
- Kulbrinter, aromatisk
- Aminer
- Uorganiske kemikalier
- Klorforbindelser
- Catechols
- Fenoler
- Benzenderivater
- Alkoholer
- Aminoalkoholer
- Ethanolaminer
- Biogene monoaminer
- Biogene aminer
- Catecholamines
- Calciumforbindelser
- Hypofysehormoner, posterior
- Hypofysehormoner
- Chlorider
- Hydrochlorsyre
- Noradrenalin
- Vasopressiner
- Dopamin
- Calciumchlorid
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- IRB Study 4762
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
IPD-deling Understøttende informationstype
- STUDY_PROTOCOL
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