- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02415998
Transesophageal Echocardiography (TEE) to Guide and Confirm Epidural Catheters in Pediatric Patients
Studieoversigt
Detaljeret beskrivelse
The aim of this study is to assess whether transesophageal echocardiography (TEE) can be used to successfully guide an epidural catheter to a targeted thoracic level in pediatric patients. The catheter will be placed in the epidural space under real-time TEE imaging and assistance by a trained TEE operator.
The primary outcome is to determine the success rate achieved using TEE guidance to thread an epidural catheter to a targeted thoracic spinal level. Post-operative radiograph will be used to confirm catheter position.
The secondary outcomes include analysis of catheter tip position within the epidural space as anterior, lateral or inferior to the spinal cord. Further, efficacy of the catheter will be determined using the following criteria from previous studies: Hemodynamic response at skin incision analyzed by heart rate and systemic blood pressure changes using the no change in HR or BP or changes < 20% from baseline were considered "sufficient block" to surgical stimulation, while HR or BP changes > 20% from baseline were considered "not sufficient block" to surgical stimulation.
Undersøgelsestype
Tilmelding (Faktiske)
Kontakter og lokationer
Studiesteder
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Iowa
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Iowa City, Iowa, Forenede Stater, 52242
- University of Iowa Hosptials and Clinics
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- pediatric patients scheduled to undergo cardiothoracic surgery or interventional cardiology diagnostic procedures under general anesthesia. All subjects will also be scheduled to undergo post-operative chest x-ray as a routine part of their clinical care, so no additional exposure to ionizing radiation will occur due to this study.
Exclusion Criteria:
- patients with known esophageal abnormalities, lesions or disease that would disqualify the patient for the use of TEE as standard procedure. We will further exclude any patients that are solely undergoing TEE diagnostic procedures and only include patients that are already scheduled to undergo procedures where TEE is used as part of routine surgical preparation.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
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TEE
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Epidural catheter will be placed under guidance of transesophageal echography in specific thoracic spinal segment.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Number of Participants With Successful Epidural Catheter Placement
Tidsramme: within one day
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The success rate achieved using TEE guidance to thread an epidural catheter to within one targeted thoracic spinal level.
Post-operative radiograph will be used to confirm catheter position.
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within one day
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Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: Kenichi Ueda, MD, University of Iowa
Publikationer og nyttige links
Generelle publikationer
- Tsui BC, Berde CB. Caudal analgesia and anesthesia techniques in children. Curr Opin Anaesthesiol. 2005 Jun;18(3):283-8. doi: 10.1097/01.aco.0000169236.91185.5b.
- Willschke H, Marhofer P, Bosenberg A, Johnston S, Wanzel O, Sitzwohl C, Kettner S, Kapral S. Epidural catheter placement in children: comparing a novel approach using ultrasound guidance and a standard loss-of-resistance technique. Br J Anaesth. 2006 Aug;97(2):200-7. doi: 10.1093/bja/ael121. Epub 2006 May 23.
- Hassan SZ. Caudal anesthesia in infants. Anesth Analg. 1977 Sep-Oct;56(5):686-9. doi: 10.1213/00000539-197709000-00016.
- Valairucha S, Seefelder C, Houck CS. Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation. Paediatr Anaesth. 2002 Jun;12(5):424-8. doi: 10.1046/j.1460-9592.2002.00884.x.
- Blanco D, Llamazares J, Rincon R, Ortiz M, Vidal F. Thoracic epidural anesthesia via the lumbar approach in infants and children. Anesthesiology. 1996 Jun;84(6):1312-6. doi: 10.1097/00000542-199606000-00006.
- Baidya DK, Pawar DK, Dehran M, Gupta AK. Advancement of epidural catheter from lumbar to thoracic space in children: Comparison between 18G and 23G catheters. J Anaesthesiol Clin Pharmacol. 2012 Jan;28(1):21-7. doi: 10.4103/0970-9185.92429.
- Chawathe MS, Jones RM, Gildersleve CD, Harrison SK, Morris SJ, Eickmann C. Detection of epidural catheters with ultrasound in children. Paediatr Anaesth. 2003 Oct;13(8):681-4. doi: 10.1046/j.1460-9592.2003.01151.x.
- Tsui BC, Seal R, Koller J. Thoracic epidural catheter placement via the caudal approach in infants by using electrocardiographic guidance. Anesth Analg. 2002 Aug;95(2):326-30, table of contents. doi: 10.1097/00000539-200208000-00016.
- Tsui BC, Tarkkila P, Gupta S, Kearney R. Confirmation of caudal needle placement using nerve stimulation. Anesthesiology. 1999 Aug;91(2):374-8. doi: 10.1097/00000542-199908000-00010.
- Rapp HJ, Folger A, Grau T. Ultrasound-guided epidural catheter insertion in children. Anesth Analg. 2005 Aug;101(2):333-339. doi: 10.1213/01.ANE.0000156579.11254.D1.
- Roberts SA, Galvez I. Ultrasound assessment of caudal catheter position in infants. Paediatr Anaesth. 2005 May;15(5):429-32. doi: 10.1111/j.1460-9592.2004.01512.x.
- Owall A, Stahl L, Settergren G. Incidence of sore throat and patient complaints after intraoperative transesophageal echocardiography during cardiac surgery. J Cardiothorac Vasc Anesth. 1992 Feb;6(1):15-6. doi: 10.1016/1053-0770(91)90037-t.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- 201207769
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Kliniske forsøg med Epidural Space
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Azienda Ospedaliero-Universitaria CareggiAfsluttetAnæstesi, epidural | Analgesi, epidural
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Istanbul University - Cerrahpasa (IUC)AfsluttetAnæstesi, epidural | Analgesi, epidural | UltralydsbilleddannelseKalkun
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University of SaskatchewanAfsluttetAnæstesi, epidural | Analgesi, epidural | AsepsisCanada
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Poznan University of Medical SciencesMedical University of Gdansk; Clinical Hospital Heliodor Swiecicki of the...AfsluttetEpidural analgesi | Abdominal kirurgi | Epidural; AnæstesiPolen
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Brigham and Women's HospitalTilmelding efter invitationEpidural analgesi | Indlæringskurve | Epidural analgesi til fødsel og fødselForenede Stater
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Città di Roma HospitalAfsluttet
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University Hospital, Strasbourg, FranceRekruttering
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University of PadovaRekrutteringEpidural kateterisationItalien
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Kyungpook National University HospitalRekrutteringAnalgesi, epiduralKorea, Republikken
Kliniske forsøg med TEE
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Toshiba America Medical Systems, Inc.Afsluttet
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Toshiba America Medical Systems, Inc.AfsluttetPatient, der kræver TEE-procedure af deres lægeForenede Stater
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Kenichi UedaAfsluttetEpidural | RygradForenede Stater
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Shanghai Chest HospitalThe First Affiliated Hospital with Nanjing Medical University; RenJi Hospital og andre samarbejdspartnereIkke rekrutterer endnu
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Weill Medical College of Cornell UniversityAfsluttetKoronar sygdom | HjerteklapsygdomForenede Stater
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Patrick F Wouters, MD PhDAfsluttetEkkokardiografi, Doppler | Ekkokardiografi, tredimensionel | Ekkokardiografi, transesophageal | Ekkokardiografi, transthoraxBelgien
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Groupe des jeunes de la filiale d'imagerie cardiovasculaireAfsluttetHjerte-kar-sygdomme | Valvulær hjertesygdom | Viden, holdninger, praksisFrankrig
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The Cleveland ClinicAfsluttet
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Chinese Academy of Medical Sciences, Fuwai HospitalIkke rekrutterer endnuAorta regurgitation | Transkateter udskiftning af aortaklapKina
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Far Eastern Memorial HospitalAfsluttetHjertestop uden for hospitaletTaiwan