- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT03110185
Postoperative Delirium: Brain Vulnerability and Recovery
23. maj 2020 opdateret af: Ben Palanca, Washington University School of Medicine
In this study, we propose to use EEG and a brain imaging technique known as diffuse optical tomography (DOT) to study when people are in delirium and when they recovery.
We plan to also compare brain function of patients who recovered from delirium to patients who did not have delirium using DOT and fMRI.
We will also continually monitor the participant's EMR to help coordinate timing of study procedures, as well as to collect information pertaining to their surgery, recovery progress, and indicators of mental status including delirium.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Postoperative delirium - a mental state of confusion, inattention, and impaired thought - is a potentially life-threatening condition.
As many as half of patients that have heart and non heart-related surgery will experience postoperative delirium.
Patients diagnosed with postoperative delirium have poorer outcomes and longer hospitalizations.
Unfortunately, it is an under-diagnosed condition with a variable delay in when it appears.
Additionally, there are no objective tools or tests that can be before or after surgery to anticipate and identify those patients who are at risk.
Electroencephalography [EEG] and functional magnetic resonance imaging [fMRI] have helped us understand the changes in the brain during delirium.
These suggest that a weakening in correlated activity within a group of brain regions, known as the default mode network (DMN), may be related to delirium.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
91
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Missouri
-
Saint Louis, Missouri, Forenede Stater, 63110
- Barnes-Jewish Hospital/Washington University in St. Louis School of Medicine
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
60 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Common inclusion criteria:
- Age ≥ 60
- Surgery requiring cardiopulmonary bypass (CPB) for coronary artery bypass grafting, septal myectomy and/or heart valve repair/replacement
- English speaking.
Common exclusion criteria:
- Implanted pacemaker
- Automatic internal cardiac defibrillator or other implant for which non-contrast magnetic resonance imaging (MRI) is contraindicated
- Concomitant aortic or cerebrovascular procedure
- Inability to lay flat or still for MRI
- Legal blindness or severe deafness
- Seizure history
- Known focal brain lesion larger than 3 cm.
Delirium Case Arm:
1. Delirious as diagnosed by the Confusion Assessment Method (CAM)/ Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) at some point during postoperative day 1-5.
Postoperative Control Arm:
1. Not delirious as diagnosed by the CAM/CAM-ICU on postoperative day 1-5.
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Ikke-randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Andet: delirium
Patients in the cardiothoracic ICU diagnosed with postoperative delirium.
Subjects will wear a diffuse optical tomography device in addition to the normal monitors.
A non-contrast functional MRI will be performed.
|
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
|
Andet: no delirium
Patients in the cardiothoracic ICU not diagnosed with postoperative delirium.
Subjects will be monitored in the same way as the delirium arm
|
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
Brain activity will be recorded to evaluate differences in brain activity between patients with a delirium diagnosis and non-delirious control patients.
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
EEG During Delirium and After Recovery and in Patient Controls.
Tidsramme: Data acquisition will occur on 4 separate days between postoperative days 1-8.
|
Delta (0.5-4 Hz), theta (4-8 Hz), and alpha (8-12 Hz) EEG waveforms.
|
Data acquisition will occur on 4 separate days between postoperative days 1-8.
|
Functional Connectivity Diffuse Optical Tomography (fcDOT) in Patients During Delirium and After Recovery and in Patient Controls
Tidsramme: Data acquisition will occur on 4 separate days between postoperative days 1-8.
|
Functional connectivity between anterior and posterior Default Mode Network regions using diffuse optical imaging.
|
Data acquisition will occur on 4 separate days between postoperative days 1-8.
|
Functional Connectivity Magnetic Resonance Imaging (fcMRI) in Patients After Recovery From Delirium and in Patient Controls.
Tidsramme: Within one month after hospital discharge.
|
Functional connectivity between anterior and posterior Default Mode Network regions assessed from resting-state fcMRI acquired during eyes open wakefulness.
Scored using r-value, using a scale of -1 to +1. -1 = strong negative correlation, +1 = strong positive correlation
|
Within one month after hospital discharge.
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Efterforskere
- Ledende efterforsker: Ben Palanca, MD, PhD, MSc, Washington University School of Medicine
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
25. november 2015
Primær færdiggørelse (Faktiske)
8. marts 2019
Studieafslutning (Faktiske)
8. marts 2019
Datoer for studieregistrering
Først indsendt
14. januar 2016
Først indsendt, der opfyldte QC-kriterier
6. april 2017
Først opslået (Faktiske)
12. april 2017
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
2. juni 2020
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
23. maj 2020
Sidst verificeret
1. maj 2020
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 201511004
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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