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Validation and Feasibility of Noninvasive Oxygen Delivery Index Monitoring in Cardiac Surgery Patients

30. april 2026 opdateret af: University of Minnesota
This study will establish the feasibility and preliminary validity of real-time oxygen delivery index (DO₂i) monitoring using noninvasive hemoglobin (SpHb, Masimo) and minimally invasive cardiac output (FloTrac, Edwards) in cardiac surgery patients.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Anslået)

150

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Forenede Stater
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55455
        • University of Minnesota
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adults undergoing cardiac surgery

Beskrivelse

Inclusion Criteria:

  • Adults ≥ 18 years undergoing cardiac surgery
  • Placement of pulmonary artery catheter with continuous cardiac output (CCO) as part of routine clinical care
  • Placement of arterial line with FloTrac as part of routine clinical care
  • Availability of ≥ 3 arterial blood gas samples at specified timepoints

Exclusion Criteria:

  • Mechanical circulatory support planned or in use (IABP, Impella, ECMO)
  • Patients without BOTH pulmonary artery catheter with CCO and arterial line with FloTrac
  • Patients who are Research Opt-Out

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Cardiac surgery patients

The study uses a within-patient repeated-measures design, where each patient serves as their own control across the three timepoints. The following measures will be recorded:

  • SpHb, Perfusion Index, SpO₂ from Masimo Radical-7 (timestamp to HH:MM:SS)
  • FloTrac cardiac index from Edwards HemoSphere
  • ABG hemoglobin, SaO₂, PaO₂, and lactate from ABL analyzer
  • Continuous cardiac index from Swan-Ganz catheter
  • Mean arterial pressure, heart rate and rhythm
  • Patient temperature from the bladder
  • Pressor requirements
Enhed: SpHb monitor
The SpHb monitor is an FDA approved device being used according to its approved indications. No additional invasive procedures, blood draws, or interventions are performed for research purposes.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Agreement Between SpHb-Based and Pulmonary Artery Catheter Oxygen Delivery Index
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post-protamine
Bias and 95% limits of agreement between monitor-derived DO₂i (calculated from continuous SpHb and FloTrac cardiac index) and pulmonary artery catheter DO₂i (calculated from arterial blood gas hemoglobin and Swan-Ganz cardiac index), analyzed using Bland-Altman method with mixed-effects modeling to account for repeated measures. Agreement is considered acceptable if percentage error is <30%.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post-protamine

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Directional Agreement for Changes in Oxygen Delivery Index
Tidsramme: Changes between consecutive intraoperative timepoints (baseline to post-heparin, post- heparin to post-protamine) during cardiac surgery
Four-quadrant concordance rate (with 15% exclusion zone) for directional changes in DO₂i between consecutive timepoints. Concordance is defined as agreement in direction of change (increase vs decrease) between monitor-derived and gold-standard DO₂i measurements. Scores range from 0- 100%, with higher percentages indicating better directional agreement.
Changes between consecutive intraoperative timepoints (baseline to post-heparin, post- heparin to post-protamine) during cardiac surgery
Correlation Between Oxygen Delivery Index and Arterial Lactate
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Pearson or Spearman correlation coefficient between DO₂i (both monitor-derived and gold- standard) and simultaneously measured arterial lactate concentration. Correlation coefficients range from -1 to +1, with negative values indicating inverse relationship between DO₂i and lactate.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Agreement Between FloTrac and Swan-Ganz Cardiac Index
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Percentage error between FloTrac arterial pressure-based cardiac index and Swan-Ganz thermodilution continuous cardiac index. Percentage error is calculated as (1.96 × SD of differences) / mean cardiac index × 100%. Agreement is considered acceptable if percentage error is <30%.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Impact of Baseline SpHb Calibration on Agreement
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Comparison of limits of agreement before and after in vivo SpHb calibration (baseline- adjusted SpHb using first arterial blood gas hemoglobin value as reference). Measured as change in bias and 95% limits of agreement between uncalibrated and baseline-calibrated SpHb-based DO₂i compared to gold standard.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
SpHb Signal Usability Rate
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Percentage of planned timepoints with valid SpHb signal defined by perfusion index (PI) ≥ 0.5. Scores range from 0-100%, with 100% indicating valid signal at all timepoints.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Perfusion Index Threshold for Acceptable SpHb Accuracy
Tidsramme: Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine
Minimum perfusion index value associated with acceptable SpHb accuracy, defined as SpHb bias within ±1 g/dL of arterial blood gas hemoglobin. Perfusion index values range from 0-20%, with higher values indicating better peripheral perfusion.
Three intraoperative timepoints during cardiac surgery: baseline, post-heparin, and post- protamine

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Major Adverse Cardiac Events (Exploratory)
Tidsramme: Within 30 days of surgery
Composite endpoint including all-cause mortality, myocardial infarction (elevated troponin with ECG changes or clinical symptoms), stroke (new neurologic deficit with imaging confirmation), or urgent revascularization.
Within 30 days of surgery
Acute Kidney Injury (Exploratory)
Tidsramme: Within 30 days of surgery
AKI defined and staged using KDIGO criteria based on postoperative serum creatinine changes: Stage 1 (1.5-1.9× baseline or ≥0.3 mg/dL increase), Stage 2 (2.0-2.9× baseline), Stage 3 (≥3× baseline or ≥4.0 mg/dL or initiation of renal replacement therapy).
Within 30 days of surgery

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Minnesota

Efterforskere

  • Ledende efterforsker: Benjamin Gorbaty, MD, University of Minnesota

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 (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. august 2027

Studieafslutning (Anslået)

1. august 2027

Datoer for studieregistrering

Først indsendt

30. april 2026

Først indsendt, der opfyldte QC-kriterier

30. april 2026

Først opslået (Faktiske)

7. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

7. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. april 2026

Sidst verificeret

1. april 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • ANES-2026-34768

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

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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