- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT03505112
The Effect of Goal-directed Hemodynamic Therapy in Radical Cystectomy
The Effect of Goal-directed Hemodynamic Therapy on Clinical Outcomes in Patients Undergoing Radical Cystectomy: : A Randomized Controlled Trial
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Select
-
Seoul, Select, Corée, République de, 110-744
- Jin-Tae Kim
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Patients undergoing open radical cystectomy
- Patients with American Society of Anesthesiologists physical status I-III
Exclusion Criteria:
- Significant hepatic dysfunction, significant renal dysfunction (estimated glomerular filtration rate <60 ml/min)
- Congestive heart failure (New York Heart Association scores ≥3), Left Ventricular Ejection Fraction < 35%
- Arrhythmia
- Coagulopathy (PT INR >1.5)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: Goal-directed therapy group
The patients in goal-directed therapy (GDT) group will be managed according to the goal-directed therapy protocol during the surgery.
|
The patients in GDT group will receive intravenous crystalloid fluid or vasopressor or inotropic agent according to the goal-directed therapy protocol utilizing FloTrac / EV1000 clinical platform (Edwards Lifesciences, Irvine, CA, USA). After induction of anesthesia, the baseline stroke volume index (SVI) is measured and then 200-250 ml of crystalloid is administered over 5-10 minutes. If SVI increase by ≥10%, 200-250 ml of crystalloid is given repeatedly until the increase in SVI <10%. If SVI does not increase by ≥10% and there is no decrease in mean arterial pressure (MAP), revaluate SVI every 10 minutes. Despite an increase in SVI of <10% after fluid challenge, if a decrease in MAP is accompanied by cardiac index (CI) ≤ 2.5 L/min/m2, dobutamine is administered by continuous infusion. If there is a decrease in MAP but no decrease in CI, start low dose norepinephrine continuous infusion.
Autres noms:
|
Aucune intervention: Control group
The patients in control group will be managed according to standard perioperative care.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
A composite of postoperative complications
Délai: through the hospitalization period, an average of 2 weeks
|
Total incidence of postoperative complications including gastrointestinal complications, complications of infections, wound complications, cardiac events, thromboembolic complications, genitourinary complications, neurological complications based on the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
The incidence of postoperative gastrointestinal complications
Délai: through the hospitalization period, an average of 2 weeks
|
Gastrointestinal complications include ileus, constipation, gastric ulcer, anastomic bowel leak according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative complications of infections
Délai: through the hospitalization period, an average of 2 weeks
|
Complications of infections include urinary tract infection, sepsis, pneumonia, wound infection according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative wound complications
Délai: through the hospitalization period, an average of 2 weeks
|
Wound Complications mean wound dehiscence diagnosed clinically and requiring resuturing, according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative cardiac events
Délai: through the hospitalization period, an average of 2 weeks
|
Cardiac events include myocardial infarction, arrhythmia, congestive heart failure, pulmonary edema and transient brain natriuretic peptide increase (serum brain natriuretic peptide values 100-500 pg/ml) according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative thromboembolic complications
Délai: through the hospitalization period, an average of 2 weeks
|
Thromboembolic complication means pulmonary embolism evidenced by spiral computerized tomography scanning according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative genitourinary complications
Délai: through the hospitalization period, an average of 2 weeks
|
Genitourinary complications include renal dysfunction, renal failure, urinary leakage according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
The incidence of postoperative neurological complications
Délai: through the hospitalization period, an average of 2 weeks
|
Neurological complications mean presence of a de novo focal deficit, confusion/delirium according to the Clavien-Dindo classification for radical cystectomy.
|
through the hospitalization period, an average of 2 weeks
|
Collaborateurs et enquêteurs
Parrainer
Publications et liens utiles
Publications générales
- Pearse RM, Harrison DA, MacDonald N, Gillies MA, Blunt M, Ackland G, Grocott MP, Ahern A, Griggs K, Scott R, Hinds C, Rowan K; OPTIMISE Study Group. Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review. JAMA. 2014 Jun 4;311(21):2181-90. doi: 10.1001/jama.2014.5305. Erratum In: JAMA. 2014 Oct 8;312(14):1473.
- Wuethrich PY, Burkhard FC, Thalmann GN, Stueber F, Studer UE. Restrictive deferred hydration combined with preemptive norepinephrine infusion during radical cystectomy reduces postoperative complications and hospitalization time: a randomized clinical trial. Anesthesiology. 2014 Feb;120(2):365-77. doi: 10.1097/ALN.0b013e3182a44440.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 1712-125-909
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
Essais cliniques sur Goal-directed therapy
-
University of RochesterComplété
-
Medical University of South CarolinaNational Institute on Deafness and Other Communication Disorders (NIDCD)Actif, ne recrute pasAccident vasculaire cérébral | Aphasie | Aphasie Non FluentÉtats-Unis
-
Columbia UniversityRésilié
-
NeuroTronik Inc.InconnueInsuffisance cardiaque | Insuffisance cardiaque aiguëParaguay
-
NeuroTronik Inc.InconnueInsuffisance cardiaque aiguëPanama
-
University of Applied Sciences and Arts of Southern...Vrije Universiteit Brussel; Universiteit Antwerpen; THIM - die internationale...ComplétéEn bonne santéSuisse
-
University of Alabama at BirminghamComplétéAccident vasculaire cérébral | Parésie du membre supérieur | AVC (Accident Cérébrovasculaire)États-Unis
-
Abbott Medical DevicesComplétéFibrillation auriculaire paroxystiqueAustralie, Allemagne, France, Italie, Le Portugal, Royaume-Uni
-
Abbott Medical DevicesComplétéFlutter auriculaire typiqueÉtats-Unis, Canada
-
University of Roma La SapienzaComplétéÉchec de l'implant dentaire | Mucosite buccaleItalie