Trauma Heart to Arm Time (THAT)
In the prehospital setting it would be helpful to assess primary changes in central blood volume or preload (venous return, stroke volume, diastolic ventricular volume) that occur during the stability phase following injury when regulatory mechanisms are still functioning.
Obviously in this setting a non invasive bedside beat-to-beat index would be helpful.
Pulse Transit Time (PTT) is the sum of Pre-Ejection Period (PEP), the time interval between the onset of ventricular depolarization and the ventricular ejection, and Vascular Transit Time (VTT), the time it takes for the pulse wave to travel from the aortic valve to the peripheral arteries (Obrist et al. 1979). PEP variations are known to correlate with reductions in central blood volume induced by head-up tilt (Chan et al., 2007b, 2008). The same authors also demonstrated that PTT variations follow closely PEP variations and therefore central blood volume variations (Chan et al., 2007b). Following central blood volume reductions induced by head-up tilting ventricular diastolic filling time increases involving an increase in PEP and PTT. Chan et al. (Chan et al., 2007b) concluded that PTT could have been used to assess early central hypovolemia and suggested that joint analysis of PTT and RR intervals could help in predicting the extent of blood volume loss. The investigators hypothesized that sympathetic drive associated with trauma would act on cardiac contractility through beta activity thus shortening PTT without reducing RR interval to the same extent in healthy hearts. We also hypothesized that progressive hypovolemia would lead to a rising of PTT (augmented diastolic filling time) and a RR interval shortening (relative tachycardia). In this study the investigators propose and index based on the beat-to-beat PTT/RR ratio to assess central hypovolemia in traumatic patients enrolled by our Helicopter Emergency Medical System (HEMS) in a prehospital setting.
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Milano、イタリア、20100
- A.R.E.U. - A.A.T. 118 Milano
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- all trauma victims enrolled by our Helicopter Emergency Medical System (HEMS)
Exclusion Criteria:
- need of immediate life-saving manoeuvres as decided by onboard physician following Prehospital Trauma Care (PTC) criteria (CITATION PTC)
- Cardiac arrest
- presence of preexisting chronic illnesses involving the autonomic nervous system such as hypertension, diabetes and any neurological disease
- any preexisting medical therapy including those administered by the emergency medical team as defined in point 1)
- presence of supraventricular ectopic beats more than 5% of total recorded beats
- absence of sinus rhythm
- presence of intraventricular or bundle branch blocks or artificial pacemaker
- spinal chord trauma above D2
- patient age <18 years
- presence of burns not allowing monitoring
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:ケースのみ
- 時間の展望:見込みのある
コホートと介入
グループ/コホート |
介入・治療 |
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Trauma victims
All prehospital traumatic patients enrolled by our Helicopter Emergency Medical System (HEMS)
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Three-lead electrocardiogram (ECG), PPG oxymetry, non-invasive blood pressure (NIBP) are registered
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
Non invasive monitoringの臨床試験
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Royal Brompton & Harefield NHS Foundation TrustUniversity of Oxford; National Institute for Health Research, United Kingdom完了
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IRCCS San RaffaeleCasa di Cura del Policlinico di Milano募集
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Sheffield Hallam UniversitySheffield Teaching Hospitals NHS Foundation Trust完了
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Advanced Medical Solutions Ltd.Imarc Research, Inc.募集