- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07538388
유도 후 저혈압 치료를 위한 지속적 노르에피네프린 투여 대 볼루스 노르에피네프린 투여 (INDUCT-Multi)
고위험 비심장 수술 환자에서 유도 후 저혈압 치료를 위한 지속적 노르에피네프린 투여 대 볼루스 노르에피네프린 투여 - 다기관 INDUCT 시험 (INDUCT-Multi)
연구 개요
상세 설명
일반 마취 유도 후 저혈압은 비심장 수술 환자에서 흔히 발생하며 급성 신손상과 관련이 있습니다. 마취 유도 후 저혈압의 위험 요소에는 고령, 미국 마취과학회 신체 상태 등급 상승, 만성 동맥 고혈압 및 혈관 확장 마취 약물의 고용량 투여가 포함됩니다. 신중한 마취 관리가 혈압 안정성을 유지하고 마취 유도 후 저혈압을 제한하는 데 도움이 될 수 있다고 가정하는 것이 합리적입니다. 이 가정과 일관되게, 일반 마취 유도 중 동맥 카테터를 통한 지속적인 혈압 모니터링은 임상의가 마취 유도 후 저혈압을 감소시키는 데 도움이 되므로 저혈압 관련 합병증 위험이 있는 비심장 수술 환자에게 권장됩니다.
지속적인 모니터링 외에도 마취의사는 혈압을 유지하기 위해 노르에피네프린과 같은 혈관 수축제를 정기적으로 투여합니다. 노르에피네프린은 반감기가 짧은 빠르게 작용하는 혈관 수축제로, 일반 마취 유도 중 반복적인 수동 볼루스 투여로 일반적으로 투여됩니다. 볼루스로 투여할 경우 혈압을 효과적이고 빠르게 상승시킵니다. 그러나 혈압 안정성을 보장하기 위해 볼루스는 자주 반복되고 적절한 시기에 투여되어야 합니다.
단일 기관 무작위 시험에서 우리는 일반 마취 유도 중 노르에피네프린의 볼루스 투여와 비교한 지속적 투여가 고위험 비심장 수술 환자의 혈압 안정성 유지에 도움이 된다는 것을 입증했습니다. 이제 우리는 동맥 카테터를 통한 지속적인 혈압 모니터링을 받는 고위험 비심장 수술 환자에서 일반 마취 유도 중 노르에피네프린의 볼루스 투여와 비교한 지속적 투여가 마취 유도 후 저혈압을 감소시킨다는 가설을 검증하는 것을 목표로 합니다.
연구 유형
등록 (추정된)
단계
- 해당 없음
연락처 및 위치
연구 연락처
- 이름: Kristen K Thomsen, MD
- 전화번호: +4940741070215
- 이메일: kr.thomsen@uke.de
연구 장소
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Berlin, 독일
- 아직 모집하지 않음
- Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin
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연락하다:
- Sascha Treskatsch, MD
- 전화번호: +49 30 450 551 522
- 이메일: sascha.treskatsch@charite.de
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Düsseldorf, 독일
- 모병
- Department of Anesthesiology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf
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연락하다:
- Sebastian Roth, MD
- 전화번호: +49 211 81 16253
- 이메일: Sebastian.Roth@med.uni-duesseldorf.de
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Hamburg, 독일
- 모병
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf
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연락하다:
- Kristen K Thomsen, MD
- 전화번호: +4940741070215
- 이메일: kr.thomsen@uke.de
-
München, 독일
- 모병
- Department of Anaesthesiology, University Hospital LMU Munich
-
연락하다:
- Agnes Meidert, MD
- 전화번호: +49 89 440081065
- 이메일: Agnes.meidert@med.uni-muenchen.de
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참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
포함 기준:
동의하는 환자 중 45세 이상으로, 전신 마취 하에 선택적 주요 비심장 수술을 예정하고 있으며, 요골 동맥 카테터를 이용한 지속적 동맥 혈압 모니터링이 계획되어 있고, 급성 신장 손상 발생 위험 기준 중 최소 두 가지에 해당하는 환자를 포함합니다:
- 연령 65세 이상
- ASA 신체 상태 III 또는 IV
- 만성 동맥 고혈압
- 약물 치료가 필요한 당뇨병
- 복강 내 수술
- 수술 전 신기능 저하 (혈청 크레아티닌 ≥1.2 mg/dL)
제외 기준:
- 임신
- 심장 부정맥
- 두개내 출혈 또는 두개내 동맥류 병력
- 전신 마취 유도 중 지속적 노르에피네프린 주입이 임상적으로 필요한 경우 (예: 심한 대동맥판 협착증, 관상동맥 질환 또는 심부전)
- 독일어로 이해, 읽기 및 사전 동의서 작성이 불가능한 환자
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 더블
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: 지속적 노르에피네프린 투여
지속적 노르에피네프린 투여군에 배정된 환자에게는 주사기 주입 펌프를 통해 노르에피네프린을 지속적으로 투여합니다.
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노르에피네프린의 지속 투여가 지정된 환자의 경우, 주사기 주입 펌프가 준비되어 말초 정맥 또는 중심 정맥 카테터에 연결됩니다.
담당 마취의사는 노르에피네프린 주입을 시작하고 필요에 따라 주입 속도를 조정하며, 필요 시 주사기 주입 펌프를 통해 추가 노르에피네프린 볼루스를 투여할 수 있습니다.
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간섭 없음: 볼루스 노르에피네프린 투여
수동 볼루스 노르에피네프린 투여에 배정된 환자에서, 노르에피네프린은 수동으로 볼루스 용량으로 투여됩니다.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
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Area under a mean arterial pressure (MAP) of 65 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
|
Area under a MAP of 60 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area under a MAP of 50 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area under a MAP of 40 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area above a MAP of 100 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area above a MAP of 110 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area above a MAP of 120 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Area above a MAP of 140 mmHg (mmHg x min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Duration of a MAP <65 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP <60 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP <50 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP <40 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP >100 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP >110 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP >120 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Duration of a MAP >140 mmHg (min)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Absolute (n) and relative (%) number of patients with any MAP measurement <65 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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Absolute (n) and relative (%) number of patients with any MAP measurement <60 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement <50 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement <40 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement >100 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement >110 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement >120 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with any MAP measurement >140 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <65 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <60 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <50 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <40 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >100 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >110 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >120 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >140 mmHg
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
|
Cumulative dose of norepinephrine indexed to body weight (µg kg-1)
기간: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
|
First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.
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기타 결과 측정
결과 측정 |
기간 |
|---|---|
|
Acute kidney injury
기간: Within the first 3 postoperative days
|
Within the first 3 postoperative days
|
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Nonfatal cardiac arrest
기간: Within the first 3 postoperative days
|
Within the first 3 postoperative days
|
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Myocardial infarction
기간: Within the first 3 postoperative days
|
Within the first 3 postoperative days
|
|
Death
기간: Within the first 3 postoperative days
|
Within the first 3 postoperative days
|
공동 작업자 및 조사자
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .