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

17. august 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Observasjonsmessig

Registrering (Antatt)

150

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Forente stater
    • Minnesota
      • Minneapolis, Minnesota, Forente stater, 55455
        • University of Minnesota
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / 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
Enhet: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Minnesota

Etterforskere

  • Hovedetterforsker: Benjamin Gorbaty, MD, University of Minnesota

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

15. oktober 2026

Primær fullføring (Antatt)

1. august 2027

Studiet fullført (Antatt)

1. august 2027

Datoer for studieregistrering

Først innsendt

30. april 2026

Først innsendt som oppfylte QC-kriteriene

30. april 2026

Først lagt ut (Faktiske)

7. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

18. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

17. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • ANES-2026-34768

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Ja

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