| 試験進捗状況 | 開始前/Preinitiation |
| UMIN試験ID | UMIN000046758 |
| 受付番号 | R000053344 |
| 科学的試験名 | 人工心肺中における酸素運搬量係数(DO2i)を用いた目標指向型体外循環管理(Goal directed perfusion : GDP)と術後急性腎障害(AKI)発生率の調査 |
| 一般公開日(本登録希望日) | 2022/01/28 |
| 最終更新日 | 2022/01/28 (1版) |
| 基本情報/Basic information | |||
| 一般向け試験名/Public title | 人工心肺中における酸素運搬量係数(DO2i)を用いた目標指向型体外循環管理(Goal directed perfusion : GDP)と術後急性腎障害(AKI)発生率の調査 | Goal directed perfusion (GDP) using oxygen delivery index (DO2i) during cardiopulmonary resuscitation and incidence of postoperative acute kidney injury (AKI) | |
| 一般向け試験名略称/Acronym | 人工心肺中における酸素運搬量係数(DO2i)を用いた目標指向型体外循環管理(Goal directed perfusion : GDP)と術後急性腎障害(AKI)発生率の調査 | Goal directed perfusion (GDP) using oxygen delivery index (DO2i) during cardiopulmonary resuscitation and incidence of postoperative acute kidney injury (AKI) | |
| 科学的試験名/Scientific Title | 人工心肺中における酸素運搬量係数(DO2i)を用いた目標指向型体外循環管理(Goal directed perfusion : GDP)と術後急性腎障害(AKI)発生率の調査 | Goal directed perfusion (GDP) using oxygen delivery index (DO2i) during cardiopulmonary resuscitation and incidence of postoperative acute kidney injury (AKI) | |
| 科学的試験名略称/Scientific Title:Acronym | 人工心肺中における酸素運搬量係数(DO2i)を用いた目標指向型体外循環管理(Goal directed perfusion : GDP)と術後急性腎障害(AKI)発生率の調査 | Goal directed perfusion (GDP) using oxygen delivery index (DO2i) during cardiopulmonary resuscitation and incidence of postoperative acute kidney injury (AKI) | |
| 試験実施地域/Region |
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| 対象疾患/Condition | ||||||
| 対象疾患名/Condition | 人工心肺を用いた開心術を受ける成人患者 | Adult patients undergoing open heart surgery with artificial heart lung | ||||
| 疾患区分1/Classification by specialty |
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| 疾患区分2/Classification by malignancy | 悪性腫瘍以外/Others | |||||
| ゲノム情報の取扱い/Genomic information | いいえ/NO | |||||
| 目的/Objectives | ||
| 目的1/Narrative objectives1 | DO2iを300 mL/min/m2以上に管理することで術後AKI発症を抑えることができると仮説を立て検証する。AKI発生率を低下させる事ができれば、挿管時間やICU滞在日数を短縮でき患者予後や医療経済の面で有益である。 | We hypothesized that controlling DO2i to 300 mL/min/m2 or higher would reduce the incidence of postoperative AKI, and that reducing the incidence of AKI would reduce intubation time and ICU stay, which would be beneficial in terms of patient outcome and medical economy. |
| 目的2/Basic objectives2 | 有効性/Efficacy | |
| 目的2 -その他詳細/Basic objectives -Others | ||
| 試験の性質1/Trial characteristics_1 | ||
| 試験の性質2/Trial characteristics_2 | ||
| 試験のフェーズ/Developmental phase | ||
| 評価/Assessment | ||
| 主要アウトカム評価項目/Primary outcomes | DO2iを300 mL/min/m2以上で管理した際のAKI発生率 | Incidence of AKI when DO2i is controlled at 300 mL/min/m2 or higher |
| 副次アウトカム評価項目/Key secondary outcomes | ||
| 基本事項/Base | ||
| 試験の種類/Study type | 観察/Observational | |
| 試験デザイン/Study design | ||
| 基本デザイン/Basic design | ||
| ランダム化/Randomization | ||
| ランダム化の単位/Randomization unit | ||
| ブラインド化/Blinding | ||
| コントロール/Control | ||
| 層別化/Stratification | ||
| 動的割付/Dynamic allocation | ||
| 試験実施施設の考慮/Institution consideration | ||
| ブロック化/Blocking | ||
| 割付コードを知る方法/Concealment | ||
| 介入/Intervention | ||
| 群数/No. of arms | ||
| 介入の目的/Purpose of intervention | ||
| 介入の種類/Type of intervention | ||
| 介入1/Interventions/Control_1 | ||
| 介入2/Interventions/Control_2 | ||
| 介入3/Interventions/Control_3 | ||
| 介入4/Interventions/Control_4 | ||
| 介入5/Interventions/Control_5 | ||
| 介入6/Interventions/Control_6 | ||
| 介入7/Interventions/Control_7 | ||
| 介入8/Interventions/Control_8 | ||
| 介入9/Interventions/Control_9 | ||
| 介入10/Interventions/Control_10 | ||
| 適格性/Eligibility | |||||
| 年齢(下限)/Age-lower limit |
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| 年齢(上限)/Age-upper limit |
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| 性別/Gender | 男女両方/Male and Female | ||||
| 選択基準/Key inclusion criteria | 当院で人工心肺を用いた開心術を受ける成人患者 | Adult patients undergoing open heart surgery with artificial heart lung at our hospital | |||
| 除外基準/Key exclusion criteria | 透析患者、術前からの著しい腎機能障害症例(eGFR < 45mL/min/1.73m2)、循環停止症例、再心停止症例、人工心肺離脱困難症例、研究の参加に同意しなかった者 | Dialysis patients, patients with significant preoperative renal dysfunction (eGFR < 45mL/min/1.73m2), patients with circulatory arrest, patients with recurrent cardiac arrest, patients with difficulty in weaning from artificial heart lung, and patients who did not consent to participate in the study. | |||
| 目標参加者数/Target sample size | 80 | ||||
| 責任研究者/Research contact person | ||||||||||||||
| 責任研究者/Name of lead principal investigator |
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| 所属組織/Organization | 山形大学医学部附属病院 | Yamagata University Medical School Hospital | ||||||||||||
| 所属部署/Division name | 麻酔科 | Department of Anesthesiology | ||||||||||||
| 郵便番号/Zip code | 9909585 | |||||||||||||
| 住所/Address | 山形市飯田西2-2-2 | 2-2-2, Iida-Nishi, Yamagata City | ||||||||||||
| 電話/TEL | 0236331122 | |||||||||||||
| Email/Email | me.nakamura@med.id.yamagata-u.ac.jp | |||||||||||||
| 試験問い合わせ窓口/Public contact | ||||||||||||||
| 試験問い合わせ窓口担当者/Name of contact person |
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| 組織名/Organization | 山形大学医学部附属病院 | Yamagata University Medical School Hospital | ||||||||||||
| 部署名/Division name | 臨床工学部 | Department of Clinical Engineering | ||||||||||||
| 郵便番号/Zip code | 9909585 | |||||||||||||
| 住所/Address | 山形市飯田西2-2-2 | 2-2-2, Iida-Nishi, Yamagata City | ||||||||||||
| 電話/TEL | 0236285711 | |||||||||||||
| 試験のホームページURL/Homepage URL | ||||||||||||||
| Email/Email | me.nakamura@med.id.yamagata-u.ac.jp | |||||||||||||
| 実施責任組織/Sponsor | ||
| 機関名/Institute | 山形大学 | Yamagata University |
| 機関名/Institute (機関選択不可の場合) |
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| 部署名/Department | ||
| 研究費提供組織/Funding Source | ||
| 機関名/Organization | 自己調達 | Department of Anesthesiology, Yamagata University School of Medicine |
| 機関名/Organization (機関選択不可の場合) |
山形大学医学部麻酔科 | |
| 組織名/Division | ||
| 組織の区分/Category of Funding Organization | 自己調達/Self funding | |
| 研究費拠出国/Nationality of Funding Organization | ||
| その他の関連組織/Other related organizations | ||
| 共同実施組織/Co-sponsor | ||
| その他の研究費提供組織/Name of secondary funder(s) | ||
| IRB等連絡先(公開)/IRB Contact (For public release) | ||
| 組織名/Organization | 山形大学医学部倫理委員会 | Yamagata University Faculty of Medicine Ethics Committee |
| 住所/Address | 山形市飯田西2-2-2 | 2-2-2, Iida-Nishi, Yamagata City |
| 電話/Tel | 0236331122 | |
| Email/Email | me.nakamura@med.id.yamagata-u.ac.jp | |
| 他機関から発行された試験ID/Secondary IDs | ||
| 他機関から発行された試験ID/Secondary IDs | いいえ/NO | |
| 試験ID1/Study ID_1 | ||
| ID発行機関1/Org. issuing International ID_1 | ||
| 試験ID2/Study ID_2 | ||
| ID発行機関2/Org. issuing International ID_2 | ||
| 治験届/IND to MHLW | ||
| 試験実施施設/Institutions | ||
| 試験実施施設名称/Institutions | ||
| その他の管理情報/Other administrative information | ||||||||
| 一般公開日(本登録希望日)/Date of disclosure of the study information |
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| 関連情報/Related information | ||
| プロトコル掲載URL/URL releasing protocol | ||
| 試験結果の公開状況/Publication of results | 未公表/Unpublished | |
| 結果/Result | ||
| 結果掲載URL/URL related to results and publications | ||
| 組み入れ参加者数/Number of participants that the trial has enrolled | ||
| 主な結果/Results | ||
| 主な結果入力日/Results date posted | ||
| 結果掲載遅延/Results Delayed | ||
| 結果遅延理由/Results Delay Reason | ||
| 最初の試験結果の出版日/Date of the first journal publication of results | ||
| 参加者背景/Baseline Characteristics | ||
| 参加者の流れ/Participant flow | ||
| 有害事象/Adverse events | ||
| 評価項目/Outcome measures | ||
| 個別症例データ共有計画/Plan to share IPD | ||
| 個別症例データ共有計画の詳細/IPD sharing Plan description | ||
| 試験進捗状況/Progress | ||||||||
| 試験進捗状況/Recruitment status | 開始前/Preinitiation | |||||||
| プロトコル確定日/Date of protocol fixation |
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| 倫理委員会による承認日/Date of IRB |
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| 登録・組入れ開始(予定)日/Anticipated trial start date |
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| フォロー終了(予定)日/Last follow-up date |
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| 入力終了(予定)日/Date of closure to data entry | ||||||||
| データ固定(予定)日/Date trial data considered complete | ||||||||
| 解析終了(予定)日/Date analysis concluded | ||||||||
| その他/Other | ||
| その他関連情報/Other related information | CPB開始までは通常の管理を行い、CPB中GDP目標値はDO2i > 300mL/min/m2とする。DO2iが目標値を下回った際は、灌流量またはヘマトクリット値を上昇させ対応する。CPBからの離脱とその後は通常の管理とする。また、炎症のマーカーとして、IL-6を麻酔導入後、プロタミン投与後、ICU入室時、術後翌日の朝に測定する。さらに、尿細管損傷のマーカーとして、好中球ゼラチナーゼ結合性リポカインを導尿カテーテル挿入後、人工心肺終了時、ICU入室時、術翌日の朝に測定する。
IL-6については、採血後に遠心分離し血漿を冷凍保存する。NGALについては採尿後に遠心分離し上清を冷蔵保存する。LSIには保存しておいた検体を外注依頼する。 診療録から1から3までの情報を収集する。 1. 術前情報 性別、年齢、身長、体重、体表面積、ヘマトクリット値、eGFR、血清クレアチニン値、左室駆出率、Euro score Ⅱ 2. 手術情報 術式、手術時間、人工心肺時間、大動脈遮断時間、最低体温、最低ヘマトクリット値、人工心肺中輸血量、人工心肺中輸液量、心筋保護液注入量、人工心肺中尿量、除水量、最高乳酸値、灌流量、灌流圧、DO2i、組織酸素飽和度 3. 術後情報 尿量、血清クレアチニン値、挿管時間、ICU滞在日数、腎代替療法の有無 |
If the DO2i falls below the target value, the perfusion rate or hematocrit level should be increased. The patient should be weaned from CPB and managed as usual thereafter. As a marker of inflammation, IL-6 will be measured after induction of anesthesia, after administration of protamine, upon admission to the ICU, and on the morning of the next day after surgery. As a marker of tubular damage, neutrophil gelatinase-binding lipokine will be measured after insertion of urinary catheter, at the end of cardiopulmonary resuscitation, in the ICU, and in the morning of the next day after surgery.
For IL-6, centrifuge the plasma after blood collection and store it frozen; for NGAL, centrifuge the supernatant after urine collection and store it refrigerated; for LSI, subcontract the stored specimens. Collect the information from 1 to 3 from the medical record. 1. 1) Preoperative information Gender, age, height, weight, body surface area, hematocrit level, eGFR, serum creatinine level, left ventricular ejection fraction, Euro score II 2. surgical information surgical technique, operative time, cardiopulmonary time, aortic interruption time, minimum body temperature, minimum hematocrit level, blood transfusion volume during cardiopulmonary intervention, cardioprotective fluid infusion volume, urine volume during cardiopulmonary intervention, water removal volume, maximum lactate level, perfusion volume, perfusion pressure, DO2i, tissue oxygen saturation 3. postoperative information Urine volume, serum creatinine level, intubation time, ICU stay, presence of renal replacement therapy |
| 管理情報/Management information | ||||||||
| 登録日時/Registered date |
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| 最終更新日/Last modified on |
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| 閲覧ページへのリンク/Link to view the page | |
| URL(日本語) | https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053344 |
| URL(英語) | https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053344 |