Volume Kinetics for Starch Solution and Acetated Ringers

NCT ID: NCT01195025

Last Updated: 2014-10-22

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-08-31

Study Completion Date

2011-05-31

Brief Summary

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Volume kinetics is a method mostly used, so far, to study the distribution and elimination of crystalloid solutions. Voluven (in Sweden the most commonly used colloid for replacement of bleeding during surgery) is poorly studied, though. Also, a recent study showed unexpected volume kinetics for a crystalloid solution when it was given after a colloid solution. The investigators aim to study the volume kinetics of crystalloids and colloids and also the combination of the two in more detail. The investigators will also compare the invasive hemoglobin measurements with measurements from a new non-invasive tool (Radical 7, from Masimo Inc.) which could help to make volume kinetics more practical for everyday use. Finally the investigators will also study the concentrations of a few coagulation factors to see if they can explain the variations in coagulability that has been described in earlier studies of infusion solutions.

Detailed Description

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We will study ten volunteers, each one on three occasions. Each volunteer will receive only crystalloid one time, only colloid another time, and on the third occasion first a colloid and then a crystalloid one hour later. The different protocols will be in random order in the different volunteers. During all these tests we will sample the hemoglobin (both invasive and non-invasive) every fifth minute in the beginning (every tenth minute later) after the infusion. On six to nine occasions during each test we will analyse Albumin, Cystatin-C, Ig-G, Ig-M as markers of hemodilution and D-Dimer, Fibrinogen, Factor VII, PK-INR (prothrombin complex international normalized ratio), and aPTT (activated partial thromboplastin time) as markers of coagulation. The volunteers are also monitored regarding non-invasive blood pressure and pulse rate.

Conditions

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Blood Volume Blood Coagulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A.acetatedRingers, B.colloid & C.colloid+acetatedRingers

First intervention: A. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by 150 minutes of equilibration, when blood samples were collected.

Washout \>7 days

Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.

Washout \> 7 Days

Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.

Group Type OTHER

acetated Ringers

Intervention Type DRUG

Infusion of Ringer acetate 20 ml/kg over 30 min

colloid

Intervention Type DRUG

Infusion of starch 10 ml/kg over 30 min

colloid+acetated Ringer

Intervention Type DRUG

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Intervention Type DEVICE

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

A.colloid, B.colloid+acetatedRinger & C.acetatedRingers

First intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.

Washout \>7 days

Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.

Washout \> 7 Days

Third intervention: C. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.

Group Type OTHER

acetated Ringers

Intervention Type DRUG

Infusion of Ringer acetate 20 ml/kg over 30 min

colloid

Intervention Type DRUG

Infusion of starch 10 ml/kg over 30 min

colloid+acetated Ringer

Intervention Type DRUG

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Intervention Type DEVICE

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

A.acetatedRingers, B.acetatedRingers+colloid & C.colloid

First intervention: A. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.

Washout \>7 days

Second intervention: B.Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.

Washout \> 7 Days

Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.

Group Type OTHER

acetated Ringers

Intervention Type DRUG

Infusion of Ringer acetate 20 ml/kg over 30 min

colloid

Intervention Type DRUG

Infusion of starch 10 ml/kg over 30 min

colloid+acetated Ringer

Intervention Type DRUG

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Intervention Type DEVICE

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

A.colloid, B.acetatedRingers & C.colloid+acetatedRingers

First intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.

Washout \>7 days

Second intervention: B. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.

Washout \> 7 Days

Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.

Group Type OTHER

acetated Ringers

Intervention Type DRUG

Infusion of Ringer acetate 20 ml/kg over 30 min

colloid

Intervention Type DRUG

Infusion of starch 10 ml/kg over 30 min

colloid+acetated Ringer

Intervention Type DRUG

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Intervention Type DEVICE

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

A.colloid+acetatedRingers, B.colloid & C.acetated Ringers

First intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.

Washout \>7 days

Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.

Washout \> 7 Days

Third intervention: C. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.

Group Type OTHER

acetated Ringers

Intervention Type DRUG

Infusion of Ringer acetate 20 ml/kg over 30 min

colloid

Intervention Type DRUG

Infusion of starch 10 ml/kg over 30 min

colloid+acetated Ringer

Intervention Type DRUG

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Intervention Type DEVICE

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

Interventions

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acetated Ringers

Infusion of Ringer acetate 20 ml/kg over 30 min

Intervention Type DRUG

colloid

Infusion of starch 10 ml/kg over 30 min

Intervention Type DRUG

colloid+acetated Ringer

Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

Intervention Type DRUG

Non-invasive hemoglobin with pulse-oximeter (SpHb)

Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

Intervention Type DEVICE

Other Intervention Names

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Voluven Voluven acetated Ringers Radical 7, Masimo

Eligibility Criteria

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Exclusion Criteria

under age \< 18 years
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Linkoeping

OTHER

Sponsor Role lead

Responsible Party

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Joachim Zdolsek

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joachim Zdolsek, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Linköping, Sweden

Locations

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University Hospital, Intensive care unit

Linköping, Linköping, Sweden

Site Status

Countries

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Sweden

References

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Hahn RG, Wuethrich PY, Zdolsek JH. Can perioperative hemodilution be monitored with non-invasive measurement of blood hemoglobin? BMC Anesthesiol. 2021 May 6;21(1):138. doi: 10.1186/s12871-021-01351-4.

Reference Type DERIVED
PMID: 33957864 (View on PubMed)

Hahn RG, Bergek C, Geback T, Zdolsek J. Interactions between the volume effects of hydroxyethyl starch 130/0.4 and Ringer s acetate. Crit Care. 2013 May 29;17(3):R104. doi: 10.1186/cc12749.

Reference Type DERIVED
PMID: 23718743 (View on PubMed)

Bergek C, Zdolsek JH, Hahn RG. Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid. Eur J Anaesthesiol. 2013 Feb;30(2):73-9. doi: 10.1097/EJA.0b013e3283592733.

Reference Type DERIVED
PMID: 23303244 (View on PubMed)

Bergek C, Zdolsek JH, Hahn RG. Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid. Eur J Anaesthesiol. 2012 Dec;29(12):586-92. doi: 10.1097/EJA.0b013e3283592733.

Reference Type DERIVED
PMID: 23047301 (View on PubMed)

Other Identifiers

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VkVR

Identifier Type: -

Identifier Source: org_study_id

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