A Critical Appraisal of the Role of Near Infrared Spectroscopy (NIRS) in the Pediatric Intensive Care Unit (PICU)

NCT ID: NCT01282099

Last Updated: 2014-06-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

22 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-09-30

Study Completion Date

2013-02-28

Brief Summary

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While near infrared spectroscopy is an exciting technology, scientific rigor is required in order to optimize its appropriate use in the clinical arena. This study will explore the feasibility and clinical applicability of data obtained from the NIRS device. The ability to noninvasively monitor peripheral perfusion remains an area of intense research. The most widely used method is pulse oximetry. The international mandate of its use in operating rooms in the early 1990s after the publication of the Harvard minimum standards for monitoring speaks to its unquestionable utility. Its pervasive application notwithstanding, pulse oximetry merely provides a calibrated ratio of arterial and venous hemoglobin saturation. While this data is valuable, time-tested, and even may hold the promise of accurately noninvasively trending cardiac output, cellular dysmetabolism -- hallmarks of vulnerable, yet viable tissue beds -- are beyond the predictive values of currently available devices.

Detailed Description

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Conditions

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Pediatric Intensive Care Unit

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Cardiac patients

Postoperative congenital heart disease patients requiring stay in the PICU

No interventions assigned to this group

non-cardiac patients

non-cardiac patients requiring stay in the PICU

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* neonates to 16 year olds
* requiring stay in the PICU greater than 24 hours

Exclusion Criteria

* anticipated PICU stay less than 24 hours
* children with ALLOW NATURAL DEATH orders
Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Akron Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael L Forbes, MD, FAAP

Role: PRINCIPAL_INVESTIGATOR

Akron Children's Hospital

Locations

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Akron Children's Hospital

Akron, Ohio, United States

Site Status

Countries

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United States

References

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Lima A, Bakker J. Noninvasive monitoring of peripheral perfusion. Intensive Care Med. 2005 Oct;31(10):1316-26. doi: 10.1007/s00134-005-2790-2. Epub 2005 Sep 17.

Reference Type BACKGROUND
PMID: 16170543 (View on PubMed)

Kelleher JF. Pulse oximetry. J Clin Monit. 1989 Jan;5(1):37-62. doi: 10.1007/BF01618369.

Reference Type BACKGROUND
PMID: 2647912 (View on PubMed)

Webster JG 1997 Design of Pulse Oximeters (Bristol: Institute of Physics Publishing)

Reference Type BACKGROUND

Lima AP, Beelen P, Bakker J. Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion. Crit Care Med. 2002 Jun;30(6):1210-3. doi: 10.1097/00003246-200206000-00006.

Reference Type BACKGROUND
PMID: 12072670 (View on PubMed)

Armonda RA, McGee B, Veznadaraglu E, Rosenwasser RH. Near-infrared spectroscopy (NIRS) measurements of cerebral oximetry in the neurovascular ICU. Crit Care Med 1999; 27:173

Reference Type BACKGROUND

Kohn, Linda T, Corrigan, J, Donaldson, Molla S. To err is human: building a safer health system. Institute of Medicine (U.S.). Committee on Quality of Health Care in America. Vol. 627, Nov.1999

Reference Type BACKGROUND

Standards of evidence for the safety and effectiveness of critical care monitoring devices and related interventions. Coalition for Critical Care Excellence: Consensus Conference on Physiologic Monitoring Devices. Crit Care Med. 1995 Oct;23(10):1756-63. doi: 10.1097/00003246-199510000-00022.

Reference Type BACKGROUND
PMID: 7587243 (View on PubMed)

Prough DS, Pollard V. Cerebral near-infrared spectroscopy: ready for prime time? Crit Care Med. 1995 Oct;23(10):1624-6. doi: 10.1097/00003246-199510000-00004. No abstract available.

Reference Type BACKGROUND
PMID: 7587225 (View on PubMed)

Feldman MD, Petersen AJ, Karliner LS, Tice JA. Who is responsible for evaluating the safety and effectiveness of medical devices? The role of independent technology assessment. J Gen Intern Med. 2008 Jan;23 Suppl 1(Suppl 1):57-63. doi: 10.1007/s11606-007-0275-4.

Reference Type BACKGROUND
PMID: 18095046 (View on PubMed)

Mullner M, Sterz F, Binder M, Hirschl MM, Janata K, Laggner AN. Near infrared spectroscopy during and after cardiac arrest--preliminary results. Clin Intensive Care. 1995;6(3):107-11.

Reference Type BACKGROUND
PMID: 10150558 (View on PubMed)

Schwarz G, Litscher G, Kleinert R, Jobstmann R. Cerebral oximetry in dead subjects. J Neurosurg Anesthesiol. 1996 Jul;8(3):189-93. doi: 10.1097/00008506-199607000-00001.

Reference Type BACKGROUND
PMID: 8803829 (View on PubMed)

Tobias JD. Cerebral oximetry monitoring with near infrared spectroscopy detects alterations in oxygenation before pulse oximetry. J Intensive Care Med. 2008 Nov-Dec;23(6):384-8. doi: 10.1177/0885066608324380.

Reference Type BACKGROUND
PMID: 18794168 (View on PubMed)

Tobias JD. Cerebral oximetry monitoring provides early warning of hypercyanotic spells in an infant with tetralogy of Fallot. J Intensive Care Med. 2007 Mar-Apr;22(2):118-20. doi: 10.1177/0885066606297966.

Reference Type BACKGROUND
PMID: 17456731 (View on PubMed)

Lee TS, Hines GL, Feuerman M. Significant correlation between cerebral oximetry and carotid stump pressure during carotid endarterectomy. Ann Vasc Surg. 2008 Jan;22(1):58-62. doi: 10.1016/j.avsg.2007.07.022. Epub 2007 Nov 26.

Reference Type BACKGROUND
PMID: 18023554 (View on PubMed)

Other Identifiers

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100603

Identifier Type: -

Identifier Source: org_study_id

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