Goal-Directed Therapy in Cancer Surgery

NCT ID: NCT01946269

Last Updated: 2013-09-19

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

128 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-09-30

Study Completion Date

2014-05-31

Brief Summary

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The purpose of this study is to determine whether a goal-directed resuscitation therapy within the first 8 hours after major abdominal cancer surgery reduces postoperative complications compared to a standard therapy.

Detailed Description

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Conditions

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Postoperative Care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Standard group

Group Type ACTIVE_COMPARATOR

Standard protocol

Intervention Type OTHER

The control group will be managed by the surgical ICU staff in the postoperative period according to institutional protocol of hemodynamic monitoring.

Goal-directed therapy (GDT) protocol

Group Type ACTIVE_COMPARATOR

Goal-directed Resuscitation Therapy (GDT)

Intervention Type OTHER

* A target value of a cardiac index (CI) greater than 2.5 L/min/m2 and a mean arterial pressure of 70 mmHg will be sought.
* The first step will be fluid resuscitation with 200ml aliquots of Lactated Ringer's solution plus human albumin 20% 50 mL whenever the CI is lower than 2.5 L/min/m2. The fluid challenge will be stopped if the CVP rises by more than 4 mmHg during the infusion period or CI increases less than 10%.
* When the CI is lower than or equal to 2.5L/min/m2 despite of fluid challenge, dobutamine will be initiated with increasing doses up to 20mcg/kg/min.
* The final step will be red blood transfusion to reach a hematocrit higher than 28%.
* If necessary, norepinephrine infusion will be used to maintain a mean arterial pressure above 70 mmHg.

Interventions

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Goal-directed Resuscitation Therapy (GDT)

* A target value of a cardiac index (CI) greater than 2.5 L/min/m2 and a mean arterial pressure of 70 mmHg will be sought.
* The first step will be fluid resuscitation with 200ml aliquots of Lactated Ringer's solution plus human albumin 20% 50 mL whenever the CI is lower than 2.5 L/min/m2. The fluid challenge will be stopped if the CVP rises by more than 4 mmHg during the infusion period or CI increases less than 10%.
* When the CI is lower than or equal to 2.5L/min/m2 despite of fluid challenge, dobutamine will be initiated with increasing doses up to 20mcg/kg/min.
* The final step will be red blood transfusion to reach a hematocrit higher than 28%.
* If necessary, norepinephrine infusion will be used to maintain a mean arterial pressure above 70 mmHg.

Intervention Type OTHER

Standard protocol

The control group will be managed by the surgical ICU staff in the postoperative period according to institutional protocol of hemodynamic monitoring.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to ICU in immediate postoperatory of major abdominal surgery for cancer treatment
* Age over 18 years-old

Exclusion Criteria

* Weight under 55 kilograms or over 140 kilograms;
* Contra-indication for invasive hemodynamic monitoring;
* Expected ICU permanence less than 24 hours;
* Active bleeding
* Vasoplegic shock with noradrenaline dose higher than 1mcg/kg/min
* Enrolled in other study
* Refuse to consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Ludhmila Abrahão Hajjar

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Intensive Care Unit of the Cancer Institute of Sao Paulo State

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Aline Müller, MD

Role: CONTACT

Phone: 55-11-974130225

Email: [email protected]

Facility Contacts

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Aline Müller, MD

Role: primary

References

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Gerent ARM, Almeida JP, Fominskiy E, Landoni G, de Oliveira GQ, Rizk SI, Fukushima JT, Simoes CM, Ribeiro U Jr, Park CL, Nakamura RE, Franco RA, Candido PI, Tavares CR, Camara L, Dos Santos Rocha Ferreira G, de Almeida EPM, Filho RK, Galas FRBG, Hajjar LA. Effect of postoperative goal-directed therapy in cancer patients undergoing high-risk surgery: a randomized clinical trial and meta-analysis. Crit Care. 2018 May 23;22(1):133. doi: 10.1186/s13054-018-2055-4.

Reference Type DERIVED
PMID: 29792232 (View on PubMed)

Other Identifiers

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GRICS-02

Identifier Type: -

Identifier Source: org_study_id