A Pilot Study- Monitoring Cerebral Blood Flow in Neonates With Congenital Heart Defects

NCT ID: NCT03512613

Last Updated: 2018-06-04

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

Total Enrollment

55 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-05-29

Study Completion Date

2019-05-31

Brief Summary

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Congenital heart defects have an incidence of 9/1000 live births. Infants with congenital heart defects such as Transposition of Great Arteries / Hypoplastic Left Heart are at risk for brain injury because of concomitant brain malformations. Previous studies of cerebral MRI in infants with congenital heart defects showed that in 20-40% of cases there was preoperative brain injury and post operative with the same incidence. These findings are strongly associated with early and long-term neurodevelopmental injury.

There is a necessity for a non invasive device who will monitor the cerebral blood flow during the hospitalization prior and post the cardiac defect repair surgery.

The previous modal of the study device has been cleared for marketing by the FDA (k150268).

The main goal of this study is to demonstrate that the new design of Ornim's c-FLOW 3310-P is easy to operate and effective in monitoring changes in cerebral blood flow in neonates as demonstrated in adults.

Detailed Description

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55 eligible neonates whom have been deemed as candidates for a cardiac surgery will be enroll to the study.

At the first phase, 10 neonates will be monitored. After the investigator has assessed the patient as eligible for the study and consent will be received by the parents, the subject will be provided with a study enrollment number.

All clinical assessments routinely preformed as per standard of care during all hospitalization, such as hemodynamic continues parameters, discreet samples will be documented in the medical records, and later on the requested assessments will be recorded in the designated Case Report Form.

Monitoring will be performed a day prior to the repair surgery, following the surgery at the same day and one and two days after, for 3 hours per day.

Additional standard of care parameters will be collected :Heart rate, Mean Arterial Blood Pressure, Saturation, Ventilator rate, Medications, Blood gases ( blood tests), Echocardiogram, pre-surgery Head US,. additional examination will be performed intended for the study: two post surgery Head US, S100B biomarker for brain injury and Neurological examinations prior and 7 days post- surgery( By standardized questionnaires).

Sample size: 55:

A sample size of 55 will enable to detect an increase of 20% in flow with a standard deviation of 50 assuming normal distribution a type 1 error of 5% and power of 80%.

In order to evaluate the study design and data quality the sponsor will perform an interim analysis for the 10 first neonates.

Quality assurance: Following the study initiation monitoring visit will be performed for the first patient. Additional visits will be performed according to recruitment rate. Source data verification and safety events follow up will be performed during those visits.

Plan for missing data: Every effort will be made to complete follow-up for all subjects and avoid missing data, in particular regarding essential items.

Statistical analysis: Descriptive statistics will be used to summarize results. Categorical measurements will be presented in contingency tables with counts \& percent.

Continuous measurements will be presented with N, means ±Standard Deviation, or median with 25th \& 75th percentiles Minimum \& Maximum.

The percent of change in flow pre \& post maneuver will be calculated using one sample t-test.

Spearman correlation will be used to correlate the autoregulation index and neurological outcomes.

Significance level will be defined as a=0.05. Statistical analyses will be carried out using SPSS (Statistical Package for the Social Sciences) 24.01 software.

Conditions

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Congenital Heart Defect Cerebrovascular Circulation

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Interventions

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c-FLOW 3310-P

c-FLOW 3310-P is a continuous, non-invasive monitor of cerebral deep tissue blood flow used to measure relative changes in blood flow.

The device monitors regional micro circulatory blood flow in tissues, by using sensors placed near the area of interest.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Mutual parents' consent (outstanding exceptional cases who approved by the EC)
2. Born at gestational age of more than 34+6/7 weeks
3. Cardiac surgery between 0- 4 weeks of age
4. Head circumference \>= 31 cm

Exclusion Criteria

1. Patient with implants located in the intended area of the c-FLOW 3310-P sensor location.
2. Laceration of scalp injury at the intended area of the c-FLOW 3310-P sensors
3. Known brain malformation
4. Hydrocephalus
5. Resuscitation between the time of surgery and neurological outcome assessment
Maximum Eligible Age

4 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ornim Medical

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Omer Bar Yosef, MD

Role: PRINCIPAL_INVESTIGATOR

Sheba Medical Center

Locations

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Sheba Medical Center

Ramat Gan, , Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Omer Bar Yosef, MD

Role: CONTACT

+97252-6667344

Oliana Vazhgovsky, BA

Role: CONTACT

Facility Contacts

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Omer Bar Yosef, MD

Role: primary

+972-526667344

Oliana Vazhgovsky, SC

Role: backup

+972-542641448

References

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Govindan RB, Massaro AN, Andescavage NN, Chang T, du Plessis A. Cerebral pressure passivity in newborns with encephalopathy undergoing therapeutic hypothermia. Front Hum Neurosci. 2014 Apr 24;8:266. doi: 10.3389/fnhum.2014.00266. eCollection 2014.

Reference Type RESULT
PMID: 24795612 (View on PubMed)

Massaro AN, Govindan RB, Vezina G, Chang T, Andescavage NN, Wang Y, Al-Shargabi T, Metzler M, Harris K, du Plessis AJ. Impaired cerebral autoregulation and brain injury in newborns with hypoxic-ischemic encephalopathy treated with hypothermia. J Neurophysiol. 2015 Aug;114(2):818-24. doi: 10.1152/jn.00353.2015. Epub 2015 Jun 10.

Reference Type RESULT
PMID: 26063779 (View on PubMed)

Tsalach A, Ratner E, Lokshin S, Silman Z, Breskin I, Budin N, Kamar M. Cerebral Autoregulation Real-Time Monitoring. PLoS One. 2016 Aug 29;11(8):e0161907. doi: 10.1371/journal.pone.0161907. eCollection 2016.

Reference Type RESULT
PMID: 27571474 (View on PubMed)

Hori D, Hogue CW Jr, Shah A, Brown C, Neufeld KJ, Conte JV, Price J, Sciortino C, Max L, Laflam A, Adachi H, Cameron DE, Mandal K. Cerebral Autoregulation Monitoring with Ultrasound-Tagged Near-Infrared Spectroscopy in Cardiac Surgery Patients. Anesth Analg. 2015 Nov;121(5):1187-93. doi: 10.1213/ANE.0000000000000930.

Reference Type RESULT
PMID: 26334746 (View on PubMed)

Rachelia, N. (2012). Non-Invasive Blood Flow Measurements Using Ultrasound Modulated Diffused Light. In Photons Plus Ultrasound: Imaging and Sensing 2012.

Reference Type RESULT

Other Identifiers

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RDCL- IL-SMC-021

Identifier Type: -

Identifier Source: org_study_id

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