Tissue Oxygen Deprivation as Detected With Raman in Association With Umbilical Artery Catheters

NCT ID: NCT04038203

Last Updated: 2024-01-12

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

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2023-12-31

Study Completion Date

2024-04-30

Brief Summary

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Umbilical artery catheters (UACs) are associated with significant morbidity in preterm neonates however are necessary for the management of this high risk population. UACs have been linked to serious adverse events (SAEs) including arterial thrombosis, necrotizing enterocolitis, limb ischemia, and renal failure. Resonance Raman Spectroscopy (RRS), raman for short, is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues.

In this prospective, observational study, daily measurements of StO2 of low birth weight neonates using raman spectroscopy will be correlated with UACs.The study team hypothesizes that raman can detect changes in peripheral tissue oxygenation in the ipsilateral extremity to the UAC and that raman is more sensitive at detecting changes in peripheral tissue oxygenation then common metrics used to monitor neonatal hemodynamics. If successful, this study would demonstrate that raman can be used as an early marker of tissue oxygen deprivation in neonates with UACs and maybe used to guide management in other clinical scenarios where StO2 is affected.

Detailed Description

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Conditions

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Tissue Oxygenation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Neonates with UAC placement

Neonates with birth weight less than 1500 grams with UAC placed on admission. Raman measurements will be obtained simultaneously on the right AND left lower extremity for 15 minutes daily in the first week of life.

Resonance Raman Spectroscopy (RPS)

Intervention Type DEVICE

RRS is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues. Raman measurements for the UAC neonates will be obtained simultaneously on the right AND left lower extremity for 15 minutes daily in the first week of life.

Interventions

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Resonance Raman Spectroscopy (RPS)

RRS is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues. Raman measurements for the UAC neonates will be obtained simultaneously on the right AND left lower extremity for 15 minutes daily in the first week of life.

Intervention Type DEVICE

Other Intervention Names

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Raman

Eligibility Criteria

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Inclusion Criteria

1. Birth weight less than 1500 grams.
2. Admitted to the NICU.
3. UAC placed on admission.

1. Admitted to the labor and delivery or antenatal floors with reasonable chance of delivery of a neonate weighing less than 1500 grams as determined by the obstetrics team.

Exclusion Criteria

1\. Neonates with congenital heart defects or major congenital anomalies such as known or suspected inborn errors of metabolism, ambiguous genitalia, neural tube defects, malignancy, abdominal wall defects, airway defects and chromosomal anomalies.

1. Mother is pregnant with fetus with congenital heart defect or major congenital anomaly as described above.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lauren Ruoss, MD

Role: PRINCIPAL_INVESTIGATOR

University of Florida

Locations

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UF Health Children's Hospital

Gainesville, Florida, United States

Site Status

Countries

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United States

References

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Shahid S, Dutta S, Symington A, Shivananda S; McMaster University NICU. Standardizing umbilical catheter usage in preterm infants. Pediatrics. 2014 Jun;133(6):e1742-52. doi: 10.1542/peds.2013-1373. Epub 2014 May 19.

Reference Type BACKGROUND
PMID: 24843063 (View on PubMed)

Elboraee MS, Toye J, Ye XY, Shah PS, Aziz K; Canadian Neonatal Network Investigators. Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants. Am J Perinatol. 2018 Feb;35(3):233-241. doi: 10.1055/s-0037-1606607. Epub 2017 Sep 14.

Reference Type BACKGROUND
PMID: 28910847 (View on PubMed)

McAdams RM, Winter VT, McCurnin DC, Coalson JJ. Complications of umbilical artery catheterization in a model of extreme prematurity. J Perinatol. 2009 Oct;29(10):685-92. doi: 10.1038/jp.2009.73. Epub 2009 Jun 25.

Reference Type BACKGROUND
PMID: 19554012 (View on PubMed)

Huxtable RF, Proctor KG, Beran AV. Effect of umbilical artery catheters on blood flow and oxygen supply to extremities. Pediatr Res. 1976 Jul;10(7):656-60. doi: 10.1203/00006450-197607000-00005.

Reference Type BACKGROUND
PMID: 934731 (View on PubMed)

Iyengar A, Gaillardetz A, Tighiouart H, Castillo B, Romfh P, Davis JM. Direct Measurement of Tissue Oxygenation in Neonates via Resonance Raman Spectroscopy: A Pilot Study. Neonatology. 2017;112(2):137-142. doi: 10.1159/000458514. Epub 2017 May 18.

Reference Type BACKGROUND
PMID: 28514777 (View on PubMed)

Lin SJ, Koltz PF, Davis W, Vicari F. Lower extremity ischemia following umbilical artery catheterization: a case study and clinical update. Int J Surg. 2009 Jun;7(3):182-6. doi: 10.1016/j.ijsu.2008.12.038. Epub 2008 Dec 25.

Reference Type BACKGROUND
PMID: 19349222 (View on PubMed)

Ward KR, Barbee RW, Reynolds PS, Torres Filho IP, Tiba MH, Torres L, Pittman RN, Terner J. Oxygenation monitoring of tissue vasculature by resonance Raman spectroscopy. Anal Chem. 2007 Feb 15;79(4):1514-8. doi: 10.1021/ac061072x.

Reference Type BACKGROUND
PMID: 17297949 (View on PubMed)

Robert B. Resonance Raman spectroscopy. Photosynth Res. 2009 Aug-Sep;101(2-3):147-55. doi: 10.1007/s11120-009-9440-4. Epub 2009 Jul 1.

Reference Type BACKGROUND
PMID: 19568956 (View on PubMed)

Spiro TG. Resonance Raman spectroscopy as a probe of heme protein structure and dynamics. Adv Protein Chem. 1985;37:111-59. doi: 10.1016/s0065-3233(08)60064-9.

Reference Type BACKGROUND
PMID: 2998161 (View on PubMed)

Gay AN, Lazar DA, Stoll B, Naik-Mathuria B, Mushin OP, Rodriguez MA, Burrin DG, Olutoye OO. Near-infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets. J Pediatr Surg. 2011 Jun;46(6):1034-40. doi: 10.1016/j.jpedsurg.2011.03.025.

Reference Type BACKGROUND
PMID: 21683194 (View on PubMed)

Gordon PV, Swanson JR, Attridge JT, Clark R. Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria? J Perinatol. 2007 Nov;27(11):661-71. doi: 10.1038/sj.jp.7211782. Epub 2007 Jul 5.

Reference Type BACKGROUND
PMID: 17611610 (View on PubMed)

Other Identifiers

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OCR25462

Identifier Type: OTHER

Identifier Source: secondary_id

IRB201900739

Identifier Type: -

Identifier Source: org_study_id

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