Noninvasive Monitor of Vascular Volume Fluid Shifts

NCT ID: NCT05080881

Last Updated: 2023-04-25

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WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-15

Study Completion Date

2022-12-01

Brief Summary

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Blood volume measurements are a critical step in the emergency care of trauma patients. The typical approach to this is to rely on historical information, physical examination and metrics such as heart rate. There is currently no good real-time measure to track blood volume. This study investigates the use of phonocardiography (listening to the sounds made by the heart) to track changes in central blood volume.

Detailed Description

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Blood draw subjects:

Participation in this study group may last up to 60 minutes. Participants will begin with a brief medical exam to determine eligibility. This will include a review of any history of cardiovascular disease and of medications. Prior to a scheduled blood draw, eligible participates will have physiological measurements taken, which may include phonocardiographic measurements, cardiac output, plethysmography (volume changes), multifrequency bioimpedance, thoracic impedance, heart rate, blood pressure, pulse oximetry, continuous non-invasive hematocrit measurement, and respiration. The phonocardiographic measurements may be taken with both a commercial and a custom-built device. These are all non-invasive measurements. After 15 minutes of baseline measurements, a blood draw will proceed normally while the physiological measurements continue. After the participant is finished donating blood, the participant will be asked to stay in place for an additional 15 minutes to continue to collect physiological data. Participants are asked not to eat or drink during the 15 minutes as this will provide better data collection. The information collected as data for this study includes: information about medical history, body measurements, and physiological measurements.

Conditions

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Blood Loss

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Blood draw

All blood draw subjects will have baseline data collected over 15 minutes. The participants with then donate blood. For 15 minutes after the blood donation, the participant will stay in place and will continue to have data collected.

Group Type EXPERIMENTAL

phonocardiographic measurement: InnoVital Systems

Intervention Type DIAGNOSTIC_TEST

The instrument consists of one or more low-profile microphones in plastic housings with nitrile or silicon diaphragms. These sensors convert heart sounds into analog signals that will be acquired by the BIOPAC data acquisition system.

phonocardiographic measurement: ThinkLabs StethOne

Intervention Type DIAGNOSTIC_TEST

This device senses heart sounds and may be listened to using headphones and converted to an analog signal and saved using the BIOPAC data acquisition system.

physiological measurements: BIOPAC

Intervention Type DIAGNOSTIC_TEST

Non-invasive blood pressure, electrocardiogram, heart rate, respiratory rate, and leg circumference - This is a commercially available device used regularly in health care settings to monitor continual blood pressure and heart rate.

physiological measurements: Masimo Radical-7

Intervention Type DIAGNOSTIC_TEST

A commercially available device for pulse oximetry and continuous non-invasive hematocrit measurement.

physiological measurements: CoVa Monitoring System 2

Intervention Type DIAGNOSTIC_TEST

This device will be used for thoracic bioimpedance and other physiological measures. This is a commercially available device. It also measures ECG, heart rate, heart rate variability, estimated stroke volume, and estimated cardiac output. The study team may measure either while body bioimpedance or thoracic bioimpedance.

Thoracic impedance

Intervention Type DIAGNOSTIC_TEST

Thoracic impedance is measured using the Starling device (https://usstarling.baxter.com/starling-system). Baxter uses a series of proprietary algorithms to infer stroke volume and cardiac output from thoracis impedance. Calculated values will be recorded, but the main variable that will be recorded is simply the temporal profile of thoracic impedance during the manipulations in each group (changing lower body negative pressure or therapeutic phlebotomy).

Interventions

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phonocardiographic measurement: InnoVital Systems

The instrument consists of one or more low-profile microphones in plastic housings with nitrile or silicon diaphragms. These sensors convert heart sounds into analog signals that will be acquired by the BIOPAC data acquisition system.

Intervention Type DIAGNOSTIC_TEST

phonocardiographic measurement: ThinkLabs StethOne

This device senses heart sounds and may be listened to using headphones and converted to an analog signal and saved using the BIOPAC data acquisition system.

Intervention Type DIAGNOSTIC_TEST

physiological measurements: BIOPAC

Non-invasive blood pressure, electrocardiogram, heart rate, respiratory rate, and leg circumference - This is a commercially available device used regularly in health care settings to monitor continual blood pressure and heart rate.

Intervention Type DIAGNOSTIC_TEST

physiological measurements: Masimo Radical-7

A commercially available device for pulse oximetry and continuous non-invasive hematocrit measurement.

Intervention Type DIAGNOSTIC_TEST

physiological measurements: CoVa Monitoring System 2

This device will be used for thoracic bioimpedance and other physiological measures. This is a commercially available device. It also measures ECG, heart rate, heart rate variability, estimated stroke volume, and estimated cardiac output. The study team may measure either while body bioimpedance or thoracic bioimpedance.

Intervention Type DIAGNOSTIC_TEST

Thoracic impedance

Thoracic impedance is measured using the Starling device (https://usstarling.baxter.com/starling-system). Baxter uses a series of proprietary algorithms to infer stroke volume and cardiac output from thoracis impedance. Calculated values will be recorded, but the main variable that will be recorded is simply the temporal profile of thoracic impedance during the manipulations in each group (changing lower body negative pressure or therapeutic phlebotomy).

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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InnoVital Systems ThinkLabs StethOne BIOPAC Masimo Radical-7 CoVa Monitoring System 2 Baxter

Eligibility Criteria

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Inclusion Criteria

* In generally good health
* Free of systemic diseases
* No contraindications to LBNP exposure.
* No prior history of cardiovascular disease
* Normal resting systolic blood pressure (SBP, 100-140 mm Hg) and diastolic blood pressure (DBP, 60-90 mm Hg).


* In generally good health
* Free of systemic diseases
* No current or prior history of cardiovascular disease or cardiovascular reactive drugs
* Blood donors through the DHMC blood donation center
* Healthy volunteers
* People who are taking part in another study where about 500 ml of blood is being drawn
* Therapeutic phlebotomy patients (hemochromatosis or polycythemia vera patients)

Exclusion Criteria

* Individuals who, after lying supine for five minutes, show a greater than 10 mm Hg drop in systolic pressure or a greater than 20 beats/minute increase in heart rate with standing during pre-enrollment evaluation

Blood draw participants:


* Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Responsible Party

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James C. Leiter

Principal Investigator, Professor of Molecular and Systems Biology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James C Leiter, M.D.

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Medical Center

Locations

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Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Countries

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United States

Other Identifiers

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D18144

Identifier Type: -

Identifier Source: org_study_id

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