The use of the LiDCORapid monitor to help guide how much fluids to give patients undergoing major head and neck cancer surgery
ISRCTN | ISRCTN86457179 |
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DOI | https://doi.org/10.1186/ISRCTN86457179 |
Secondary identifying numbers | 8 |
- Submission date
- 11/11/2010
- Registration date
- 07/03/2011
- Last edited
- 10/05/2018
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year
Plain English summary of protocol
Not provided at time of registration
Contact information
Dr James McCaul
Scientific
Scientific
Maxillofacial Unit
Horton Wing
St Luke's Hospital
Little Horton Lane
Bradford
BD5 0NA
United Kingdom
Phone | +44 (0)7801 350 191 |
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jim.mccaul@btinternet.com |
Study information
Study design | Randomised controlled pilot study |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
Scientific title | The use of LiDCORapid for fluid optimisation in patients undergoing major head and neck cancer surgery: a randomised controlled pilot study |
Study acronym | LiDCORapid |
Study objectives | Does the use of LiDCORapid intra-operative optimisation influence the time to declaration of medically fit for discharge from hospital following major head and neck cancer surgery? The null hypothesis is that fluid optimisation using LiDCORapid has no influence on outcomes after major head and neck cancer surgery. |
Ethics approval(s) | Leeds (Central) Research Ethics Committee, 02/08/2010, ref: 10/H1313/4 |
Health condition(s) or problem(s) studied | Head and neck cancer |
Intervention | Control group: Patients allocated to traditional fluid management. Tidal ventilation will be set at 8 ml/kg. Maintenance crystalloid will be administered as compound sodium lactate (Hartmanns) at a rate of 1.5 ml/kg/hr. Fluid boli (initially volulyte 6% upto 50 m/kg then a gelatin based colloid thereafter and blood products where indicated) will be administered according to standard management whereby fluid is given guided by a combination of core-peripheral temperature difference and a urine output (aiming to achieve greater than 0.5 ml/kg/hr. Other factors that influence fluid administration will be determined by a combination of heart rate, blood pressure, central venous pressure (CVP), urine output, estimated evaporative fluid loss/blood loss and serial haemoglobin measurements. As a measure of end organ perfusion we will aim to achieve a minimum urine output of 0.5 ml/kg/hour. The LiDCORapid monitor will be obscured from the surgeons view behind the anaesthetic machine and will face away from the surgical team. The screen of the LiDCORapid monitor will be covered. During control cases the anaesthetic team will intermittently go to the monitor but will not raise the cover (therefore the anaesthetist will remain blinded to the information provided by the LiDCORapid machine). An independent research nurse will collect the data from the monitor at the end of each case. LiDCORapid intervention group: Patients allocated to LiDCORapid guided fluid management. Ventilation will be set at 8 ml/kg. Maintenance crystalloid will be administered as compound sodium lactate (Hartmanns) at a rate of 1.5 ml/kg/hr. Fluid administration by the anaesthetist will be guided by the LiDCORapid monitor. Fluid boli (initially volulyte 6% upto 50 m/kg then a gelatin based colloid thereafter and blood products where indicated) will be administered. A fluid bolus of 3 ml/kg will be given when the SVV exhibits a consistent rise above 10%. During cases using the LiDCORapid monitor the anaesthetic team will behave in the same manner as per the control group regarding viewing the LiDCORapid machine. The surgical team who look after the patient post-operatively will be blinded to the study group to which each patient belongs. At any point where clinical acumen suggests that fluid is necessary despite conflicting information from the monitor this will be given. Duration of LiDCORapid guided fluid management: Approximately 11 hours (during major head and neck surgery). Each participant is expected to be in the study from giving consent to when they are discharged from hospital, a total period of approximately 10 days. |
Intervention type | Other |
Primary outcome measure | Time to being declared medically fit for discharge (in hours from end of operation) |
Secondary outcome measures | 1. Length of stay in intensive treatment unit (ITU) (total time in ICU including note of readmission if occurs) 2. Total number of days in hospital 3. Readmissions within 30 days of surgery 4. Free tissue transfer complications 5. Return to theatre rate 6. Infective complications and their duration 7. Inpatient mortality Process outcome measures: 8. Difference in stroke volume and cardiac output between control and intervention groups at the beginning and end of the operation 9. Total volume of fluid given intra-operatively, colloid and crystalloid 10. Blood transfusion requirements (transfusion threshold of less than 8 g/dl unless patient has ischaemic heart disease in which case we would aim to keep Hb 9 - 11 g/dl per usual clinical practice |
Overall study start date | 01/09/2010 |
Completion date | 31/08/2012 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Both |
Target number of participants | Target sample size is 82 patients (41 in each arm) |
Key inclusion criteria | Any patient (aged over 18 years, either sex) undergoing major head and neck cancer surgery with free tissue transfer reconstruction |
Key exclusion criteria | 1. Patients declining to join the study 2. Patients with an arrhythmia that precludes the use of stroke volume variation (SVV), e.g., atrial fibrillation or significant sinus arrhythmia |
Date of first enrolment | 01/09/2010 |
Date of final enrolment | 31/08/2012 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
St Luke's Hospital
Bradford
BD5 0NA
United Kingdom
BD5 0NA
United Kingdom
Sponsor information
Bradford Teaching Hospitals NHS Foundation Trust (UK)
Hospital/treatment centre
Hospital/treatment centre
Research and Development Department
Bradford Institute for Health Research
Bradford Royal Infirmary
Duckworth Lane
Bradford
BD9 6RJ
England
United Kingdom
Phone | +44 (0)1274 382 575 |
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john.wright@bradfordhospitals.nhs.uk | |
Website | http://www.bradfordresearch.nhs.uk/index.php |
https://ror.org/05gekvn04 |
Funders
Funder type
Government
Bradford Teaching Hospitals NHS Foundation Trust (UK)
No information available
National Institute of Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) programme application pending as of 11/11/2010
No information available
Results and Publications
Intention to publish date | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration 1. 2011 conference proceedings in https://doi.org/10.1016/j.bjoms.2012.04.201 2. 2012 conference proceedings in https://doi.org/10.1016/j.bjoms.2012.04.201 |
IPD sharing plan |
Editorial Notes
10/05/2018: Conference proceedings added to publication and dissemination plan.
02/03/2016: No publications found, verifying study status with principal investigator