Preoperative Significant Clinical Findings Using Focused Ultrasound Examination
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|ClinicalTrials.gov Identifier: NCT02824692|
Recruitment Status : Unknown
Verified July 2016 by Dekel Lait MD, Rambam Health Care Campus.
Recruitment status was: Not yet recruiting
First Posted : July 7, 2016
Last Update Posted : July 7, 2016
|Condition or disease||Intervention/treatment|
|Congestive Heart Failure||Device: heart lungs and abdomen ultrasound|
Emergent orthopedic and urological surgeries in the elderly population are characterized by high incidence of chronic diseases of the target population on one hand, and the time factor which limits the possibility to properly assess the preoperative condition on the other hand.
Therefore, anesthesiologist often perform these procedures such as hip replacement with insufficient data as compared to an elective case.
In Israel, a hip fracture must be operated on within 18 hours. This type of fracture is common to the elderly population who naturally suffer more from chronic diseases that might influence the management of anesthesia. Due to the emergent nature of the procedures involved, the patients are often operated on with only basic preoperative assessment such as ECG, chest x-ray and blood tests.
A more elaborated assessment, such as a valid echocardiography , evaluation of pleural effusion or the presence of ascites are often impossible to acquire due to inaccessibility of the echo lab (high burden, missing qualified personal ) or the availability of operation theater.
This is an observational pilot study in which the ability of a focused, bedside preoperative ultrasound examination preformed by a qualified anesthesiologist to expose significant clinical data will be evaluated.
Sample size: 30 patient. Male and female over the age 65. The examination will cover the heart (eg. volemic status, global systolic function, existence of severe valvular pathology, pericardial effusion), lungs (eg. pleural effusion, atelectasis, pneumothorax ) and abdomen ( e.g ascites ). It will be preformed at the patient bed using the VIVID5S General Electric device. All fields will be examined using the low frequency cardiac probe.
The data will be documented and saved electronically by the main investigator. All recorded ultrasound examination will be saved and coded with a number (no patient details).
All data collected will be validated by a physician experienced in the field. Any mismatch between the anesthesiologist records to the validated data will be documented.
Clinically significant findings will be documented and transferred (after validation) to the anesthesiologist performing the anesthesia (only senior anesthesiologist ).
On the following day, the anesthesiologist will document :
- Any changes in anesthetic management due to the examination findings
- Subjective report regarding the utility of the examination
Anesthetic changes and subjective report will be graphically documented. The anesthesiologist preforming the examination underwent the necessary qualifications to preform the exam. In any case, the preoperative examination and operation will not be held by the same anesthesiologist.
Patient enrollment to the study will be preformed at the ward, E.R or preoperative hall. It must be emphasized that in any case the performance of the operation will not be detained by the examination.
|Study Type :||Observational|
|Estimated Enrollment :||30 participants|
|Official Title:||The Incidence of Significant Clinical Findings Using Focused Ultrasound Examination for the Heart, Lungs and Abdomen in Elderly Patients Before Emergent Surgery|
|Study Start Date :||July 2016|
|Estimated Primary Completion Date :||March 2017|
|Estimated Study Completion Date :||July 2017|
- Device: heart lungs and abdomen ultrasound
Other Name: VIVID5S GE device
- The incidence of significant clinical findings using focused ultrasound examination for the heart, lungs and abdomen in elderly patients before emergent surgery [ Time Frame: up to 55 weeks ]Clinical findings that are considered significant (eg. pneumothorax, severe aortic stenosis, pericardial effusion) will be documented and presented in a table - demonstrating their prevalence among the study population.
- Sensitivity and specificity of a qualified anesthesiologist in the diagnosis of clinically significant findings in focused ultra sound examination for the heart, lung and abdoman [ Time Frame: up to 55 weeks ]Significant clinical finding that will be missed or wrongly diagnosed by the anesthesiologist will be noted
- Changes in anesthetic management following the focused ultrasound examination [ Time Frame: up to 55 weeks ]The data will be collected and presented in a table stressing the changes made and their prevalence in the study population
- Overall satisfaction of anesthesiologists from the clinical data provided to them [ Time Frame: up to 55 weeks ]The data will be collected through a questionnaire containing numerical answers (between 1-5) regarding the usefulness and credibility of the ultra sound exam
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02824692
|Contact: dekel lait, MDfirstname.lastname@example.org|
|Study Director:||lior fuchs, MD||Soroka University Medical Center|