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Trial record 19 of 619 for:    oximeter

Alternate Methodology of Pulse Oximeter Validation

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ClinicalTrials.gov Identifier: NCT03628560
Recruitment Status : Recruiting
First Posted : August 14, 2018
Last Update Posted : July 2, 2019
Sponsor:
Information provided by (Responsible Party):
Duke University

Brief Summary:
This study will determine if the replacement of the measured arterial blood oxygen saturation with expired (end-tidal) oxygen value is an acceptable method to calculate the accuracy of pulse oximeters.

Condition or disease Intervention/treatment Phase
Hypoxemia Desaturation of Blood Device: RespirAct Step-Wise Normocapnia desaturation sequence Device: RespirAct Slope Normocapnia desaturation sequence Device: RespirAct Step-Wise Hypocapnia desaturation sequence Device: RespirAct Slope Hypocapnia desaturation sequence Device: ROBD Step-Wise desaturation sequence Not Applicable

Detailed Description:

Pulse oximeters are non-invasive devices that use light to display an estimate (denoted by SpO2) of the true arterial blood oxygen saturation (SaO2). The accuracy of the pulse oximeter is determined from desaturation sequences (reduction in SpO2 from 100 to 70%) performed in healthy volunteers. The current standard desaturation sequence is a step-wise reduction in 5% SpO2 increments, achieved by reduction in inspired oxygen delivered by a gas blender such as the ROBD (Reduced Oxygen Breathing Device). This mixes oxygen and nitrogen (components of air) to produce the desired gas mixture. Throughout the desaturation sequence arterial blood gas samples are drawn at each step. The blood gas samples are processed through a co-oximeter to measure the SaO2. For each SaO2 measurement there will be a corresponding SpO2 recorded. All data points from all subjects are amalgamated together to allow calculation of how well SpO2 corresponds to the SaO2 throughout the range of 70 - 100% oxygen saturation. Accuracy, A[RMS], is the unit of measure and this incorporates both bias and precision.

When the ROBD is used in a desaturation sequence, the subjects' arterial blood carbon dioxide (CO2) level will initially be normal (normocapnia). With the reduction in SpO2 during the desaturation sequence, the subjects' breathing rate will increase and this will cause the a physiological reduction in the blood CO2 value (hypocapnia). The extent of hypocapnia will vary from one subject to another. It is not known whether the presence of hypocapnia may have an effect upon the accuracy measurement.

The RespirAct is a gas blender which, in contrast to the ROBD, can control both the oxygen level as well as the carbon dioxide level. The end-tidal oxygen level (PAO2) is continuously displayed by the RespirAct during the desaturation sequence. The PAO2 closely approximates to arterial blood oxygen (PaO2) - the degree of closeness will be measured in the study. Through an accepted formula, the SaO2 can be derived from the measured PAO2. The derived SaO2 values can subsequently be used to measure the accuracy of the pulse oximeter. This A[RMS] can then be compared with the A[RMS] calculated from the blood gas co-oximeter PaO2 / SaO2 values. If the accuracies are comparable then this would remove the need for arterial line placement during pulse oximeter validation studies.

Eligible healthy volunteers will complete five (5) oxygen desaturation sequences with adjustment of sequence type and/or CO2 level. Two sequences will be delivered by step-wise reduction and two will be delivered by gradual slope. Two sequences will be delivered at normocapnia and two will be delivered at hypocapnia values. The ROBD sequence will be a step-wise reduction with CO2 value set by the subjects' own breathing control.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: Alternate Methodology of Pulse Oximeter Validation
Actual Study Start Date : September 26, 2018
Estimated Primary Completion Date : November 30, 2019
Estimated Study Completion Date : November 30, 2019

Arm Intervention/treatment
Experimental: RespirAct Step-Wise Normocapnia desaturation sequence
Reduction in oxygen saturation 100 to 70% in approximate 5% steps.
Device: RespirAct Step-Wise Normocapnia desaturation sequence
Blood carbon dioxide controlled at normal value (normocapnia).

Experimental: RespirAct Slope Normocapnia desaturation sequence
Reduction in oxygen saturation 100 to 70% as gradual slope.
Device: RespirAct Slope Normocapnia desaturation sequence
Blood carbon dioxide controlled at normal value (normocapnia).

Experimental: RespirAct Step-Wise Hypocapnia desaturation sequence
Reduction in oxygen saturation 100 to 70% in approximate 5% steps.
Device: RespirAct Step-Wise Hypocapnia desaturation sequence
Blood carbon dioxide controlled at lower than normal value (hypocapnia).

Experimental: RespirAct Slope Hypocapnia desaturation sequence
Reduction in oxygen saturation 100 to 70% as gradual slope.
Device: RespirAct Slope Hypocapnia desaturation sequence
Blood carbon dioxide controlled at lower than normal value (hypocapnia).

Active Comparator: ROBD Step-Wise desaturation sequence
ROBD = Reduced Oxygen Breathing Device. Reduction in oxygen saturation 100 to 70% in approximate 5% steps. This represents the standard type of desaturation sequence for pulse oximeter accuracy testing.
Device: ROBD Step-Wise desaturation sequence
Blood carbon dioxide is controlled at normal or lower value by subject's own breathing rate.




Primary Outcome Measures :
  1. Accuracy of FDA-approved pulse oximeter when calculated with RespirAct-derived end-tidal PAO2 values and with co-oximeter measured arterial PaO2 values [ Time Frame: 1 study day ]
    The unit of measure of accuracy is called A[RMS] and is a composite value of bias and precision.

  2. PAO2 values [ Time Frame: 1 study day ]
    RespirAct-derived end-tidal PAO2 values with co-oximeter measured arterial PaO2 values


Secondary Outcome Measures :
  1. Accuracy, A[RMS], when a step-wise desaturation sequence is used against a slope desaturation sequence. [ Time Frame: 1 study day ]
    The unit of measure of accuracy is called ARMS and is a composite value of bias and precision.

  2. Level of PaCO2 (hypocapnia versus normocapnia) [ Time Frame: 1 study day ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 50 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Aged 18 - 50 years
  • Subject is willing to provide written informed consent and is able to comply with anticipated study procedures

Exclusion Criteria:

  • Body Mass Index (BMI) < 18.0 or > 30.0
  • Known significant respiratory, cardiovascular or medical condition that precludes study participation as judged by investigator
  • Anemia [hemoglobin value below lower range of normal for gender]
  • Abnormal hemoglobin electrophoresis result
  • Exposure to nicotine [positive test at screening or study day]
  • Abnormal drug screen [positive test at screening or on day of study]
  • Positive pregnancy test for females [serum test at screening; urine test on study day]
  • Abnormal Allen's test for collateral circulation
  • Abnormal Electrocardiogram
  • Abnormal Pulmonary Function Test
  • Abnormal venous blood gas result
  • Intolerance of facemask

Information from the National Library of Medicine

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): NCT03628560


Contacts
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Contact: David MacLeod 919-681-6437 david.macleod@duke.edu

Locations
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United States, North Carolina
Duke University Recruiting
Durham, North Carolina, United States, 27710
Contact: David MacLeod, MB BS    919-681-6437    david.macleod@duke.edu   
Sponsors and Collaborators
Duke University
Investigators
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Principal Investigator: David B MacLeod, FRCA Duke University

Additional Information:
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Responsible Party: Duke University
ClinicalTrials.gov Identifier: NCT03628560     History of Changes
Other Study ID Numbers: Pro00100105
First Posted: August 14, 2018    Key Record Dates
Last Update Posted: July 2, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: No
Pediatric Postmarket Surveillance of a Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Duke University:
Healthy volunteer
Oximetry
Pulse oximeter
Hypoxia
Additional relevant MeSH terms:
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Hypoxia
Signs and Symptoms, Respiratory
Signs and Symptoms