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CompletedNCT03323580Updated Mar 24, 2023

Effects of Intraoperative GDFT on the Postoperative Brain Edema

An interventional study of GDFT and traditional fluid therapy in Fluid Therapy, Brain Edema and Brain Tumor, sponsored by Beijing Tiantan Hospital. Completed at 1 site in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-03-24.

Sponsored by Beijing Tiantan Hospital · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
480
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Whether a fluid protocol aiming for protecting vital organ perfusion or fluid restriction is favorable to post-craniotomy outcomes such as brain edema remains uncertain. To our knowledge, there has been no extensive and quantitative analysis of brain edema following SVV-based GDFT in neurosurgical patients with malignant supratentorial glioma. So the study aims to observe the effect of the stroke volume variation-based GDFT on the postoperative brain edema and decrease the incidence of postoperative complications in neurosurgical patients with malignant supratentorial gliomas.

02

Conditions studied

  • Fluid Therapy
  • Brain Edema
  • Brain Tumor

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03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Preoperative brain image indicating high-grade glioma (HGG), verified by postoperative histology of the World Health Organization (WHO) as grade III or IV tumors.
  2. Age 18-65 years, and American Society of Anaesthesiologists (ASA) physical status I to III.
  3. Signed informed consent.

Exclusion criteria

Exclusion Criteria:

  1. Renal insufficiency or the creatinine clearance is \< 30 mL/kg.
  2. Heart disease, New York Heart Association Functional Classification (NYHA) class II or higher heart failure, or if their cardiac ejection fraction is \< 20%.
  3. Chronic obstructive pulmonary disease.
  4. Extensive peripheral arterial occlusive disease.
  5. Coagulopathy.
  6. Surgery in the prone position.
  7. Recurrent carcinoma or tumor in the brain ventricular.
  8. Body Mass Index \<18.5 kg·m-2 or >30.0 kg·m-2.
  9. Awake craniotomy.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
480 participants (actual)

Study arms

  • Experimental
    GDFT group

    The patients will receive fluid therapy under goal directed.

    Other: GDFT

  • Sham comparator
    Routine group

    The patients will receive routine fluid therapy.

    Other: traditional fluid therapy

Interventions

  • OtherGDFT

    Target parameter will be titrated with fluid bolus, and thus individual amount varied depending on the parameter value at that time. Maintenance of oxygenation, hemoglobin, blood glucose, core temperature and hemodynamics, such as mean arterial pressure and heart rate, will be applied according to the same standard for each patient.

  • Othertraditional fluid therapy

    Fluid therapy will be done without goal directed. Maintenance of oxygenation, hemoglobin, blood glucose, core temperature and hemodynamics, such as mean arterial pressure and heart rate, will be applied according to the same standard for each patient.

05

What researchers measure

Primary outcomes

  1. Quantitative analysis of brain edema

    Postoperative brain edema is defined as edema surrounding the surgical resection cavity, which will be evaluated through CT images.Image evaluators will manually delineate region of interest (ROI) and operative cavity on each slice. The area will be calculated automatically by PACS system. The total volume will be acquired by multiplying area and slice thickness. The volume of edema will be calculated by the totoal volume of edema plus cavity minus the volume of cavity.

    Time frame: Within 24 hours postoperatively

Secondary outcomes

  1. The incidence of delirium

    Delirium was assessed twice daily (between 8-10 am and between 6-8 pm) with the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) for critical care patients, or the 3-minute Diagnostic interview for Confusion Assessment Method (3D-CAM) for ward assessments, combined with the Richmond Agitation Sedation Scale (RASS). Delirium assessments were only conducted in patients with RASS sedation score exceeding -4.

    Time frame: During the first 3 postoperative days

06

Study locations

1 site
  • Beijing Tiantan Hospital
    Beijing, Beijing 100050, China
07

References and documents

Publications

  • Liu X, Zhang X, Fan Y, Li S, Peng Y. Effect of intraoperative goal-directed fluid therapy on the postoperative brain edema in patients undergoing high-grade glioma resections: a study protocol of randomized control trial. Trials. 2022 Nov 19;23(1):950. doi: 10.1186/s13063-022-06859-9. PubMed 36401274 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03323580
Lead sponsor
Beijing Tiantan Hospital
Responsible party
Yuming Peng (Ph.D.,M.D., Beijing Tiantan Hospital) — Principal investigator
First posted
Oct 27, 2017
Start date
Nov 26, 2018
Primary completion
Sep 21, 2022
Completion
Oct 31, 2022
Last update
Mar 24, 2023

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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