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Blood VolumeNCT01195025

Volume Kinetics for Starch Solution and Acetated Ringers

A study testing acetated Ringers, colloid and colloid+acetated Ringer in people with Blood Volume and Blood Coagulation, run by University Hospital, Linkoeping at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Volume kinetics is a method mostly used, so far, to study the distribution and elimination of crystalloid solutions. Voluven (in Sweden the most commonly used colloid for replacement of bleeding during surgery) is poorly studied, though. Read more about this study

Who is it for?
Ages 18 to 50 years, men onlyHealthy volunteers can take part
Conditions the study is for
Blood Volume, Blood Coagulation
What is being tested?
acetated Ringers, colloid and colloid+acetated Ringer
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteSweden
Study dates
Aug 2010to May 2011
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • Men only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

None listed.

Who cannot join

  • under age < 18 years

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • University Hospital, Intensive care unit

    Linköping, Linköping, 581 85

Other trials in Sweden

About this study

Volume kinetics is a method mostly used, so far, to study the distribution and elimination of crystalloid solutions. Voluven (in Sweden the most commonly used colloid for replacement of bleeding during surgery) is poorly studied, though. Also, a recent study showed unexpected volume kinetics for a crystalloid solution when it was given after a colloid solution. The investigators aim to study the volume kinetics of crystalloids and colloids and also the combination of the two in more detail. The investigators will also compare the invasive hemoglobin measurements with measurements from a new non-invasive tool (Radical 7, from Masimo Inc.) which could help to make volume kinetics more practical for everyday use. Finally the investigators will also study the concentrations of a few coagulation factors to see if they can explain the variations in coagulability that has been described in earlier studies of infusion solutions.

Read the detailed description

We will study ten volunteers, each one on three occasions. Each volunteer will receive only crystalloid one time, only colloid another time, and on the third occasion first a colloid and then a crystalloid one hour later. The different protocols will be in random order in the different volunteers. During all these tests we will sample the hemoglobin (both invasive and non-invasive) every fifth minute in the beginning (every tenth minute later) after the infusion. On six to nine occasions during each test we will analyse Albumin, Cystatin-C, Ig-G, Ig-M as markers of hemodilution and D-Dimer, Fibrinogen, Factor VII, PK-INR (prothrombin complex international normalized ratio), and aPTT (activated partial thromboplastin time) as markers of coagulation. The volunteers are also monitored regarding non-invasive blood pressure and pulse rate.

Being tested
acetated Ringers, colloid, colloid+acetated Ringer, Non-invasive hemoglobin with pulse-oximeter (SpHb)
Keywords
Blood volume, blood coagulation, volume kinetics
Medical subject headings
Thrombosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • acetated RingersDrug

    Infusion of Ringer acetate 20 ml/kg over 30 min

  • colloidDrug

    Also called Voluven

    Infusion of starch 10 ml/kg over 30 min

  • colloid+acetated RingerDrug

    Also called Voluven, acetated Ringers

    Infusion of combined colloid+acetated Ringer; 10 ml/kg of starch was infused between 0 and 30 min, followed by 20 ml/kg of Ringers acetate between 105 and 135 min.

  • Non-invasive hemoglobin with pulse-oximeter (SpHb)Device

    Also called Radical 7, Masimo

    Non-invasive hemoglobin with pulse-oximeter (SpHb) was measured in all subjects, during all infusions.

Study groups in NCT01195025
Study groupRoleWhat they receive
A.acetatedRingers, B.colloid & C.colloid+acetatedRingersOtherFirst intervention: A. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by 150 minutes of equilibration, when blood samples were collected. Washout >7 days Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples. Washout > 7 Days Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.
Receives: Drug: acetated Ringers; Drug: colloid; Drug: colloid+acetated Ringer; Device: Non-invasive hemoglobin with pulse-oximeter (SpHb)
A.colloid, B.colloid+acetatedRinger & C.acetatedRingersOtherFirst intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples. Washout >7 days Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples. Washout > 7 Days Third intervention: C. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.
Receives: Drug: acetated Ringers; Drug: colloid; Drug: colloid+acetated Ringer; Device: Non-invasive hemoglobin with pulse-oximeter (SpHb)
A.acetatedRingers, B.acetatedRingers+colloid & C.colloidOtherFirst intervention: A. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected. Washout >7 days Second intervention: B.Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples. Washout > 7 Days Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.
Receives: Drug: acetated Ringers; Drug: colloid; Drug: colloid+acetated Ringer; Device: Non-invasive hemoglobin with pulse-oximeter (SpHb)
A.colloid, B.acetatedRingers & C.colloid+acetatedRingersOtherFirst intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples.acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected. Washout >7 days Second intervention: B. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected. Washout > 7 Days Third intervention: C. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples.
Receives: Drug: acetated Ringers; Drug: colloid; Drug: colloid+acetated Ringer; Device: Non-invasive hemoglobin with pulse-oximeter (SpHb)
A.colloid+acetatedRingers, B.colloid & C.acetated RingersOtherFirst intervention: A. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed 90 minutes later by acetated Ringers 20 ml/kg bodyweight during 30 minutes. thereafter the subjects stayed for Another 285 minutes of equilibration and blood samples. Washout >7 days Second intervention: B. Voluven 6 % (starch solution) 10 ml/kg bodyweight during 30 minutes followed by 390 minutes of equilibration and blood samples. Washout > 7 Days Third intervention: C. acetated Ringers 20 ml/kg bodyweight during 30 minutes followed by150 minutes of equilibration, when blood samples were collected.
Receives: Drug: acetated Ringers; Drug: colloid; Drug: colloid+acetated Ringer; Device: Non-invasive hemoglobin with pulse-oximeter (SpHb)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Volume Effects for Hydroxyethyl Starch, Ringer's Solution or a Combination of Both.

    volume kinetics: mathematical calculation from hemoglobin variations during and after an infusion.

    Degree of plasma dilution depending on which solution(s) and how much solution is/are given.

    Measured: 420 minutes

  2. Elimination Half Life for Different Fluids Alone or When Combined

    Volume kinetic analyses of the dilution of hemoglobin for different infusion fluids alone or in combination.

    Measured: 420 minutes

Secondary outcomes (3)
  1. Accuracy of Non-invasive Hemoglobin Monitoring for Different Fluids

    Pulse-oximeter based measurements compared with invasive hemoglobin measurements. All paired in the study.

    Accuracy depending on which infusion is selected (Ringer's, Hydroxyethyl starch or a combination of both).

    Measured: 420 min

  2. Accuracy of Noninvasive Haemoglobin Measurement by Pulse Oximetry, for Different Fluids (Start to End of Infusion)

    Difference between true hemoglobin B-Hb and measured hemoglobin with pulseoximeter (SpHb)at the end of an infusion in relation to the initial measured values SpHb and B-Hb at the start of the infusion.

    Relative difference (%) = (SpHb - Hb)/((Hb+SpHb)/2) x 100

    Measured: 30 min

  3. Variation of Coagulation Factors and Plasma Proteins During and After Infusion of Crystalloid and Colloid Solutions.

    The investigators will measure a few markers of coagulation (fibrinogen, thrombocytes, D-Dimer, PK-INR, aPTT, and coagulation factor VII) as well as Cystatin C, serum albumine and hemoglobin and how the concentration of these vary with the different dilutions of blood during and after infusion of a colloid and/or a crystalloid solution.

    Measured: 420 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Sep 2010 (estimated)
  2. Study startAug 2010
  3. Primary completionMay 2011
  4. Study completionMay 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01195025
Sponsor's protocol ID
VkVR
Status last verified
Oct 2014
First submitted
31 Aug 2010
Last updated
22 Oct 2014
Data monitoring committee
No

Publications

  • Hahn RG, Wuethrich PY, Zdolsek JH. Can perioperative hemodilution be monitored with non-invasive measurement of blood hemoglobin? BMC Anesthesiol. 2021 May 6;21(1):138. doi: 10.1186/s12871-021-01351-4.

    PubMed 33957864
  • Hahn RG, Bergek C, Geback T, Zdolsek J. Interactions between the volume effects of hydroxyethyl starch 130/0.4 and Ringer s acetate. Crit Care. 2013 May 29;17(3):R104. doi: 10.1186/cc12749.

    PubMed 23718743
  • Bergek C, Zdolsek JH, Hahn RG. Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid. Eur J Anaesthesiol. 2013 Feb;30(2):73-9. doi: 10.1097/EJA.0b013e3283592733.

    PubMed 23303244
  • Bergek C, Zdolsek JH, Hahn RG. Accuracy of noninvasive haemoglobin measurement by pulse oximetry depends on the type of infusion fluid. Eur J Anaesthesiol. 2012 Dec;29(12):586-92. doi: 10.1097/EJA.0b013e3283592733.

    PubMed 23047301

Questions about this trial

What is this clinical trial studying?

A study testing acetated Ringers, colloid and colloid+acetated Ringer in people with Blood Volume and Blood Coagulation, run by University Hospital, Linkoeping at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 0 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Oct 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 22 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Volume Effects for Hydroxyethyl Starch, Ringer's Solution or a Combination of Both. (time frame: 420 minutes). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01195025, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Oct 2014.

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