Adverse Effect of Unspecified General AnestheticsNCT01314287
Effect of Coughing on Oxygenation in the Post Anaesthetic Care Unit
An observational study of Adverse Effect of Unspecified General Anesthetics, run by NHS Research and Development at 1 site in United Kingdom.
Trial summary
General anaesthesia causes small areas of lung to collapse (referred to as atelectasis) and many strategies are used to prevent or reverse this, but these strategies only temporarily improve lung function and do not persist into the post anaesthesia care unit (PACU) where atelectasis may still be present. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Adverse Effect of Unspecified General Anesthetics
- How many people
- 84 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- Jan 2011to Jul 2013
- Phase
- Observational
- Are there results?
- None posted in the registry
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 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: The study subjects will be adult patients undergoing routine operations which are expected to last longer than 45 minutes.
Who may be able to join
- Patients will be selected who require, as part of their normal clinical anaesthetic care, a breathing tube in their lungs and a small plastic tube (catheter) placed in an artery for monitoring and blood sampling
Who cannot join
- Refusal or inability to provide written, informed consent
- Respiratory disease which is severe enough to prevent the safe use of the oxygen levels required for this study
- A expectation that the patient will require their breathing to be supported artificially after the operation
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
St James's University Hospital
Leeds, West Yorkshire, LS9 7TF
About this study
Official title: Observational Study of the Effect of Coughing on Emergence From Anaesthesia on Oxygenation in the Postanaesthetic Care Unit
General anaesthesia causes small areas of lung to collapse (referred to as atelectasis) and many strategies are used to prevent or reverse this, but these strategies only temporarily improve lung function and do not persist into the post anaesthesia care unit (PACU) where atelectasis may still be present. One possible explanation for this is that coughing occurring at the end of the anaesthesic may cause atelectasis to occur. Over 70% of patients cough when their breathing tube is removed as they emerge from the anaesthetic, and our hypothesis is that the presence of the breathing tube prevents a normal cough from occurring and may worsen atelectasis. This study will use alveolar-arterial oxygen difference (AaDO2)as a measure of how well the lungs are oxygenating the blood. This will be measured 30 minutes before the end of the anaesthetic as a control measure of the patient's lung function, and again 60 minutes after the patient has woken up, and the change compared with the amount of coughing observed as the patient emerges from the anaesthetic.
Read the detailed description
This is an observational study which hopes to answer the question of whether the amount of coughing that occurs when a patient emerges from anaesthesia has a negative impact on the ability of the lung to transfer oxygen to the blood in the post anaesthetic care unit (PACU). The patients' involvement starts 45 minutes before the anticipated end of surgery when a standard lung recruitment manoevre will be performed. Fifteen minutes later a 2ml blood sample is taken from the arterial catheter which was placed at the beginning of surgery. From this, together with routinely monitored clinical data, the alveolar/arterial oxygen difference (AaDO2) is calculated. The AaDO2 is used as a measure of the degree of impairment of the lung's ability to fully oxygenate the blood. Next, as the patient wakes up from the anaesthesia, an observer (who is not involved in the clinical care of the patient) will record the amount of coughing that occurs. Assessment of coughing will involve recording:
- time spent coughing
- the number of coughs before and after removing the breathing tube Postoperative care will be routine with oxygen given as required. 1 hour after removal of the tracheal tube a second arterial blood sample is taken from the arterial catheter whilst the patient is breathing 40% oxygen and once again the AaDO2 is calculated. Following the second blood sample the subject's involvement with the study ends.
During the operation no stipulations are made regarding the anaesthetic technique to be used, which is left entirely at the discretion of the anaesthetist with clinical responsibility for the patient. In the last 30 minutes of the operation, the patient's artificial ventilation will be with an oxygen concentration of 40% and a set 'positive end expiratory pressure'(PEEP). Other than that, anaesthetists will be free to wake the patient up by their own preferred method. Also, if at any time the responsible anaesthetist feels the adjustment of the ventilation is required in order to act in the patient's best interest, the patient will be removed from the trial.
Data to be recorded will include sex, age, ASA grade (a measurement of the patients' fitness for an anaesthetic), height and weight, whether or not the patient is a smoker and whether the patient has any lung disease. At the end of surgery, the operation performed and its duration will be recorded. These data are required to characterise the population of patients studied and allow comparison with other research.
No medication or perioperative treatment need be withheld or modified as a consequence of the patient being enrolled in the study. There is no requirement for starting any addition medication as a consequence of the study. Patients may withdraw at any time by withdrawal of consent, in which case all subject data will be destroyed and only the fact that consent was withdrawn will be documented. The anaesthetist with clinical responsibility for the patient may withdraw the patient from the study at any time, in which case the reason for withdrawal will be documented on the data collection form and any data collected will be kept until study completion.
- Keywords
- Anaesthesia, pulmonary complications, Atelectasis
- Medical subject headings
- Pulmonary Atelectasis
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in oxygenation before and after emergence from general anaesthesia
Change between intraoperative and postoperative AaDO2 for each patient in relation to the amount of coughing observed on emergence from anaesthesia.
Measured: 2 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Mar 2011 (estimated)
- Study startJan 2011
- Primary completionJul 2013
- Study completionJul 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Adverse Effect of Unspecified General AnestheticsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 84 participants (actual)
Sponsor and investigators
- Lead sponsor
- NHS Research and Development
- Sponsor type
- Other government
- Collaborators
- The Leeds Teaching Hospitals NHS Trust
- Responsible party
- Principal investigator, Andrew Lumb, NHS Research and Development
- Investigators
- Andrew B Lumb, MB BS FRCA, Principal investigator, Leeds Teaching Hospitals NHS Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01314287
- Sponsor's protocol ID
- AN10/9556
- Other IDs
- 10/H1307/127
- Status last verified
- Apr 2014
- First submitted
- 11 Mar 2011
- Last updated
- 11 Apr 2014
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 11 Apr 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Observational Study of the Effect of Coughing on Emergence From Anaesthesia on Oxygenation in the Postanaesthetic Care Unit
- ClinicalTrials.gov ID
- NCT01314287
- Acronym / sponsor ID
- AN10/9556
- Keywords
- Anaesthesia, pulmonary complications, Atelectasis
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 84 participants (actual)
- Lead sponsor
- NHS Research and DevelopmentOther government
- Collaborators
- The Leeds Teaching Hospitals NHS Trust
- Study start
- Jan 2011
- Primary completion
- Jul 2013 (actual)
- Study completion
- Jul 2013 (actual)
- First posted
- 14 Mar 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
General anaesthesia causes small areas of lung to collapse (referred to as atelectasis) and many strategies are used to prevent or reverse this, but these strategies only temporarily improve lung function and do not persist into the post anaesthesia care unit (PACU) where atelectasis may still be present. One possible explanation for this is that coughing occurring at the end of the anaesthesic may cause atelectasis to occur. Over 70% of patients cough when their breathing tube is removed as they emerge from the anaesthetic, and our hypothesis is that the presence of the breathing tube prevents a normal cough from occurring and may worsen atelectasis. This study will use alveolar-arterial oxygen difference (AaDO2)as a measure of how well the lungs are oxygenating the blood. This will be measured 30 minutes before the end of the anaesthetic as a control measure of the patient's lung function, and again 60 minutes after the patient has woken up, and the change compared with the amount of coughing observed as the patient emerges from the anaesthetic.
Detailed description
This is an observational study which hopes to answer the question of whether the amount of coughing that occurs when a patient emerges from anaesthesia has a negative impact on the ability of the lung to transfer oxygen to the blood in the post anaesthetic care unit (PACU). The patients' involvement starts 45 minutes before the anticipated end of surgery when a standard lung recruitment manoevre will be performed. Fifteen minutes later a 2ml blood sample is taken from the arterial catheter which was placed at the beginning of surgery. From this, together with routinely monitored clinical data, the alveolar/arterial oxygen difference (AaDO2) is calculated. The AaDO2 is used as a measure of the degree of impairment of the lung's ability to fully oxygenate the blood. Next, as the patient wakes up from the anaesthesia, an observer (who is not involved in the clinical care of the patient) will record the amount of coughing that occurs. Assessment of coughing will involve recording:
- time spent coughing
- the number of coughs before and after removing the breathing tube Postoperative care will be routine with oxygen given as required. 1 hour after removal of the tracheal tube a second arterial blood sample is taken from the arterial catheter whilst the patient is breathing 40% oxygen and once again the AaDO2 is calculated. Following the second blood sample the subject's involvement with the study ends.
During the operation no stipulations are made regarding the anaesthetic technique to be used, which is left entirely at the discretion of the anaesthetist with clinical responsibility for the patient. In the last 30 minutes of the operation, the patient's artificial ventilation will be with an oxygen concentration of 40% and a set 'positive end expiratory pressure'(PEEP). Other than that, anaesthetists will be free to wake the patient up by their own preferred method. Also, if at any time the responsible anaesthetist feels the adjustment of the ventilation is required in order to act in the patient's best interest, the patient will be removed from the trial.
Data to be recorded will include sex, age, ASA grade (a measurement of the patients' fitness for an anaesthetic), height and weight, whether or not the patient is a smoker and whether the patient has any lung disease. At the end of surgery, the operation performed and its duration will be recorded. These data are required to characterise the population of patients studied and allow comparison with other research.
No medication or perioperative treatment need be withheld or modified as a consequence of the patient being enrolled in the study. There is no requirement for starting any addition medication as a consequence of the study. Patients may withdraw at any time by withdrawal of consent, in which case all subject data will be destroyed and only the fact that consent was withdrawn will be documented. The anaesthetist with clinical responsibility for the patient may withdraw the patient from the study at any time, in which case the reason for withdrawal will be documented on the data collection form and any data collected will be kept until study completion.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- The study subjects will be adult patients undergoing routine operations which are expected to last longer than 45 minutes.
Key inclusion criteria (1 listed)
- Patients will be selected who require, as part of their normal clinical anaesthetic care, a breathing tube in their lungs and a small plastic tube (catheter) placed in an artery for monitoring and blood sampling
Key exclusion criteria (3 listed)
- Refusal or inability to provide written, informed consent
- Respiratory disease which is severe enough to prevent the safe use of the oxygen levels required for this study
- A expectation that the patient will require their breathing to be supported artificially after the operation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Change in oxygenation before and after emergence from general anaesthesia
Time frame: 2 hours
Change between intraoperative and postoperative AaDO2 for each patient in relation to the amount of coughing observed on emergence from anaesthesia.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Apr 2014.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Andrew B Lumb, MB BS FRCA principal investigator
Leeds Teaching Hospitals NHS Trust
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Adverse Effect of Unspecified General Anesthetics, run by NHS Research and Development at 1 site in United Kingdom.
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 1 inclusion and 3 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 11 Apr 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 United Kingdom. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Change in oxygenation before and after emergence from general anaesthesia (time frame: 2 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 11 Apr 2014.