AzTrials
AzTrials

Meningioma of BrainGM-HESNCT07476404

Re-bleeding in Giant Meningioma and Intraoperative Hydroxyethyl Starch (HES) Fluid Therapy

An observational study of Meningioma of Brain and Meningioma Surgery, run by Chiang Mai University at 1 site in Thailand.

Completed

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

Official record
Search all trials

Trial summary

Project Summary: Retrospective Cohort Study 1. Core ObjectiveThe primary goal is to determine if the volume of Hydroxyethyl Starch (HES) 130/0.4 (specifically Voluven® or Volulyte®) administered during the removal of giant meningiomas (tumors > 5 cm) increases the risk of postoperative complications. 2. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Meningioma of Brain, Meningioma Surgery
What is being tested?
exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4
How many people
300 participants
Where
1 siteThailand
Study dates
1 Mar 2025to 1 Mar 2026
How long will I take part?
7 Days
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
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients diagnosed of giant meningiomas, diameter of at least 5 cm. They were scheduling for craniotomy during 2016-2024. Withdrawal Criteria: There are no specific withdrawal criteria listed for this study. Ethical Consideration: Since this is a retrospective study using existing hospital electronic records, individual informed consent is not required.

Who may be able to join

  • Inclusion CriteriaTo be included in the study, participants must meet all of the following requirements:Age: Patients must be at least 18 years old.
  • Diagnosis: Patients must be diagnosed with a meningioma. Tumor Size: The tumor must be classified as "giant," defined as having a diameter of 5 cm or larger as seen on a CT scan.
  • Surgery Type: Patients must have undergone a craniotomy to remove the tumor. Timeframe: The surgery must have occurred between the years 2016 and 2024

Who cannot join

  • Exclusion CriteriaPatients will be excluded from the study if they meet any of the following conditions:
  • Recurrent Cases: Patients with a recurrent meningioma (rather than a first-time surgery).
  • Emergency Cases: Patients requiring an emergency craniotomy. Pregnancy: Any patient who is pregnant. Major Complications: Patients who experienced cardiac arrest during the surgery.

Trial locations and contacts

1 site in 1 country.

Thailand1 site
  • Chiang Mai University

    Chiang Mai, 50200

Other trials in Thailand

About this study

Official title: Re-bleeding in Giant Meningioma and Intraoperative Hydroxyethyl Starch (HES) Fluid Therapy: A Retrospective Cohort Study

Project Summary: Retrospective Cohort Study

  1. Core ObjectiveThe primary goal is to determine if the volume of Hydroxyethyl Starch (HES) 130/0.4 (specifically Voluven® or Volulyte®) administered during the removal of giant meningiomas (tumors > 5 cm) increases the risk of postoperative complications.
  2. Research Question Does the volume of intraoperative HES solution influence the rate of re-bleeding (requiring a second surgery within 48 hours) or the development of Acute Kidney Injury (AKI) within 7 days after the initial craniotomy?Outcomes:
  3. Outcomes Primary: Incidence of re-bleeding at the tumor bed requiring re-operation within 48 hours Secondary: New-onset postoperative AKI within 7 days (defined by KDIGO criteria)
Read the detailed description

Background \& Rationale

HES Properties: HES is a synthetic colloid used to maintain blood volume during surgery. While newer "third-generation" HES (130/0.4) is designed to be safer, it may still interfere with blood clotting.

Coagulation Concerns: HES can reduce levels of Factor VIII and von Willebrand factor (vWF) by 50-80%, potentially leading to "dilutional coagulopathy" where the blood cannot clot effectively.

Knowledge Gap: Current evidence is inconclusive regarding whether low-to-moderate doses of HES are truly safe during the removal of large, vascular brain tumors like giant meningiomas.

Study Methodology Study Population: Adult patients (> 18 years) who underwent craniotomy for a giant meningioma (> 5 cm) at Maharaj Nakorn Chiang Mai Hospital between January 1, 2016, and December 31, 2024.

Data Collection: Researchers will review electronic medical records to extract data on:

Patient demographics (age, sex, ASA physical status). Surgical details (operation time, estimated blood loss). Fluid management (volume of HES, crystalloids, and blood products given). Laboratory results (pre- and post-operative Serum Creatinine)

Ethical Considerations and Privacy: As a retrospective review of existing records, there is no direct patient contact. Data will be coded to maintain strict confidentiality.Benefits: The findings will help anesthesiologists optimize fluid therapy to improve patient safety and reduce surgical risks.

Statistical Analysis Plan

  1. Grouping and ComparisonIn a cohort design, patients will be grouped based on their exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4: Exposed Group: Patients who received HES during surgery. Non-Exposed Group: Patients who did not receive HES (received only crystalloids or other fluids). Dose-Response Analysis: Patients may also be categorized by the volume of HES received (e.g., < 500 ml vs. 500-1,000 ml vs. > 1,000 ml) to see if higher doses correlate with higher bleeding risk.
  2. Primary and Secondary Outcomes Primary Outcome: The cumulative incidence of re-bleeding and required re-craniotomy within 48 hours. Secondary Outcome: The incidence of new-onset postoperative Acute Kidney Injury (AKI) within 7 days, defined by the KDIGO criteria (Serum Creatinine increase > 0.3 mg/dl or > 1.5x baseline).
  3. Analytic StatisticsRisk Estimation: We will primarily report Relative Risk (RR) or Hazard Ratios (HR) to describe the risk of bleeding in the HES group compared to the non-HES group.

Confounder Adjustment: We will use Multivariable Logistic Regression or Cox Proportional Hazards Regression to adjust for potential confounders such as age, sex, ASA grade, tumor size, and total blood loss.

Handling Continuous Data: Factors like the volume of HES and estimated blood loss (EBL) will be analyzed using mean/standard deviation and compared using t-tests or Mann-Whitney U tests.

Sample Size Consideration for Cohort Study

For a cohort study, the sample size is determined by the expected incidence of re-bleeding in the unexposed group versus the exposed group.Based on our previous data, the incidence of re-operation is approximately 1.5% to 1.6%.With we planned 9-year data collection (2016-2024), we aim to include all eligible giant meningioma cases (> 5 cm) to maximize the power of the study.

Being tested
exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4
Keywords
Re-bleeding after craniotomy to remove giant meningioma
Medical subject headings
Meningioma

What participants receive

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

  • exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4Other

    did and did not receive HES (received only crystalloids or other fluids)

Study groups in NCT07476404
Study groupRoleWhat they receive
Exposed GroupPatients who received HES during surgery
Receives: Other: exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4
Non-Exposed GroupPatients who did not receive HES (received only crystalloids or other fluids).
Receives: Other: exposure to Hydroxyethyl Starch (HES) Voluven® or Volulyte® 130/0.4

What is being measured

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

  1. The cumulative incidence of re-bleeding and required re-craniotomy within 48 hours

    The cumulative incidence of re-bleeding and required re-craniotomy within 48 hours

    Measured: 7 days

Secondary outcomes (1)
  1. The incidence of new-onset postoperative Acute Kidney Injury (AKI)

    defined by the KDIGO criteria (Serum Creatinine increase > 0.3 mg/dl > 1.5x baseline

    Measured: 7 days

Timeline

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

  1. First posted17 Mar 2026
  2. Study start1 Mar 2025
  3. Primary completion14 Feb 2026
  4. Study completion1 Mar 2026

Resources

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
300 participants (actual)
Target duration
7 Days
IDs, dates and publications
ClinicalTrials.gov ID
NCT07476404
Sponsor's protocol ID
ANE-2568-0034
Acronym
GM-HES
Status last verified
Mar 2026
First submitted
12 Mar 2026
Last updated
17 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: This is a retrospective cohort study using electronic medical records from a single center.To protect patient privacy and maintain strict confidentiality, only the research team has authorized access to the data.The data is recorded using research codes instead of hospital identification numbers to ensure anonymity.Currently, there is no established protocol or administrative framework for sharing these specific patient records with external researchers

Publications

  • Vahdat S. A review of pathophysiological mechanism, diagnosis, and treatment of thrombosis risk associated with COVID-19 infection. Int J Cardiol Heart Vasc. 2022 Aug;41:101068. doi: 10.1016/j.ijcha.2022.101068. Epub 2022 Jun 3.

    PubMed 35677840
  • Beltrame JF, Tavella R, Zeitz CJ. Beyond Structural Angiography: The Emergence of Functional Coronary Angiography. J Am Coll Cardiol. 2022 Jun 21;79(24):2379-2382. doi: 10.1016/j.jacc.2022.04.014. No abstract available.

    PubMed 35710188
  • Podcast: Enigmatic neutron stars may soon give up their secrets. Nature. 2020 Jun 15. doi: 10.1038/d41586-020-01424-3. Online ahead of print. No abstract available.

    PubMed 34127830
  • Bonnesen B, Sivapalan P, Jordan A, Pedersen JW, Bergsoe CM, Eklof J, Toennesen LL, Jensen SG, Naqibullah M, Saghir Z, Jensen JS. Risk of Malignancy in Patients with Asthma-COPD Overlap Compared to Patients with COPD without Asthma. Biomedicines. 2022 Jun 21;10(7):1463. doi: 10.3390/biomedicines10071463.

    PubMed 35884768
  • Shanmugam S. Inverse Electrode Placement May Help to Improve Electrotherapeutic Effects in the Field of Chronic Pain Management. Korean J Pain. 2016 Jul;29(3):202-4. doi: 10.3344/kjp.2016.29.3.202. Epub 2016 Jul 1. No abstract available.

    PubMed 27413488
  • Disseldorp DJ, Poeze M, Hannemann PF, Brink PR. Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures? J Wrist Surg. 2015 Aug;4(3):207-13. doi: 10.1055/s-0035-1558831.

    PubMed 26261748
  • Slawin J, Kubler P, Szczepanski A, Piatek J, Stepkowski M, Reczuch K. Radial artery occlusion after percutaneous coronary interventions - an underestimated issue. Postepy Kardiol Interwencyjnej. 2013;9(4):353-61. doi: 10.5114/pwki.2013.38865. Epub 2013 Nov 18.

    PubMed 24570753
  • Zhu Z, Liang Z, Liany H, Yang C, Wen L, Lin Z, Sheng Y, Lin Y, Ye L, Cheng Y, Chang Y, Liu L, Yang L, Shi Y, Shen C, Zhou F, Zheng X, Zhu J, Liang B, Ding Y, Zhou Y, Yin X, Tang H, Zuo X, Sun L, Bei JX, Liu J, Yang S, Yang W, Cui Y, Zhang X. Discovery of a novel genetic susceptibility locus on X chromosome for systemic lupus erythematosus. Arthritis Res Ther. 2015 Dec 3;17:349. doi: 10.1186/s13075-015-0857-1.

    PubMed 26635088
  • Varughese AM, Nick TG, Gunter J, Wang Y, Kurth CD. Factors predictive of poor behavioral compliance during inhaled induction in children. Anesth Analg. 2008 Aug;107(2):413-21. doi: 10.1213/ane.0b013e31817e616b.

    PubMed 18633018
  • Gruber EM, Laussen PC, Casta A, Zimmerman AA, Zurakowski D, Reid R, Odegard KC, Chakravorti S, Davis PJ, McGowan FX Jr, Hickey PR, Hansen DD. Stress response in infants undergoing cardiac surgery: a randomized study of fentanyl bolus, fentanyl infusion, and fentanyl-midazolam infusion. Anesth Analg. 2001 Apr;92(4):882-90. doi: 10.1097/00000539-200104000-00016.

    PubMed 11273919
  • Elgellab A, Riou Y, Abbazine A, Truffert P, Matran R, Lequien P, Storme L. Effects of nasal continuous positive airway pressure (NCPAP) on breathing pattern in spontaneously breathing premature newborn infants. Intensive Care Med. 2001 Nov;27(11):1782-7. doi: 10.1007/s00134-001-1117-1. Epub 2001 Oct 31.

    PubMed 11810123
  • Hayek SM, Fattouh M, Dews T, Kapural L, Malak O, Mekhail N. Successful treatment of spontaneous cerebrospinal fluid leak headache with fluoroscopically guided epidural blood patch: a report of four cases. Pain Med. 2003 Dec;4(4):373-8. doi: 10.1111/j.1526-4637.2003.03037.x.

    PubMed 14750917
  • Young KW, Greenwood CE, van Reekum R, Binns MA. A randomized, crossover trial of high-carbohydrate foods in nursing home residents with Alzheimer's disease: associations among intervention response, body mass index, and behavioral and cognitive function. J Gerontol A Biol Sci Med Sci. 2005 Aug;60(8):1039-45. doi: 10.1093/gerona/60.8.1039.

    PubMed 16127110

Questions about this trial

What is this clinical trial studying?

An observational study of Meningioma of Brain and Meningioma Surgery, run by Chiang Mai University at 1 site in Thailand.

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 3 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 17 Mar 2026. 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 Thailand. 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?

The cumulative incidence of re-bleeding and required re-craniotomy within 48 hours (time frame: 7 days). 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 NCT07476404, which also lists 13 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 17 Mar 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in