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Hemorrhage clinical trials

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NCT ID: NCT03434444 Recruiting - Clinical trials for Postpartum Hemorrhage

In Vitro Optimization of Oxytocin-induced Myometrial Contractility by Propranolol

Start date: September 8, 2017
Phase: N/A
Study type: Interventional

The rates of cesarean deliveries (CD) and postpartum hemorrhage (PPH) are on the rise, with failed induction and augmentation of labor as major contributing factors. Oxytocin is commonly used for labor induction, as well as during the third stage of labor to minimize the risk of primary PPH. At delivery, it is imperative that the uterus responds effectively to parenteral oxytocin. Poor response to oxytocin following delivery is commonly due to prolonged labor with oxytocin augmentation that is known to "desensitize" the myometrium. Despite the option of several second line uterotonic agents, none of them are as effective as oxytocin in controlling PPH. Given that poor uterine muscle contraction is the root cause of both failed induction or augmentation (leading to a CD in labor) and uterine atony (leading to PPH), there is an urgent and clinically important need to investigate novel methods to enhance oxytocin-induced myometrial contractions. Propranolol, a beta adrenergic receptor agonist, has the potential to improve myometrial contractions by virtue of its ability to inhibit catecholamine production. The investigators plan to investigate the effects of propranolol in both naive and desensitized myometrium, in order to better understand its potential role in improving labor induction and reducing the risk of PPH following oxytocin exposure during labor. The investigators hypothesize that propranolol is likely to potentiate the action of oxytocin upon human myometrium, to ultimately help improve the success of labor induction/augmentation and treatment of PPH.

NCT ID: NCT03432767 Recruiting - Clinical trials for Postpartum Hemorrhage

Investigating the Association of Shock Index and Hemoglobin Variation With Postpartum Hemorrhage After Vaginal Deliveries

Start date: February 16, 2016
Phase: N/A
Study type: Observational

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and morbidity, and is most commonly caused by poor uterine tone after delivery of the baby and placenta. Currently, a lack of early identification of PPH also results in delayed treatment, with an increase in morbidity. The investigators propose that 2 non-invasive methods may provide monitoring for early and accurate detection of PPH. These methods include shock index (SI) and continuous hemoglobin (Hb) monitoring. SI is defined as heart rate divided by systolic blood pressure, and can be used as a marker to predict the severity of hypovolemic shock. Continuous Hb monitoring can now be done using a non-invasive probe that is placed on the patient's finger. It provides real-time Hb values, rather than having to draw blood and wait for a lab test. The investigators hypothesize that SI will have a stronger association with postpartum blood loss than Hb variation.

NCT ID: NCT03431805 Not yet recruiting - Clinical trials for Postpartum Hemorrhage

TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery

TRAAP2
Start date: February 27, 2018
Phase: Phase 3
Study type: Interventional

The aim is to assess the impact of tranexamic acid (TXA) for preventing postpartum hemorrhage (PPH) following a cesarean section (CS).

NCT ID: NCT03431142 Not yet recruiting - Clinical trials for Prolonged DAPT in ACS Patients With Hisk of Both Ischemic and Hemorrhage

A Multicenter, Randomized, Placebo-controlled Study

EA-outcome
Start date: February 2018
Phase: Phase 4
Study type: Interventional

Current guidelines recommend that patients with ACS undergoing stent implantation might be offered extended DAPT treatment for up to 30 months if necessary. Therefore, we designed a prospective, multicenter, randomized, placebo-controlled trial among ACS patients with high-risk on ischemic and bleeding who received a new generation of DES and received 9 to 12 months of DAPT, and evaluated whether clopidogrel monotherapy reduce the risk of bleeding compared with clopidogrel plus ASA in the following 9 months and achieved non-inferior outcomes in preventing ischemic risk.

NCT ID: NCT03427957 Not yet recruiting - Clinical trials for Post-Menopausal Endometrial Thickness

Evaluation of a New Hysteroscopic Grasper for Endometrial Biopsy in Post-menopausal Patients

Start date: March 2018
Phase: N/A
Study type: Interventional

Hysteroscopic endometrial biopsy is usually performed through the classic spoon grasper. Recently, a new hysteroscopic grasper with knurled terminal end and cutting jaws was designed, in order to improve feasibility of the procedure, reduce its duration and the discomfort for the patients. This study aims to compare the outcomes of the two hysteroscopic graspers for endometrial biopsy in post-menopausal patients.

NCT ID: NCT03425305 Active, not recruiting - Heart Failure Clinical Trials

Serum Uric Acid Levels and Onset of Cardiovascular Diseases: a CALIBER Study

Start date: January 1998
Phase: N/A
Study type: Observational

Serum uric acid level is a commonly measured biomarker. The association between serum uric acid level and the risk of developing cardiovascular diseases has been observed in some studies, while others showed controversial results. Estimation of this association may help to predict cardiovascular outcomes and may guide new treatment strategies. The hypothesis is that increased serum uric acid level is associated with a range of cardiovascular diseases.

NCT ID: NCT03419923 Recruiting - Hemodialysis Clinical Trials

Three Anticoagulation Strategies for Hemodialysis in Patients at Risk of Hemorrhage

TASHA
Start date: October 1, 2017
Phase: N/A
Study type: Interventional

The aim of our study is to assess three anticoagulation strategies for intermittent hemodialysis(IHD) in patients at risk of hemorrhage. A registry of consecutive hemodialysis patients with high risk of hemorrhage were conducted at the Guangdong General Hospital, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, the Second Affiliated Hospital of Guangzhou Medicine University or Guangzhou Hospital of Chinese Medicine, between October 1st, 2017 and June 30th,2018. In this multi-center prospective and randomized study, participants were randomly divided into three groups during IHD according to different anticoagulation, including with regular saline flushes, one stage regional citrate anticoagulation (RCA) and two-stage RCA.

NCT ID: NCT03417206 Not yet recruiting - Clinical trials for Endoscopic Sinus Surgery

PRD-guided Analgesia During FESS for Intraoperative Blood Loss

FESSPRD
Start date: February 1, 2018
Phase: N/A
Study type: Interventional

The aim of this randomized trial is to assess the utility of Pupillary Dilatation Reflex (PRD) for monitoring pain perception intraoperatively and its influence on intraoperative blood loss, quality of surgical field using Boezaart Bleeding Scale (BBS) in patients undergoing functional sinus surgery (FESS) under total intravenous anaesthesia using propofol or volatile anaesthesia using sevoflurane or desflurane

NCT ID: NCT03417180 Not yet recruiting - Clinical trials for Endoscopic Sinus Surgery

SPI-guided Analgesia During FESS for Intraoperative Blood Loss

FESSSPI
Start date: February 1, 2018
Phase: N/A
Study type: Interventional

The aim of this randomized trial is to assess the utility of Surgical Pleth Index (SPI) for monitoring pain perception intraoperatively and its influence on intraoperative blood loss, quality of surgical field using Boezaart Bleeding Scale (BBS) in patients undergoing functional sinus surgery (FESS) under total intravenous anaesthesia using propofol or volatile anaesthesia using sevoflurane or desflurane

NCT ID: NCT03414307 Not yet recruiting - Clinical trials for Intracerebral Hematoma

Stereotactic, Robot-assisted Intracerebral Hemorrhage Clot Evacuation

Start date: July 2018
Phase: N/A
Study type: Interventional

Non-traumatic intracerebral hemorrhage (ICH) affects approximately 100,000 Americans yearly. Up to 30-50% of ICH is fatal, and those patients who survive are often left with significant neurologic dysfunction. In the past, medical management (e.g., control of hypertension, reversal of antiplatelet or anticoagulants) had been the most effective treatment for these patients, given the morbidity and mortality associated with open surgical treatment for evacuation of ICH. However, recent trials have demonstrated that minimally invasive stereotactic neurosurgical procedures to evacuate ICH are safe and result in improved outcomes for these patients. Initial attempts to evaluate the efficacy of surgical evacuation of ICH found no significant difference between medical management and standard craniotomy for surgical evacuation. Indeed, open surgery was often discouraged for these patients due to the significant morbidity and mortality associated with the surgical procedure itself. However, research has demonstrated that minimally invasive, image guided stereotactic frame-based and frameless methods are effective and safe for the placement of catheters for clot aspiration and fibrinolytic therapy of ICH in the basal ganglia and other deep seated regions. Larger randomized controlled trials have demonstrated that these minimally invasive approaches also offer clinical benefit for these patients.