Near Infrared Spectroscopy (NIRS) for Heart Failure Assessment.

Cardiac Failure Clinical Trial

Official title:

Near Infrared Spectroscopy (NIRS) for Heart Failure Assessment in the Outpatient Setting

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT01577810
• Other study ID #: PHNX-NIRS-12-024
• Status: Recruiting
• Phase: N/A
• First received: March 23, 2012
• Last updated: June 6, 2013
• Start date: June 2013
• Est. completion date: August 2014

Study information

• Verified date: June 2013
• Source: Phoenix Children's Hospital
• Contact: Rohit Rao, MD
• Phone: (262)309-4874
• Email: rrao[@]phoenixchildrens.com
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

It is routine practice for a cardiologist to perform a battery of tests to assess the degree of heart failure. The purpose of this study is to establish a non-invasive method to reliably predict cardiac output state in real-time in children and adolescents with heart failure in an outpatient setting. This study will rely on the use of near infrared spectroscopy monitors to measure cardiac output in the outpatient setting.

Description:

Near-infrared spectroscopy (NIRS) technology, such as that used in pulse oximetry, has been used in medicine for decades. Several characteristics contribute to its widespread use, including its noninvasive nature, reliability and safety. The Somanetics' INVOS® System harnesses this power to safely and reliably "see inside" the brain and body. NIRS devices measure the venous weighted oxy-hemoglobin saturation (color of blue blood) in a field of tissue, rather than in arteries, and thus the rSO2 parameter provides a window into regional oxygen supply-demand relationships. Monitoring rSO2 at two distinct sites (cerebral and somatic) has become common practice at our institution for all infants and children in the intensive care unit and provides valuable feedback about potentially deleterious trends in regional tissue oxygenation that cannot easily be obtained by other modalities in such patients.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 100
• Est. completion date: August 2014
• Est. primary completion date: June 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: N/A to 18 Years

Eligibility

Inclusion Criteria:

• Patient in Phoenix Children's Hospital Heart Failure Clinic

Exclusion Criteria:

Study Design

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Related Conditions & MeSH terms

• Cardiac Failure
• Heart Failure

Intervention

Device:
• Near Infrared Spectroscopy
Use of Near Infrared Spectroscopy in outpatient setting to determine global cardiac output

Locations

Country	Name	City	State
United States	Phoenix Children's Hospital Heart Failure Clinic	Phoenix	Arizona

Sponsors (1)

Lead Sponsor	Collaborator
Phoenix Children's Hospital

Country where clinical trial is conducted

United States, 

References & Publications (16)

Berens RJ, Stuth EA, Robertson FA, Jaquiss RD, Hoffman GM, Troshynski TJ, Staudt SR, Cava JR, Tweddell JS, Bert Litwin S. Near infrared spectroscopy monitoring during pediatric aortic coarctation repair. Paediatr Anaesth. 2006 Jul;16(7):777-81. — View Citation

Bernal NP, Hoffman GM, Ghanayem NS, Arca MJ. Cerebral and somatic near-infrared spectroscopy in normal newborns. J Pediatr Surg. 2010 Jun;45(6):1306-10. doi: 10.1016/j.jpedsurg.2010.02.110. — View Citation

Fortune PM, Wagstaff M, Petros AJ. Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates. Intensive Care Med. 2001 Aug;27(8):1401-7. — View Citation

Hanson SJ, Berens RJ, Havens PL, Kim MK, Hoffman GM. Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care. 2009 Mar;25(3):150-3. doi: 10.1097/PEC.0b013e31819a7f60. — View Citation

Hayashida M, Kin N, Tomioka T, Orii R, Sekiyama H, Usui H, Chinzei M, Hanaoka K. Cerebral ischaemia during cardiac surgery in children detected by combined monitoring of BIS and near-infrared spectroscopy. Br J Anaesth. 2004 May;92(5):662-9. Epub 2004 Mar 19. — View Citation

Hoffman GM, Stuth EA, Jaquiss RD, Vanderwal PL, Staudt SR, Troshynski TJ, Ghanayem NS, Tweddell JS. Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion. J Thorac Cardiovasc Surg. 2004 Jan;127(1):223-33. — View Citation

Nagdyman N, Fleck T, Barth S, Abdul-Khaliq H, Stiller B, Ewert P, Huebler M, Kuppe H, Lange PE. Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children. Intensive Care Med. 2004 Mar;30(3):468-71. Epub 2004 Jan 13. — View Citation

Nollert G, Jonas RA, Reichart B. Optimizing cerebral oxygenation during cardiac surgery: a review of experimental and clinical investigations with near infrared spectrophotometry. Thorac Cardiovasc Surg. 2000 Aug;48(4):247-53. — View Citation

Nollert G, Möhnle P, Tassani-Prell P, Uttner I, Borasio GD, Schmoeckel M, Reichart B. Postoperative neuropsychological dysfunction and cerebral oxygenation during cardiac surgery. Thorac Cardiovasc Surg. 1995 Oct;43(5):260-4. — View Citation

Petros AJ, Heys R, Tasker RC, Fortune PM, Roberts I, Kiely E. Near infrared spectroscopy can detect changes in splanchnic oxygen delivery in neonates during apnoeic episodes. Eur J Pediatr. 1999 Feb;158(2):173-4. — View Citation

Schulz G, Weiss M, Bauersfeld U, Teller J, Haensse D, Bucher HU, Baenziger O. Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation. Intensive Care Med. 2002 Feb;28(2):184-9. Epub 2002 Jan 12. — View Citation

Tsuji M, Saul JP, du Plessis A, Eichenwald E, Sobh J, Crocker R, Volpe JJ. Cerebral intravascular oxygenation correlates with mean arterial pressure in critically ill premature infants. Pediatrics. 2000 Oct;106(4):625-32. — View Citation

Watzman HM, Kurth CD, Montenegro LM, Rome J, Steven JM, Nicolson SC. Arterial and venous contributions to near-infrared cerebral oximetry. Anesthesiology. 2000 Oct;93(4):947-53. — View Citation

Weiss M, Dullenkopf A, Kolarova A, Schulz G, Frey B, Baenziger O. Near-infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturation. Paediatr Anaesth. 2005 Feb;15(2):102-9. — View Citation

Wyatt JS, Cope M, Delpy DT, Wray S, Reynolds EO. Quantification of cerebral oxygenation and haemodynamics in sick newborn infants by near infrared spectrophotometry. Lancet. 1986 Nov 8;2(8515):1063-6. — View Citation

Yoshitani K, Kawaguchi M, Iwata M, Sasaoka N, Inoue S, Kurumatani N, Furuya H. Comparison of changes in jugular venous bulb oxygen saturation and cerebral oxygen saturation during variations of haemoglobin concentration under propofol and sevoflurane anaesthesia. Br J Anaesth. 2005 Mar;94(3):341-6. Epub 2004 Dec 10. — View Citation

* Note: There are 16 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Degree of Heart Failure using NIRS	The investigators strive to discover a surrogate marker for uncompensated heart failure. The use of two-site NIRS monitoring for global cardiac output assessment, through the patterning of somatic and cerebral saturation data in combination with pulse-oximetry data and other vital signs in the outpatient setting, has not been researched although it is used widely in the inpatient arena.	5 minutes	Yes