Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT05930691 |
Other study ID # |
2023/4253 |
Secondary ID |
|
Status |
Completed |
Phase |
|
First received |
|
Last updated |
|
Start date |
May 15, 2023 |
Est. completion date |
June 21, 2023 |
Study information
Verified date |
July 2023 |
Source |
Konya City Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
Mortality rates for newborns with congenital heart disease (CHD) have dramatically decreased
thanks to surgical methods and medical treatment improvements. Up to 70% of patients may have
post- Extracorporeal life support (ECLS) cerebral dysfunction, which can result in long-term
cognitive and motor impairment, first showing as brain edema and higher intracranial pressure
(ICP). Optic Nerve Sheath Diameter (ONSD) is a non-invasive method of measuring Intracranial
Pressure (ICP). The Primary Aim of this study is to identify the correlation between ONSD and
ECLS time in newborns who get ECLS.
Description:
INTRODUCTION Mortality rates for newborns with congenital heart disease (CHD) have
dramatically decreased thanks to surgical methods and medical treatment improvements. As a
result, more emphasis is being put on reducing neonatal cardiac surgery morbidity.
Extracorporeal life support (ECLS) is increasingly being given to children, particularly for
cardiac causes, according to the Pediatric Extracorporeal Life Support Organization
Registry's global report. However, up to 70% of patients may have post-ECLS cerebral
dysfunction, which can result in long-term cognitive and motor impairment, first showing as
brain edema and higher intracranial pressure (ICP). In addition, pediatric patients may have
trouble being diagnosed with acute elevations in IİCP since the signs and symptoms are
sometimes unclear.
The gold standard for measuring intracranial pressure (ICP) still involves invasive
intracranial devices. In addition, ICP monitors have the potential to cause complications,
including bleeding in 1.1-5.8% of cases, malfunction, in 6.3-40% of cases, or infection in
0-15% of cases, with a noticeable higher risk of bacterial colonization after five days.
The optic nerve sheath surrounds the Optic Nerve (ON) and covers the optic subarachnoid
space, which is connected to the intracranial subarachnoid space area. Changes in
intracranial pressure are thus straightly transferred to the optic nerve sheath. Therefore,
Optic Nerve Sheath Diameter (ONSD) is a non-invasive method of measuring Intracranial
Pressure (ICP).
Longer ECLS periods and aortic cross-clamp times have been linked to more frequent CT
detection of cerebral edema, according to prior investigationsAccording to prior
investigations, long ECLS periods, and aortic cross-clamp times have been linked to more
frequent CT (computer tomography) detection of cerebral edema. However, there is currently no
information on the relationship between these time points and the ONSD determined by
ultrasound.
The Primary Aim of this study was to identify the correlation between ONSD and ECLS time in
newborns who get ECLS. Specifically, we tested the primary hypothesis that more ECLS time
means more ONSD valuable over the perioperative period. Our secondary aim was to investigate
the relationship between ONSD and aortic cross-clamp time and operation time and also,
operation time and preoperative and intraoperative perioperative ONSD variation for the ECLS
period.