Goal-directed Fluid Therapy during deep inferior epigastric perforator (DIEP) free flap breast reconstruction – a randomized controlled trial

2023-506152-24-00 Therapeutic use (Phase IV) Ongoing, recruiting

Start 28 Nov 2023 · Status Ongoing, recruiting · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 82
Countries 1
Sites 1

Arterial hypotension during deep inferior epigastric perforator (DIEP) free flap breast reconstruction

To investigate the effect of a goal-directed fluid management during DIEP free flap breast reconstruction on perioperative fluid administration

Key facts

Sponsor
Az Maria Middelares Gent
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Female
Therapeutic area
Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03]
Trial duration
28 Nov 2023 → ongoing
Decision date (initial)
2023-09-22
Transition trial
No
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy

To investigate the effect of a goal-directed fluid management during DIEP free flap breast reconstruction on perioperative fluid administration

Secondary objectives 1

  1. The expected fluid restriction may lead to a reduction in postoperative tissue oedema and better flap perfusion as measured by NIRS

Conditions and MedDRA coding

Arterial hypotension during deep inferior epigastric perforator (DIEP) free flap breast reconstruction

VersionLevelCodeTermSystem organ class
21.1 LLT 10066331 Arterial hypotension 10047065
23.0 LLT 10050632 Postoperative hypotension 10022117
21.0 LLT 10056679 Intraoperative hypotension 10022117

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 3

  1. Female adult patients, between 18 and 70 years of age
  2. Patients scheduled for DIEP free flap breast reconstruction
  3. Signed written informed consent form

Exclusion criteria 8

  1. present atrial fibrillation (AF)
  2. heart failure New York Heart Association (NYHA) classification 2 or higher
  3. chronic kidney disease (CKD) stage 3B or higher
  4. American Society of Anesthesiologists (ASA) classification III or higher
  5. known allergy to study specific medication
  6. participation in another clinical trial
  7. Patients who are pregnant or breastfeeding
  8. Inability of the patient to understand Dutch sufficiently

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Total intraoperative fluid volume (from anaesthesia induction until completed skin closure)

Secondary endpoints 7

  1. cumulative perioperative fluid volume (intraoperative fluid volume + fluid administered in the intensive care unit (ICU) or post-anaesthesia care unit (PACU))
  2. cumulative intraoperative norepinephrine dose (intraoperative and postoperative norepinephrine dose)
  3. peri- and postoperative blood lactate levels (hourly measurement during surgery, every four hours in the ICU until discharge)
  4. percentage of time SBP was above 100mmHg
  5. postoperative free flap perfusion monitored by NIRS during ICU/ PACU stay
  6. surgical complications (e.g. total or partial flap loss, venous flap congestion, hematoma) assessed at ICU/ PACU discharge and at hospital discharge
  7. ICU/PACU length of stay (LOS) (hours)

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Plasma-Lyte® 148 (pH 7.4) solution for infusion

PRD332654 · Product

Active substance
Magnesium Chloride Hexahydrate
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS INFUSION
Max daily dose
100 millilitre(s)/kilogram
Max total dose
150 millilitre(s)/kilogram
Max treatment duration
2 Day(s)
Authorisation status
Authorised
ATC code
B05BB01 — ELECTROLYTES
Marketing authorisation
PL 00116/0332
MA holder
BAXTER HEALTHCARE LTD.
MA country
XI
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Auxiliary 1

NORADRENALINE (NOREPINEPHRINE) 1 mg / ml Concentrate for solution for infusion

PRD589255 · Product

Active substance
Noradrenaline Tartrate
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS
Max daily dose
288 µg/Kg microgram(s)/kilogram
Max total dose
288 µg/Kg microgram(s)/kilogram
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
C01CA03 — NOREPINEPHRINE
Marketing authorisation
PL 14434/0017
MA holder
LABORATOIRE AGUETTANT
MA country
XI
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Az Maria Middelares Gent

2 Total trials 2 Recruiting
Academic / Non-commercial
Sponsor organisation
Az Maria Middelares Gent
Address
Buitenring-Sint-Denijs 30
City
Gent
Postcode
9000
Country
Belgium

Scientific contact point

Organisation
Az Maria Middelares Gent
Contact name
Ella Hermie

Public contact point

Organisation
Az Maria Middelares Gent
Contact name
Steffi Ryckaert

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Belgium Ongoing, recruiting 82 1
Rest of world 0

Investigational sites

Belgium

1 site · Ongoing, recruiting
Az Maria Middelares Gent
Anaesthesiology, Buitenring-Sint-Denijs 30, 9000, Gent

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Belgium 2023-11-28 2024-02-12

Application history

3 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-06-29 Belgium Acceptable with conditions
2023-09-22
2023-09-22
2 SUBSTANTIAL MODIFICATION SM-1 2023-10-02 Belgium Acceptable
2023-11-18
2023-11-23
3 NON SUBSTANTIAL MODIFICATION NSM-1 2024-01-04 Belgium Acceptable
2023-11-18
2024-01-04