CEUS Evaluation of Hypoxic Ischemic Injury
|ClinicalTrials.gov Identifier: NCT03549520|
Recruitment Status : Not yet recruiting
First Posted : June 8, 2018
Last Update Posted : November 1, 2018
|Condition or disease||Intervention/treatment||Phase|
|Hypoxic-Ischemic Encephalopathy Brain Ischemia Hypoxia||Drug: Sulfur hexafluoride lipid-type A microspheres||Phase 3|
There is already good evidence in the literature that CEUS may be very valuable in children, and that is why it is routinely performed off-label for this purpose in the USA. However, there are ways in which it could be improved, and more studies are needed to definitively establish its diagnostic performance. Hence, this is why we wish to perform this study.
All participants in this research study will have already scheduled standard of care brain ultrasound exam. The CEUS portion will immediately follow the standard of care brain ultrasound exam. The results of the CEUS will be reported as usual in the radiology report. The patient will be billed as per their standard clinical care (i.e. no additional costs associated with the research procedure).
A consent form signed by the patient's parents and/or legal guardian will be required to indicate agreement to participate in the study. Each parent and/or legal guardian of participant who agrees to participate will be asked to extend his/her already scheduled brain ultrasound exam by approximately 40 minutes, 10 minutes for the contrast ultrasound examination and 30 minutes for post examination monitoring of potential adverse events. Note that all CEUS exams will be performed at bedside in the neonatal and pediatric intensive care units. No transport will be needed for the post scanning monitoring period. All the rapid response equipment and resuscitation staff are readily available 24/7 in the intensive care unit setting. All participants will have an existing IV line as they are in the intensive care unit setting.
For each patient subject, the clinically indicated portion of the ultrasound examination will always be performed prior to the research portion of examination. For neonates/infants undergoing hypothermia therapy, CEUS scan will be performed initially after the rewarming period and again one week following the first CEUS scan. It is part of standard of care to obtain initial and follow up brain US for screening and monitoring of suspected hypoxic ischemic injury. For neonates/infants not undergoing hypothermia therapy, first CEUS scan will be performed at the time of injury and one week following injury. Patient charts will be reviewed for history and diagnosis.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||50 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Improved Diagnosis and Prognostication of Hypoxic Ischemic Injury in Neonates and Infants Using Contrast-Enhanced Ultrasound|
|Estimated Study Start Date :||December 2018|
|Estimated Primary Completion Date :||July 2019|
|Estimated Study Completion Date :||July 2020|
Experimental: Contrast-enhanced Ultrasonography
Intravenous administration of contrast agent Sulfur hexafluoride lipid-type A microspheres before performing contrast-enhanced ultrasound (CEUS). In pediatric patients, after reconstitution 0.03 mL per kg is administered intravenously. The weight-based dose of 0.03 mL per kg may be repeated one time during a single examination. Following each injection, an intravenous flush of 0.9% Sodium Chloride is injected. The study duration per subject will be approximately 15 minutes including the time to prepare the contrast agent and perform the CEUS, as well as the 30 minute monitoring period after the first and second injection (if there are two injections of contrast) of the contrast agent.
Drug: Sulfur hexafluoride lipid-type A microspheres
Injection of Sulfur hexafluoride lipid-type A microspheres (Lumason) contrast agent will be performed via the existing peripheral intravenous line using the FDA-recommended dose of 0.03 mg/kg.
- Qualitative and quantitative assessment of CEUS evaluation of brain perfusion [ Time Frame: 2 years ]Specific analysis plan consists of both qualitative and quantitative assessment in which description of focal perfusion deficit or lesion, for instance, is reported in correlation with clinical information. Perfusion abnormalities will be qualitatively evaluated (absent - 0, mild hypoperfusion - 1, normal - 2, hyperperfusion - 3) and quantitatively (region of interest placed on brain regions for acquisition of wash-in curves using Matlab software).
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03549520
|United States, Pennsylvania|
|The Children's Hospital of Philadelphia||Recruiting|
|Philadelphia, Pennsylvania, United States, 19104|
|Contact: Misun Hwang, MD 267-425-7110 email@example.com|
|Contact: Sandra Saade, MD 2674257139 firstname.lastname@example.org|
|Principal Investigator: Misun Hwang, MD|