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Nonin 4 Wavelength Cerebral Oximeter Study (Nonin4)

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ClinicalTrials.gov Identifier: NCT01762722
Recruitment Status : Completed
First Posted : January 8, 2013
Results First Posted : April 16, 2013
Last Update Posted : April 16, 2013
Sponsor:
Collaborator:
Nonin Medical, Inc
Information provided by (Responsible Party):
David MacLeod, Duke University

Study Description
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Brief Summary:
A cerebral oximeter is a device that uses light to measure the amount of oxygen within the brain. It is similar to the device that measures the level of oxygen in the tip of the finger, known as a pulse oximeter. The cerebral oximeter consists of a sensor placed on the forehead that both emits and detects the amount of light absorbed. This study will determine how accurate the device is by comparing the displayed value on the monitor with blood samples taken simultaneously from the arterial blood in the wrist and venous blood in the neck. In order to test the device over a suitable range, the level of oxygen within the blood will be reduced in a controlled manner by reduction of the inspired oxygen concentration. This is the equivalent of ascending to an altitude of 16,000 feet. The study will be conducted in healthy volunteers.

Condition or disease Intervention/treatment Phase
Healthy Device: Reduction of inspired oxygen Not Applicable

Detailed Description:

This is a calibration and validation study of a near-infrared spectroscopy (NIRS) device designed to measure the cerebral tissue oxygen saturation non-invasively. This is achieved by comparing NIRS-derived cerebral tissue oxygen saturation with a calculated value derived from simultaneous arterial and jugular venous blood samples.

At present the FDA have adopted the standards published in 2005 by the International Organization for Standardization (ISO), entitled ISO 9919. This is a set of technical specifications and guidelines for pulse oximeters, which share certain technical similarities to cerebral oximeters. In particular, Annex EE details the conduct of a controlled desaturation study for the calibration of pulse oximeter equipment. Specifically, the fraction of inspired oxygen delivered to test subjects is varied to achieve a series of targeted steady state saturation periods over a range of arterial oxygen saturation of 70 - 100%.

While cerebral oximeters differ from pulse oximeters in terms of the what is being measured (brain tissue v arterial blood) the FDA have maintained the requirement to examine data from human volunteer studies in which the arterial oxygen saturation ranges from 70 - 100%. Two FDA-approved cerebral oximeters were validated in a similar manner.

The device controlling the inspired gas concentration is the RespirAct, which permits precise reduction in the arterial oxygen saturation while maintaining the arterial carbon dioxide level at 40 mmHg.

The study consists of 3 sequences:

  • First sequence: reduction in arterial oxygen saturation in approximately 5% increments from 100 to 70% followed by return to room air and then a period of supplemental oxygen.
  • Second sequence: reduction in arterial oxygen saturation in a single drop from 100 to 70% followed by return to room air and then a period of supplemental oxygen.
  • Third sequence: reduction in arterial oxygen saturation in approximately 10% increments from 100 to 70% with alteration of carbon dioxide level from 35 to 45 mmHg at each interval followed by return to room air.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 23 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Calibration and Validation of the 4 Wavelength Nonin Non-invasive Cerebral Oxygen Saturation Oximeter and Cerebral Sensor
Study Start Date : September 2009
Actual Primary Completion Date : June 2010
Actual Study Completion Date : April 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Oxygen Therapy

Arms and Interventions
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Arm Intervention/treatment
Experimental: Desaturation
Human volunteers undergo oxygen desaturation in order to determine the accuracy of the device over a clinical range of oxygen saturations 70 - 100%.
 Device: Reduction of inspired oxygen
Reduction in blood oxygen saturation by sequential reduction in inspired gas composition. Steps are of 6 minutes duration with reduction in pulse oximeter oxygen saturation from 100 to 70%.
Other Name: Nonin Equanox cerebral oximeter


Outcome Measures
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Primary Outcome Measures :
  1. Accuracy of Sensor [ Time Frame: Data collected from individual participants over 1 hour timeframe. Data from cohort of subjects collected over 6 month period. ]
    A scatterplot is created with the forehead sensor saturation on the y-axis and the measured blood saturation on the x-axis. The line of identity is drawn representing the ideal points, meaning that the forehead sensor saturation is always the same as the blood saturation. The dispersion of the actual data points around this line of identity can be measured using a statistical calculation called Arithmetic Root Mean Square or ARMS. The smaller the ARMS the closer the data points lie around the line of identity, representing a more accurate sensor.


Eligibility Criteria
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Ages Eligible for Study:   21 Years to 35 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • 21 to 35 years of age
  • American Society of Anesthesiologists health assessment level 1
  • Body Mass Index (BMI) 18 to 30

Exclusion Criteria:

  • anemia
  • hemoglobinopathy (e.g. sickle cell disease, thalassemia)
  • positive pregnancy test (females)
  • significant cardiac or pulmonary disease
  • history of sleep apnea
  • tobacco, drug or alcohol abuse
  • difficult airway
  • abnormal EKG / pulmonary function test / room air saturation
  • intolerance to breathing mask apparatus
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01762722


Locations
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United States, North Carolina
Duke University Health System
Durham, North Carolina, United States, 27710
Sponsors and Collaborators
Duke University
Nonin Medical, Inc
Investigators
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Principal Investigator: David B MacLeod, FRCA Duke Health
More Information
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Publications of Results:

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Responsible Party: David MacLeod, Assistant Clinical professor, Duke University
ClinicalTrials.gov Identifier: NCT01762722    
Other Study ID Numbers: Pro00018006
First Posted: January 8, 2013    Key Record Dates
Results First Posted: April 16, 2013
Last Update Posted: April 16, 2013
Last Verified: March 2013
Keywords provided by David MacLeod, Duke University:
Spectroscopy, near infrared
Oximetry
Hypoxemia
Tissue oxygenation