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CTRI Number  CTRI/2018/03/012360 [Registered on: 06/03/2018] Trial Registered Retrospectively
Last Modified On: 23/05/2012
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Medical Device 
Study Design  Single Arm Study 
Public Title of Study   Development and evaluation of a breathing system to maintain carbondioxide level in the body for radiological investigation 
Scientific Title of Study   Development and evaluation of a MRI compatible non- rebreathing sequential gas delivery circuit to maintain constant end tidal Carbon dioxide (ETCO2), to be used for Cerebro Vascular Reactivity (CVR) assessment using fMRI and allied techniques.  
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr P Gayatri 
Designation  Additional Professor, Anesthesia 
Affiliation  Sree Chitra Tirunal Institute for Medical Sciences and Technology 
Address  Room 3110, 1st Floor,Dept of anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum.
Same as above
Thiruvananthapuram
KERALA
695011
India 
Phone    
Fax    
Email  gayat@sctimst.ac.in  
 
Details of Contact Person
Scientific Query
 
Name  Dr Bejoy Thomas 
Designation  Additional Professor, IS & IR 
Affiliation  Sree Chitra Tirunal Institute for Medical Sciences and Technology 
Address  Room 3112, 1st Floor,Dept of Imaging sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum.
Same as above
Thiruvananthapuram
KERALA
695011
India 
Phone    
Fax    
Email  bejoy@sctimst.ac.in  
 
Details of Contact Person
Public Query
 
Name  Dr P Gayatri 
Designation  Additional Professor, Anesthesia 
Affiliation  Sree Chitra Tirunal Institute for Medical Sciences and Technology 
Address  Room 3110, 1st Floor,Dept of anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum.
Same as above
Thiruvananthapuram
KERALA
695011
India 
Phone    
Fax    
Email  gayat@sctimst.ac.in  
 
Source of Monetary or Material Support  
Institute Internal Funding, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, India 
 
Primary Sponsor  
Name  SCTIMST 
Address  Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr P Gayatri  SCTIMST  Room 3112, 1St floor, Anesthesiology department, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum
Thiruvananthapuram
KERALA 
09388012974

gayat@sctimst.ac.in 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethics Committee, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Healthy Human Volunteers  healthy volunteers with no cardiac or respiratory or neurological co morbidities 
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Sequential gas delivery circuit  10% carbondioxide is introduced after the baseline values are obtained. The change in carbondioxide level after breathing 10% carbondioxide is compared with the baseline value. The same person acts as both intervention and comparator. 
Intervention  Sequential gas delivery circuit  Apply on the face and breath normally. A set of baseline carbondioxide value is obtained. 
 
Inclusion Criteria  
Age From  20.00 Year(s)
Age To  50.00 Year(s)
Gender  Both 
Details  Healthy adult humans in 20-50 years of age 
 
ExclusionCriteria 
Details  Exclusion: Smokers, persons with cardiovascular and respiratory illness such as COPD, asthma, valvular and ischemic heart disease
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
Sustained rise in end tidal carbondioxide for the desired duration   after introduction of reserve gas flow 
 
Secondary Outcome  
Outcome  TimePoints 
Rise in arterial carbondioxide.  At the same time as the rise in endtidal carbondioxide 
 
Target Sample Size   Total Sample Size="15"
Sample Size from India="15" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   25/04/2012 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="2"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details    
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary  

The circuit will be tested first outside the MR environment and later in the MRI suite.

 

Healthy volunteers will be connected to peripheral oxygen saturation monitor and ETCO2 monitor. The ETCO2 will be continuously monitored from a sample at the nose. The baseline blood pressure will be obtained and then at 5 minute intervals.

 

The volunteers will breathe a fresh gas flow (FGF) consisting of oxygen and air with this SGD through a mouth piece and a well fitting face mask.

 

The FGF of oxygen in air through the unidirectional valve will be adjusted in such a way that the reservoir bag collapses at the end of each inspiration. This will be noted as the minute ventilation. The fresh gas flow will be further reduced and ETCO2 will be noted. The FGF at which the ETCO2 rises will be noted as the alveolar ventilation.

 

The inspired CO2 will be altered and ETCO2 will be observed. The optimum FGF required to maintain a constant ETCO2 will be assessed. Further to find out if this ETCO2 correlates with the PaCO2, arterial blood gas will be analysed in the first five volunteers.  

 

Once standardisation of the circuit is completed, fMRI study to test CVR will be performed using the device in the next ten volunteers. Standard EPI fMRI sequences will be adapted for the CVR study and the data analysis methods for CVR will also be developed. 

 

For the Cerebro- Vascular Reactivity (CVR) study, we need to vary the Pa CO2 level from approximately 35 to 50 mm of Hg in short cycles of 1-2 minutes for a total of 6 cycles. Planning to study such 2 runs, for each volunteer. The total time for MRI study would be approximately 30-40 minutes including anatomic scans.

               

There is no risk to the volunteer from breathing 10% carbondioxide (CO2). Carbondioxide has been used safely in many studies previously without any adverse effects from its use in concentrations as high as 40% (1).

 

Carbondioxide is a physiological gas.The maximum level of inspired carbondioxide during the study period will be kept well within physiological levels of CO2 (2). We will make sure the inspiratory carbon dioxide level will not exceed 7 %. Therefore the maximum carbon dioxide level that will be obtained in the body will be 50 mm Hg. The inspiratory carbondioxide level will be continuously monitored and adjusted. In the rare event that the subject should breathe 10% carbon dioxide, which is the maximum level of inspiratory carbon dioxide possible from this circuit, it would still result in 68 mm Hg carbon dioxide in the blood, which is the level of permissive hypercapnia (3), i.e. the maximum allowable level of carbon dioxide in the body during disease states such as acute respiratory distress syndrome.

 

For the Cerebro- Vascular Reactivity (CVR) study, we need to vary the Pa CO2 level from approximately 35 to 50 mm of Hg in short cycles of 1-2 minutes for a total of 6 cycles. Planning to study such 2 runs, for each volunteer. The total time for MRI study would be approximately 30-40 minutes including anatomic scans.

The carbon dioxide level in the cylinder will be tested before being used on the first volunteer.

 

The oxygen levels could go down during the study if there is any malfunction of the parts of the circuit for eg. Sticky valves which can lead to hypoxemia.

 

fMRI is a safe study in normal healthy volunteers with no contraindications for MR imaging.

 
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