Tissue Oxygen Deprivation as Detected With Raman in Association With Umbilical Artery Catheters

NCT04038203 | Withdrawn DMC

• 2 other identifiers: IRB201900739OCR25462
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Umbilical artery catheters (UACs) are associated with significant morbidity in preterm neonates however are necessary for the management of this high risk population. UACs have been linked to serious adverse events (SAEs) including arterial thrombosis, necrotizing enterocolitis, limb ischemia, and renal failure. Resonance Raman Spectroscopy (RRS), raman for short, is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues. In this prospective, observational study, daily measurements of StO2 of low birth weight neonates using raman spectroscopy will be correlated with UACs.The study team hypothesizes that raman can detect changes in peripheral tissue oxygenation in the ipsilateral extremity to the UAC and that raman is more sensitive at detecting changes in peripheral tissue oxygenation then common metrics used to monitor neonatal hemodynamics. If successful, this study would demonstrate that raman can be used as an early marker of tissue oxygen deprivation in neonates with UACs and maybe used to guide management in other clinical scenarios where StO2 is affected.

Conditions

Tissue Oxygenation

Keywords

neonates; low birth weight; spectroscopy; Umbilical Artery Catheter (UAC)

Outcome Measures

Primary Outcomes (1)

• Number of participants with a Significant Adverse Event (SAEs)

  SAEs will be a composite of any of the following: lower extremity ischemia, Acute Kidney Injury (AKI), Neo natal Necrotizing Enterocolitis (NEC) or death abstracted from the medical record and/or bedside nurse interview, if necessary.

  Week 1

Study Arms (1)

Neonates with UAC placement

Neonates with birth weight less than 1500 grams with UAC placed on admission. Raman measurements will be obtained simultaneously on the right AND left lower extremity for 15 minutes daily in the first week of life.

Device: Resonance Raman Spectroscopy (RPS)

Interventions

Resonance Raman Spectroscopy (RPS) DEVICE

RRS is a technology that utilizes vibrational spectroscopy, rather than absorbance spectroscopy, to determine the oxyhemoglobin concentration in tissues. Raman measurements for the UAC neonates will be obtained simultaneously on the right AND left lower extremity for 15 minutes daily in the first week of life.

Also known as: Raman

Neonates with UAC placement

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Neonates with birth weight less than 1500 grams, admitted to the University of Florida neonatal intensive care unit (NICU), with UAC placed on admission.

You may qualify if:

• Birth weight less than 1500 grams.
• Admitted to the NICU.
• UAC placed on admission.
• Admitted to the labor and delivery or antenatal floors with reasonable chance of delivery of a neonate weighing less than 1500 grams as determined by the obstetrics team.

You may not qualify if:

• \. Neonates with congenital heart defects or major congenital anomalies such as known or suspected inborn errors of metabolism, ambiguous genitalia, neural tube defects, malignancy, abdominal wall defects, airway defects and chromosomal anomalies.
• Mother is pregnant with fetus with congenital heart defect or major congenital anomaly as described above.

Sponsors & Collaborators

• University of Florida: lead

Study Sites (1)

UF Health Children's Hospital

Gainesville, Florida, 32608, United States

Location

Related Publications (11)

• Shahid S, Dutta S, Symington A, Shivananda S; McMaster University NICU. Standardizing umbilical catheter usage in preterm infants. Pediatrics. 2014 Jun;133(6):e1742-52. doi: 10.1542/peds.2013-1373. Epub 2014 May 19.

  PMID: 24843063 BACKGROUND

• Elboraee MS, Toye J, Ye XY, Shah PS, Aziz K; Canadian Neonatal Network Investigators. Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants. Am J Perinatol. 2018 Feb;35(3):233-241. doi: 10.1055/s-0037-1606607. Epub 2017 Sep 14.

  PMID: 28910847 BACKGROUND

• McAdams RM, Winter VT, McCurnin DC, Coalson JJ. Complications of umbilical artery catheterization in a model of extreme prematurity. J Perinatol. 2009 Oct;29(10):685-92. doi: 10.1038/jp.2009.73. Epub 2009 Jun 25.

  PMID: 19554012 BACKGROUND

• Huxtable RF, Proctor KG, Beran AV. Effect of umbilical artery catheters on blood flow and oxygen supply to extremities. Pediatr Res. 1976 Jul;10(7):656-60. doi: 10.1203/00006450-197607000-00005.

  PMID: 934731 BACKGROUND

• Iyengar A, Gaillardetz A, Tighiouart H, Castillo B, Romfh P, Davis JM. Direct Measurement of Tissue Oxygenation in Neonates via Resonance Raman Spectroscopy: A Pilot Study. Neonatology. 2017;112(2):137-142. doi: 10.1159/000458514. Epub 2017 May 18.

  PMID: 28514777 BACKGROUND

• Lin SJ, Koltz PF, Davis W, Vicari F. Lower extremity ischemia following umbilical artery catheterization: a case study and clinical update. Int J Surg. 2009 Jun;7(3):182-6. doi: 10.1016/j.ijsu.2008.12.038. Epub 2008 Dec 25.

  PMID: 19349222 BACKGROUND

• Ward KR, Barbee RW, Reynolds PS, Torres Filho IP, Tiba MH, Torres L, Pittman RN, Terner J. Oxygenation monitoring of tissue vasculature by resonance Raman spectroscopy. Anal Chem. 2007 Feb 15;79(4):1514-8. doi: 10.1021/ac061072x.

  PMID: 17297949 BACKGROUND

• Robert B. Resonance Raman spectroscopy. Photosynth Res. 2009 Aug-Sep;101(2-3):147-55. doi: 10.1007/s11120-009-9440-4. Epub 2009 Jul 1.

  PMID: 19568956 BACKGROUND

• Spiro TG. Resonance Raman spectroscopy as a probe of heme protein structure and dynamics. Adv Protein Chem. 1985;37:111-59. doi: 10.1016/s0065-3233(08)60064-9.

  PMID: 2998161 BACKGROUND

• Gay AN, Lazar DA, Stoll B, Naik-Mathuria B, Mushin OP, Rodriguez MA, Burrin DG, Olutoye OO. Near-infrared spectroscopy measurement of abdominal tissue oxygenation is a useful indicator of intestinal blood flow and necrotizing enterocolitis in premature piglets. J Pediatr Surg. 2011 Jun;46(6):1034-40. doi: 10.1016/j.jpedsurg.2011.03.025.

  PMID: 21683194 BACKGROUND

• Gordon PV, Swanson JR, Attridge JT, Clark R. Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria? J Perinatol. 2007 Nov;27(11):661-71. doi: 10.1038/sj.jp.7211782. Epub 2007 Jul 5.

  PMID: 17611610 BACKGROUND

Study Officials

• Lauren Ruoss, MD

  University of Florida

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 26, 2019
• First Posted: July 30, 2019
• Study Start: December 1, 2023
• Primary Completion: April 1, 2024
• Study Completion: April 1, 2024
• Last Updated: January 12, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)