Clinical Trial: Study of New Catheter & Pressure Monitor System to Help Prevent Compartment Syndrome From Developing in the Injured Leg

Study Status: Active, not recruiting
Recruit Status: Unknown status
Study Type: Interventional

Official Title: Randomized Clinical Trial of Tissue Ultrafiltration and Pressure Monitoring for the Diagnosis and Prevention of Compartment Syndrome

Brief Summary: An investigation of a new catheter and pressure monitor system that may help to prevent a complication called compartment syndrome from developing in an injured leg. Compartment syndrome occurs when too much fluid builds up in the muscles of the injured leg. This causes a lot of swelling and increases pressures within the leg that can cause permanent damage muscles and nerves in the leg.

Detailed Summary:

Compartment Syndrome (CS) may occur in patients with a fracture or crushing injury to an extremity. The current standard-of-care for patients at risk of developing CS is clinical by watching for signs and symptoms of CS, and if needed, measuring the pressure within the muscle compartment (intramuscular pressure, IMP). Currently, IMP measurements are made by placing a percutaneous pressure sensor into the targeted muscle compartment, which is then attached to a pressure monitor. Whenever the clinical exam and/or pressure measurements suggest that CS is developing, fasciotomy is generally performed immediately.

Twin Star Medical has developed a novel Compartment Monitoring System (CMS) that consists of a pressure monitoring module and two types of catheters. Both Twin Star Catheters remove interstitial tissue fluid, which may contribute to a reduction in compartment pressure, and which may be used for clinical analysis to determine if certain analyte indicators of muscle injury (biomarkers) can be predictive of CS development. One type of catheter Pressure Measurement/Fluid Collection, (PMFC), removes fluid and monitors pressure via a solid-state fiber optic transducer at the tip of the catheter. The other type of catheter, Fluid Collection (FC), only removes fluid and does not have a pressure transducer at the tip. The monitoring module senses, displays and records pressure as measured by the PMFC catheter as well as provides a vacuum source, which is required for the operation of the fluid removal catheter. The Twin Star CMS Monitoring Module has been successfully tested to (1) ensure the delivery of the specified functional performance requirements needed to reliably operate the Twin Star Catheter, and (2) meet current electrical safety standards established for clinical use. The first model of the Twin Star catheter and monitor was reviewed and approved by the Food and
Sponsor: Twin Star Medical, Inc.

Current Primary Outcome: To determine if use of Twin Star catheter with active fluid removal reduces muscle compartment pressure vs Twin Star catheter without fluid removal by comparing the randomized groups. Success will be defined by a p-value less than 0.05 (two-sided). [ Time Frame: fluid removal will be collected & recorded at 2, 4, 8, 16, & 24 hrs after catether insertion. ]

Original Primary Outcome: Same as current

Current Secondary Outcome: Compares the treatment and control groups on change in perfusion pressure (defined as diastolic blood pressure minus IMP) over time. The randomized groups will be compared with a two-sided p-value less than 0.05 defining success. [ Time Frame: Perfusion pressure will be collected and recorded at 2, 4, 8, 16 & 24 hrs post-catheter insertion ]

Original Secondary Outcome: Same as current

Information By: Twin Star Medical, Inc.

Dates:
Date Received: May 19, 2008
Date Started: January 2009
Date Completion: December 2010
Last Updated: March 3, 2009
Last Verified: February 2009