[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"leadSponsorName\":\"Marmara University Pendik Training and Research Hospital\",\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:":415},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,13,0,[8,50,80,111,144,178,214,243,275,305,334,364,388],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":30,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":38,"lastUpdatePostDateStruct":39,"startDateStruct":42,"completionDateStruct":44,"leadSponsor":46,"locationsCount":49},"100651035","effect-of-pneumatic-tube-system-vs-personnel-transport-on-hemolysis-index-in-emergency-department-blood-samples-a-randomized-within-patient-matched-trial-100651035",false,"NCT07755007","Effect of Pneumatic Tube System vs. Personnel Transport on Hemolysis Index in Emergency Department Blood Samples: A Randomized, Within-Patient Matched Trial","Comparison of the Effect of Pneumatic Tube System and Personnel Transport on Hemolysis Index in Blood Samples From the Emergency Department: A Randomized, Within-Patient Matched, Single-Blind, Prospective Study","PTS-HEMO-ED","Inclusion Criteria:\n\n* Adults aged 18 years or older\n* Presenting to the emergency department of Marmara University Pendik Training and Research Hospital\n* Venous blood draw required for routine clinical care needing two or more yellow-cap (serum separator) tubes\n* Written informed consent provided by the participant\n\nExclusion Criteria:\n\n* Known underlying hemolytic disorder (e.g., hemolytic anemia, sickle cell disease, G6PD deficiency, autoimmune hemolytic anemia, or TTP\u002FHUS)\n* Macroscopic hemolysis visible in the sample tube immediately after phlebotomy\n* Age younger than 18 years","ALL","18 Years",{"count":20,"type":21},166,"ESTIMATED","INTERVENTIONAL",[24],"NA","Hemolysis is the most common pre-analytical error in emergency department (ED) laboratory specimens and can lead to false elevation of intracellular analytes (potassium, LDH, AST, hemoglobin), resulting in misdiagnosis and unnecessary testing. Blood samples in the ED are transported to the laboratory either by pneumatic tube systems (PTS) or manually by personnel. Although PTS shortens turnaround time, the forces generated during transport may damage erythrocyte membranes and promote hemolysis. Evidence on whether PTS increases hemolysis compared with personnel transport is inconsistent, partly because existing studies use parallel-group designs that cannot control for between-subject biological variability, and partly because findings differ across PTS brands and configurations. The Sumetzberger Power Control PTS installed at Marmara University Pendik Training and Research Hospital (speed 4-5 m\u002Fs, 120 m, cushioned capsule) has not been prospectively validated for hemolysis risk. This study uses a randomized, within-patient matched, single-blind design in which two simultaneously drawn yellow-cap tubes from the same patient are randomly allocated-one to PTS and one to personnel transport-thereby eliminating between-patient variability. The primary outcome is the Hemolysis Index (HI) category (ordinal scale 0-5 corresponding to free hemoglobin thresholds of \\\u003C50, 50-99, 100-199, 200-299, 300-500, and \\>500 mg\u002FdL). Secondary outcomes include the rate of clinically significant hemolysis (HI ≥ 1 \u002F free Hb ≥ 50 mg\u002FdL) and the correlation between transport time and HI.",[27,28,29],"Hemolysis","Diagnostic Errors","Blood Specimen Collection",[31,32,33,34,35,36],"Pneumatic Tube System","Blood Specimen Transport","Hemolysis Index","Emergency Service, Hospital","Pre-Analytical Variability","Sumetzberger","NOT_YET_RECRUITING","2026-08-05",{"date":40,"type":41},"2026-08-10","ACTUAL",{"date":43,"type":21},"2026-08",{"date":45,"type":21},"2027-01",{"name":47,"class":48},"Marmara University Pendik Training and Research Hospital","OTHER",1,{"id":51,"slug":52,"hasResults":11,"nctId":53,"briefTitle":54,"officialTitle":55,"acronym":4,"eligibilityCriteria":56,"healthyVolunteers":57,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":58,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":61,"conditions":62,"keywords":67,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":72,"lastUpdatePostDateStruct":73,"startDateStruct":75,"completionDateStruct":77,"leadSponsor":79,"locationsCount":49},"100650171","tci-versus-manual-tiva-for-sedation-during-prone-kyphoplasty-effects-on-respiration-recovery-and-eeg-100650171","NCT07745348","TCI Versus Manual TIVA for Sedation During Prone Kyphoplasty: Effects on Respiration, Recovery, and EEG","Investigation of the Effects of Target-Controlled Infusion (TCI) Anesthesia on Respiration, Recovery, and Electroencephalogram in Patients Undergoing Kyphoplasty in the Prone Position","Inclusion Criteria:\n\n\\- Age 18 years and older\n\n* ASA physical status classification I-III\n* Scheduled for kyphoplasty under sedation in the prone position\n* Provision of written informed consent\n\nExclusion Criteria:\n\n* Known allergy to any of the study medications\n\n  * ASA physical status classification IV or higher\n  * Patients deemed unsuitable for sedation (high pulmonary risk, morbid obesity, diagnosed severe obstructive sleep apnea)\n  * Refusal to participate or withdrawal of consent\n  * Diagnosis of dementia or Alzheimer's disease\n  * Communication difficulties precluding adequate assessment",true,{"count":59,"type":21},50,"OBSERVATIONAL","This single-center, prospective, observational study compares target-controlled infusion (TCI) versus manually administered total intravenous anesthesia (TIVA) for sedation in patients undergoing kyphoplasty in the prone position. The primary endpoints are the incidence of hypoxic episodes (SpO₂ \\\u003C 90%) and apneic attacks. Secondary endpoints include anesthesia quality scores, integrated pulmonary index (IPI) values, total propofol consumption, time to eye opening, time to full orientation, Modified Aldrete Scores and Richmond Agitation-Sedation Scale (RASS) scores in the recovery unit, and patient and surgeon satisfaction.",[63,64,65,66],"Kyphoplasty","Prone Position","Target Controlled Infusion of Propofol","End Tidal Carbon Dioxide",[68,69,70,71],"target controlled infusion","kyphoplasty","sedation","non-invasive etco2","2026-08-03",{"date":74,"type":41},"2026-08-04",{"date":76,"type":21},"2026-07-10",{"date":78,"type":21},"2027-08-10",{"name":47,"class":48},{"id":81,"slug":82,"hasResults":11,"nctId":83,"briefTitle":84,"officialTitle":85,"acronym":86,"eligibilityCriteria":87,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":88,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":90,"conditions":91,"keywords":95,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":104,"lastUpdatePostDateStruct":105,"startDateStruct":106,"completionDateStruct":108,"leadSponsor":110,"locationsCount":4},"100646078","large-language-models-versus-anesthesiologists-for-asa-physical-status-classification-100646078","NCT07696221","Large Language Models Versus Anesthesiologists for ASA Physical Status Classification","Comparison of Clinical Assessment and Large Language Models in Preoperative Risk Classification: A Retrospective Analysis of ChatGPT, DeepSeek, Gemini, and Claude in ASA Physical Status Classification","ASA-LLM","Inclusion Criteria:\n\n* Age 18 years or older\n* Planned elective surgery\n* Completed preoperative anesthesia evaluation\n\nExclusion Criteria:\n\n* Emergency surgical procedures\n* ASA VI (brain death)\n* Incomplete clinical records",{"count":89,"type":21},350,"The American Society of Anesthesiologists Physical Status (ASA-PS) classification is a cornerstone of preoperative risk assessment, yet interrater variability among clinicians is well documented. Large language models (LLMs) have recently demonstrated expert-level performance in several clinical classification tasks, including ASA-PS assignment.\n\nThis retrospective observational study evaluates whether four widely used LLMs - ChatGPT, DeepSeek, Gemini, and Claude - can accurately and consistently assign ASA-PS classes from structured, fully anonymized clinical vignettes derived from real preoperative anesthesia evaluations, using a consensus of senior anesthesiologists as the reference standard.\n\nNo patient data will be transmitted to third-party platforms. Clinical information will be converted by the investigators into de-identified structured vignettes containing only age range, sex, body mass index range, presence or absence of systemic diseases, functional capacity, and the major\u002Fminor nature of the planned surgery, in full compliance with national data protection legislation (KVKK).",[92,93,94],"Anesthesia","Preoperative Risk Prediction","Preoperative Risk Assessment",[96,97,98,99,100,101,102,103],"asa physical status","large language models","artificial intelligence","chatgpt","gemini","deepseek","Claude","risk classification","2026-07-06",{"date":76,"type":41},{"date":107,"type":21},"2026-07-21",{"date":109,"type":21},"2026-10-21",{"name":47,"class":48},{"id":112,"slug":113,"hasResults":11,"nctId":114,"briefTitle":115,"officialTitle":116,"acronym":117,"eligibilityCriteria":118,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":119,"enrollmentInfo":120,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":122,"conditions":123,"keywords":130,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":136,"lastUpdatePostDateStruct":137,"startDateStruct":139,"completionDateStruct":141,"leadSponsor":143,"locationsCount":4},"100646727","effect-of-obesity-phenotype-on-intraabdominal-pressure-and-bleeding-in-major-lumbar-spinal-surgery-100646727","NCT07688265","Effect of Obesity Phenotype on Intraabdominal Pressure and Bleeding in Major Lumbar Spinal Surgery","Effect of Obesity Phenotype on Intraabdominal Pressure, Intraoperative Bleeding, and Perioperative Complications in Patients Undergoing Major Lumbar Spinal Surgery: A Prospective Observational Study","OBESPINE","Inclusion Criteria:\n\n* Age 18-80 years\n* ASA Physical Status Classification I-III\n* Scheduled for elective major lumbar spinal surgery (canal stenosis decompression and\u002For instrumented fusion)\n* No prior lumbar spinal surgery\n* Written informed consent obtained\n\nExclusion Criteria:\n\n* \\- Pediatric patients (\\\u003C18 years)\n* Pregnancy\n* Emergency surgical procedures\n* Pre-existing renal failure\n* Coagulation disorder\n* Pre-existing anemia\n* Known drug allergy relevant to study medications\n* Inability to obtain written informed consent","80 Years",{"count":121,"type":21},90,"Obesity is prevalent among patients with lumbar degenerative disease and is a known risk factor for perioperative complications in spinal surgery. However, most existing evidence relies solely on body mass index (BMI) without distinguishing between central and peripheral obesity phenotypes. Central and peripheral fat distribution may have distinct biomechanical and hemodynamic consequences, particularly with respect to intraabdominal pressure (IAP) changes during prone positioning and intraoperative blood loss.\n\nThis prospective single-center observational study aims to evaluate the effect of obesity phenotype - classified as non-obese, centrally obese, or peripherally obese based on BMI and waist-to-hip ratio - on intraabdominal pressure, intraoperative blood loss, and other perioperative outcomes in adult patients undergoing major lumbar spinal surgery (decompression and\u002For instrumentation)",[124,125,126,127,128,129],"Lumbar Spinal Stenosis","Lumbar Degenerative Disease","Obesity","Intraabdominal Hypertension","Intraoperative Blood Loss","Perioperative Complications",[131,132,133,134,135],"major spinal surgery","obesity phenotype","intraabdominal pressure","intraoperative blood loss","perioperative hemorrhage","2026-07-05",{"date":138,"type":41},"2026-07-07",{"date":140,"type":21},"2026-06-15",{"date":142,"type":21},"2027-06-01",{"name":47,"class":48},{"id":145,"slug":146,"hasResults":11,"nctId":147,"briefTitle":148,"officialTitle":149,"acronym":150,"eligibilityCriteria":151,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":152,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":154,"conditions":155,"keywords":160,"overallStatus":169,"whyStopped":4,"lastUpdateSubmitDate":170,"lastUpdatePostDateStruct":171,"startDateStruct":173,"completionDateStruct":175,"leadSponsor":177,"locationsCount":49},"100639433","diagnostic-accuracy-of-gpt-4o-and-claude-for-heart-score-calculation-in-chest-pain-100639433","NCT07626060","Diagnostic Accuracy of GPT-4o and Claude for HEART Score Calculation in Chest Pain","Diagnostic Accuracy of Large Language Models (GPT-4o and Claude) in HEART Score Calculation and 30-Day MACE Prediction in Emergency Department Chest Pain Patients: A Prospective Observational Validation Study Against Three-Expert Consensus","LLM-HEART","INCLUSION CRITERIA:\n\n* Age \\>=18 years\n* Chief complaint of non-traumatic chest pain at the emergency department\n* Written informed consent obtained from the patient or legally authorized representative\n* Availability for 30-day follow-up (reachable by telephone and\u002For actively registered in the e-Nabiz national health database)\n\nEXCLUSION CRITERIA:\n\n* Traumatic chest pain etiology\n* ST-elevation myocardial infarction (STEMI) at presentation requiring immediate reperfusion protocol\n* Refusal or subsequent withdrawal of informed consent\n* Inability to complete the mandatory 30-day follow-up period\n\nWITHDRAWAL CRITERIA:\n\n* Patient or representative requests data withdrawal after initial consent\n* Administrative identification of retrospective data entry after enrollment",{"count":153,"type":21},690,"This prospective observational diagnostic accuracy study evaluates whether large language models (LLMs) - GPT-4o (OpenAI, gpt-4o-2024-11-20) and Claude (Anthropic, claude-sonnet-4-6) - can accurately calculate HEART scores from unstructured Turkish clinical notes and predict 30-day major adverse cardiac events (MACE) in emergency department patients presenting with non-traumatic chest pain.\n\nThe study will enroll 600 consecutive adult patients. For each patient, the same anonymized data (free-text anamnesis, ECG report text, troponin value, and age) will be independently processed by both LLMs via separate API calls with deterministic settings (temperature=0, JSON format). A three-expert consensus HEART score - derived through blinded independent scoring by three emergency medicine physicians with majority-vote adjudication - serves as the reference standard for agreement analysis. Actual 30-day MACE (all-cause death, AMI Type 1\u002F2\u002F4b, unplanned revascularization) determined via national health database and telephone follow-up serves as the outcome for diagnostic accuracy analysis.\n\nA secondary documentation-quality sub-study will quantify how spontaneously Turkish emergency anamnesis notes capture HEART score parameters.",[156,157,158,159],"Emergency Medicine","Artificial Intelligence (AI)","Artificial Intelligence (AI) in Diagnosis","Chest Pain Rule Out Myocardial Infarction",[161,162,163,164,165,166,167,168],"Large Language Model","GPT-4o","Claude Sonnet","Emergency Department","Diagnostic Accuracy","Medical Informatics","Physician vs AI","HEART score","RECRUITING","2026-06-22",{"date":172,"type":41},"2026-06-23",{"date":174,"type":21},"2026-06",{"date":176,"type":21},"2027-06",{"name":47,"class":48},{"id":179,"slug":180,"hasResults":11,"nctId":181,"briefTitle":182,"officialTitle":183,"acronym":4,"eligibilityCriteria":184,"healthyVolunteers":11,"sex":17,"minAge":185,"maxAge":186,"enrollmentInfo":187,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":189,"conditions":190,"keywords":198,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":206,"lastUpdatePostDateStruct":207,"startDateStruct":209,"completionDateStruct":211,"leadSponsor":213,"locationsCount":4},"100642485","perioperative-respiratory-adverse-events-in-cleft-lip-and-palate-surgery-incidence-risk-factors-and-clinical-scoring-100642485","NCT07651904","Perioperative Respiratory Adverse Events in Cleft Lip and Palate Surgery: Incidence, Risk Factors, and Clinical Scoring","Prospective Assessment of Perioperative Respiratory Adverse Events in Pediatric Patients Undergoing Cleft Lip and Palate Surgery: Predictive Risk Factors and the Role of Clinical Airway Scores","Inclusion Criteria:\n\n* Age 0-3 years (infants and toddlers)\n* Scheduled for elective cleft lip and\u002For palate repair surgery\n* General anesthesia planned\n* Written parental\u002Fguardian informed consent obtained\n\nExclusion Criteria:\n\n* Pre-existing respiratory failure or active tracheostomy\n* Emergency surgical procedures\n* Inability to obtain parental\u002Fguardian consent","0 Years","3 Years",{"count":188,"type":21},150,"Cleft lip and palate surgeries present unique anesthetic challenges due to shared airway access with the surgical field, frequent anatomical abnormalities, and a predominantly infant and toddler population. These factors substantially increase the risk of perioperative respiratory adverse events (PRAEs), including laryngospasm, bronchospasm, desaturation, post-extubation stridor, and unanticipated re-intubation.\n\nThis prospective single-center observational cohort study aims to determine the true incidence of PRAEs in pediatric patients undergoing elective cleft lip and\u002For palate repair under general anesthesia, and to identify independent predictive risk factors using standardized airway assessment tools including the Han Mask Ventilation Score and the Intubation Difficulty Score (IDS). No interventions beyond routine clinical practice will be applied. All airway management decisions will remain at the discretion of the attending anesthesiologist.",[191,192,193,194,195,196,197],"Cleft Palate","Cleft Lip","Laryngospasm","Bronchospasm","Airway Obstruction","Postoperative Complications","Difficult Intubation",[199,200,201,202,203,204,205],"cleft lip","cleft palate","pediatric anesthesia","perioperative respiratory adverse events","Han mask ventilation score","micrognathia","intubation difficulty score","2026-06-13",{"date":208,"type":41},"2026-06-16",{"date":210,"type":21},"2026-06-27",{"date":212,"type":21},"2027-12-30",{"name":47,"class":48},{"id":215,"slug":216,"hasResults":11,"nctId":217,"briefTitle":218,"officialTitle":219,"acronym":220,"eligibilityCriteria":221,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":222,"targetDuration":4,"studyType":22,"phases":224,"briefSummary":225,"conditions":226,"keywords":229,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":206,"lastUpdatePostDateStruct":238,"startDateStruct":239,"completionDateStruct":240,"leadSponsor":242,"locationsCount":49},"100641858","early-vs-late-tourniquet-release-and-phlebotomy-induced-hemolysis-in-the-emergency-department-tourni-ed-100641858","NCT07617103","Early vs. Late Tourniquet Release and Phlebotomy-Induced Hemolysis in the Emergency Department: TOURNI-ED","Early Versus Late Release of Sphygmomanometer-Applied Venous Stasis and Phlebotomy-Induced Hemolysis in the Emergency Department: A Parallel-Group Randomized Controlled Trial","TOURNI-ED","Inclusion Criteria:\n\n* Age 18 years or older\n* Presenting to the emergency department and triaged as green (semi-urgent) or yellow (urgent) category according to the Emergency Severity Index (ESI) or equivalent institutional triage system\n* Blood collection (venipuncture) indicated as part of routine clinical care by the attending emergency physician\n* Ability to provide written informed consent\n* Accessible antecubital or forearm vein suitable for standard venipuncture (not requiring intravenous catheter placement for blood collection)\n\nExclusion Criteria:\n\n* Blood collection performed via an existing intravenous catheter or central venous access device\n* Known or suspected coagulation disorder (e.g., hemophilia, thrombocytopenia with platelet count \\\u003C50,000\u002FuL, current anticoagulant therapy with active bleeding)\n* Active upper extremity injury, infection, lymphedema, or arteriovenous fistula at the potential collection site\n* Triage category red (resuscitation) at the time of blood collection\n* Declined informed consent\n* Previously enrolled in this study (re-enrollment not permitted)\n* Pregnancy (due to potential vascular changes affecting hemolysis rate)\n* Known hemolytic anemia or other hematological condition associated with baseline elevated hemolysis",{"count":223,"type":21},792,[24],"BACKGROUND:\n\nHemolysis is the most common preanalytical error in emergency department (ED) laboratories, affecting 17-26% of blood samples collected in the ED and leading to test cancellations, repeat venipuncture, delayed diagnoses, and increased healthcare costs. Venous stasis created by tourniquet application during phlebotomy is a recognized contributing factor to hemolysis. While clinical guidelines recommend releasing the tourniquet once blood flow is established, the optimal timing of tourniquet release in relation to tube filling sequence has not been systematically evaluated.\n\nOBJECTIVE:\n\nThe primary objective of this trial is to determine whether early release of sphygmomanometer-applied venous stasis (released after the first tube fills) reduces hemolysis rates compared to late release (released after the last tube fills) during routine phlebotomy in ED patients triaged as green or yellow category.\n\nDESIGN:\n\nSingle-center, parallel-group, superiority randomized controlled trial with 1:1 allocation ratio. The trial was prospectively registered prior to the enrollment of the first participant.\n\nPARTICIPANTS:\n\nAdult patients (≥18 years) presenting to the emergency department with triage category green (semi-urgent) or yellow (urgent), for whom blood collection is indicated as part of routine clinical care. Patients requiring blood collection from an intravenous catheter, those with known coagulation disorders, and those who decline to participate are excluded.\n\nINTERVENTIONS:\n\nGroup A (Early Release): Sphygmomanometer inflated to 60 mmHg for venous stasis; tourniquet released immediately after the first tube (sodium citrate, blue cap) completes filling. Remaining tubes (SST\u002Fgel, yellow cap; K2-EDTA, purple cap) are collected after release.\n\nGroup B (Late Release): Sphygmomanometer inflated to 60 mmHg; tourniquet maintained throughout all tube filling and released only after the last tube (K2-EDTA, purple cap) completes filling. Tube collection order follows the CLSI H03-A6 standard for both groups.\n\nPRIMARY OUTCOME:\n\nHemolysis rate, defined as the proportion of serum separator tube (SST\u002Fyellow cap) samples with a Hemolysis Index (HI) ≥ 1+ (corresponding to free hemoglobin ≥50 mg\u002FdL), is assessed by the clinical chemistry laboratory analyzer. The outcome assessor (laboratory technician) is blinded to group assignment.\n\nSECONDARY OUTCOMES:\n\n(1) Distribution of ordinal hemolysis index categories (-, 1+, 2+, 3+, 4+, 5+) in SST samples; (2) Proportion of hemolyzed samples requiring repeat blood collection; (3) Total blood collection duration (seconds) from sphygmomanometer inflation to last tube filling completion; (4) Complication rate (hematoma, nerve injury, vasovagal reaction, arterial puncture, multiple puncture attempts).\n\nSAMPLE SIZE:\n\nA total of 792 participants (396 per group) are required based on an assumed hemolysis rate of 12% in the late release group and 6% in the early release group (50% relative risk reduction), α=0.05 (two-tailed), 80% power (Fleiss with pooled variance), plus 10% dropout buffer.\n\nRANDOMIZATION:\n\nSimple randomization using a computer-generated random number list (randomizer.org). The allocation sequence is maintained by a designated person not involved in enrollment or data collection. Allocation is revealed sequentially at the point of care.\n\nSTATISTICAL ANALYSIS:\n\nPrimary analysis: Chi-square test comparing hemolysis rates between groups (intention-to-treat population). Secondary analyses: Mann-Whitney U test for ordinal HI distribution; logistic regression for adjusted odds ratio. Bonferroni correction applied to multiple secondary comparisons (adjusted α = 0.017). Per-protocol analysis performed as a sensitivity analysis. Missing data handled using complete case analysis with sensitivity analysis.",[27,29,227,228],"Phlebotomy","Venous Stasis",[230,231,232,233,234,235,236,237],"hemolysis","phlebotomy","tourniquet","venous stasis","emergency department","blood collection","hemolysis index","randomized controlled trial",{"date":208,"type":41},{"date":174,"type":21},{"date":241,"type":21},"2027-08",{"name":47,"class":48},{"id":244,"slug":245,"hasResults":11,"nctId":246,"briefTitle":247,"officialTitle":248,"acronym":4,"eligibilityCriteria":249,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":250,"targetDuration":4,"studyType":22,"phases":252,"briefSummary":254,"conditions":255,"keywords":257,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":267,"lastUpdatePostDateStruct":268,"startDateStruct":270,"completionDateStruct":272,"leadSponsor":274,"locationsCount":49},"100642859","phase-4-effect-of-push-dose-adrenaline-on-peri-intubation-hypotension-during-rapid-sequence-intubation-in-the-emergency-department-100642859","NCT07620327","Effect of Push-Dose Adrenaline on Peri-intubation Hypotension During Rapid Sequence Intubation in the Emergency Department","Effect of Push-Dose Adrenaline on Peri-intubation Cardiovascular and Clinical Outcomes During Rapid Sequence Intubation in the Emergency Department: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial","Inclusion Criteria:\n\n* Adult patients aged 18 years or older\n* Patients in the emergency department for whom the treating physician has made a clinical decision to perform rapid sequence intubation\n* Patients who are hypotensive, defined as systolic blood pressure less than 90 mmHg or mean arterial pressure less than 65 mmHg, or who are considered to be at significant risk of hypotension during rapid sequence intubation\n* Written informed consent obtained from the patient or from a legally authorized representative when the patient lacks decision-making capacity\n\nExclusion Criteria:\n\n* Pregnancy\n* Known allergy to adrenaline\n* Known contraindication to adrenaline administration\n* Withdrawal of consent by the patient or legally authorized representative after enrollment",{"count":251,"type":21},128,[253],"PHASE4","Rapid sequence intubation is commonly performed in the emergency department to secure the airway of critically ill patients. However, blood pressure may decrease during or shortly after intubation because of the patient's underlying illness, the effects of induction medications, and the transition to positive-pressure ventilation. This complication is known as peri-intubation hypotension and is associated with worse clinical outcomes.\n\nThis study will evaluate whether a preemptive low dose of intravenous adrenaline, also known as epinephrine, can reduce peri-intubation hypotension in adult emergency department patients undergoing rapid sequence intubation. Participants will be randomly assigned to receive either 10 mcg of intravenous adrenaline or 1 mL of 0.9% sodium chloride placebo immediately before induction. The study will compare hemodynamic changes, vasopressor requirements, safety outcomes, and mortality between the two groups.",[256],"Peri-intubation Hypotension",[258,259,260,261,262,263,264,265,266],"Push-dose adrenaline","Push-dose epinephrine","Peri-intubation hypotension","Rapid sequence intubation","Emergency department","Endotracheal intubation","Vasopressor","Epinephrine","Critical care","2026-06-07",{"date":269,"type":41},"2026-06-10",{"date":271,"type":21},"2026-06-01",{"date":273,"type":21},"2026-12-01",{"name":47,"class":48},{"id":276,"slug":277,"hasResults":11,"nctId":278,"briefTitle":279,"officialTitle":280,"acronym":281,"eligibilityCriteria":282,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":283,"targetDuration":4,"studyType":22,"phases":285,"briefSummary":286,"conditions":287,"keywords":292,"overallStatus":169,"whyStopped":4,"lastUpdateSubmitDate":299,"lastUpdatePostDateStruct":300,"startDateStruct":301,"completionDateStruct":303,"leadSponsor":304,"locationsCount":49},"100640090","nasval-svt-nasal-swab-versus-modified-valsalva-for-supraventricular-tachycardia-100640090","NCT07617077","NASVAL-SVT: Nasal Swab Versus Modified Valsalva for Supraventricular Tachycardia","A Randomized Controlled Trial Comparing Nasal Swab and Modified Valsalva Maneuver for the Treatment of Supraventricular Tachycardia","NASVAL-SVT","Inclusion Criteria:\n\n* Age 18 years or older\n* Electrocardiographically confirmed supraventricular tachycardia (SVT): narrow QRS complex (≤120 ms), regular rhythm, rapid ventricular rate, documented on 12-lead ECG or continuous cardiac monitoring\n* Hemodynamic stability, defined as ALL of the following simultaneously present:\n* Systolic blood pressure ≥90 mmHg\n* Diastolic blood pressure ≥60 mmHg\n* Alert and oriented mental status (GCS 15)\n* No signs of acute end-organ dysfunction\n* Ability and willingness to provide written informed consent\n\nExclusion Criteria:\n\n* Age younger than 18 years\n* Pregnancy (known or suspected)\n* Inability to confirm SVT diagnosis by ECG criteria\n* Delta wave or pre-excitation pattern on ECG (Wolff-Parkinson-White syndrome or asymptomatic pre-excitation) - due to risk of ventricular fibrillation with vagal maneuvers\n* Wide QRS tachycardia (QRS ≥120 ms) where ventricular tachycardia cannot be excluded\n* Absolute contraindication to modified Valsalva maneuver (inability to assume supine position or passive leg elevation)\n* Contraindication to nasal swab (nasal surgery within 30 days, active epistaxis, visible nasal polyp or mass)\n* Hemodynamic instability requiring immediate synchronized cardioversion\n* Prior enrollment in this study (re-presentation with SVT)\n* Refusal to participate",{"count":284,"type":21},60,[24],"Supraventricular tachycardia (SVT) is a common heart rhythm disorder seen in emergency departments, causing a rapid heartbeat (typically 150-250 beats per minute). The current best non-drug treatment, the modified Valsalva maneuver (mVM), successfully restores normal rhythm in about 43% of cases. When these maneuvers fail, intravenous adenosine is used, which, while effective, can cause brief but distressing side effects such as chest tightness, shortness of breath, and intense anxiety.\n\nDuring the COVID-19 pandemic, some patients briefly fainted during nasal swab collection. This happens because inserting a swab into the back of the nasal cavity (nasopharynx) stimulates the trigeminal nerve, which then activates the vagus nerve and slows the heart - a phenomenon called the trigeminocardiac (or nasocardiac) reflex. One published case report described a patient whose SVT was terminated within 10 seconds using a nasal swab.\n\nThis study compares the nasal swab technique with the modified Valsalva maneuver in patients presenting to the emergency department with SVT. Patients are randomly assigned to one of two groups. The primary outcome is whether a normal heart rhythm is restored within 1 minute of the procedure. Patient comfort and satisfaction are also measured.\n\nThe study is conducted in two phases. The first (pilot) phase (30 patients per group) will assess whether the study can be successfully conducted and collect data to finalize the required sample size. The second (main) phase will use the pilot phase's actual data to determine the final number of participants needed.",[288,289,290,291],"Supraventricular Tachycardia","Paroxysmal Supraventricular Tachycardia","Atrioventricular Nodal Reentry Tachycardia","Vagal Maneuver",[293,294,295,296,297,298,234],"SVT","nasal swab","nasocardiac reflex","trigeminocardiac reflex","Valsalva maneuver","REVERT","2026-05-23",{"date":271,"type":41},{"date":302,"type":41},"2026-05-01",{"date":176,"type":21},{"name":47,"class":48},{"id":306,"slug":307,"hasResults":11,"nctId":308,"briefTitle":309,"officialTitle":310,"acronym":311,"eligibilityCriteria":312,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":119,"enrollmentInfo":313,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":315,"conditions":316,"keywords":323,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":302,"lastUpdatePostDateStruct":329,"startDateStruct":331,"completionDateStruct":332,"leadSponsor":333,"locationsCount":49},"100637001","epidural-catheter-placement-techniques-by-anesthesia-residents-success-and-complications-100637001","NCT07573007","Epidural Catheter Placement Techniques by Anesthesia Residents: Success and Complications","Anesthesia Residents' Epidural Catheter Placement Techniques: A Prospective Observational Study on Success Rates and Complications","EPİ-TECH","Inclusion Criteria:\n\n* Age 18-80 years\n* ASA physical status I, II, or III\n* Scheduled for elective surgery requiring perioperative epidural analgesia or anesthesia (lumbar or thoracic approach)\n* Epidural catheter to be placed by a resident with ≥ 2 years of anesthesia training\n\nExclusion Criteria:\n\n* Spinal deformity (scoliosis, kyphosis, or prior spinal surgery at the target level)\n* Coagulopathy or anticoagulant therapy precluding neuraxial blockade\n* Active infection at the insertion site or systemic infection\n* Pre-existing neurological disease affecting the spinal cord or nerve roots\n* Emergency surgery\n* History of prior failed epidural catheterization\n* Patient refusal or inability to provide written informed consent\n* Local anatomical pathology precluding safe epidural access",{"count":314,"type":21},440,"This prospective observational study aims to evaluate the impact of epidural catheter placement techniques - loss of resistance (LOR) and hanging drop (HD) - on first-attempt success rates and procedural complications among anesthesia residents. Residents with at least two years of training will perform epidural catheterization under supervision for patients scheduled for elective surgery requiring perioperative epidural analgesia. An independent observer will record procedural details, complications, and postoperative pain scores. The study will enroll 440 patients aged 18-80 with ASA I-III classification.",[317,318,319,320,321,322],"Epidural Anesthesia","Catheterisation","Education","Postoperative Pain","Medical","Graduate Medical Education",[324,325,326,327,328],"epidural catheter","loss of resistance","hanging drop","procedural training","epidural space identification",{"date":330,"type":41},"2026-05-07",{"date":302,"type":21},{"date":142,"type":21},{"name":47,"class":48},{"id":335,"slug":336,"hasResults":11,"nctId":337,"briefTitle":338,"officialTitle":339,"acronym":4,"eligibilityCriteria":340,"healthyVolunteers":57,"sex":17,"minAge":186,"maxAge":341,"enrollmentInfo":342,"targetDuration":4,"studyType":22,"phases":343,"briefSummary":344,"conditions":345,"keywords":350,"overallStatus":169,"whyStopped":4,"lastUpdateSubmitDate":355,"lastUpdatePostDateStruct":356,"startDateStruct":358,"completionDateStruct":360,"leadSponsor":362,"locationsCount":363},"100634074","the-effect-of-paedfusor-tci-eleveld-tci-and-sevoflurane-anesthesia-on-postoperative-awakening-agitation-in-pediatric-patients-100634074","NCT07534956","The Effect of Paedfusor TCI, Eleveld TCI, and Sevoflurane Anesthesia on Postoperative Awakening Agitation in Pediatric Patients","Investigation of the Effects of Two Different TCI (Target Controlled Infusion) Models (Paedfusor and Eleveld) and Inhalation Anesthesia on Postoperative Awakening Agitation\u002FDelirium in Pediatric Patients","Inclusion Criteria:\n\n* Children aged 3-10 years\n* Children weighing over 10 kg\n* American Society of Anesthesiologists (ASA) physical condition classification I-II\n* Those who will undergo planned urogenital surgery under general anesthesia\n* Those who have obtained written informed consent from their parents or legal guardians\n\nExclusion Criteria:\n\n* Patients assessed as ASA III or higher\n* Known neurological or psychiatric disorders\n* Developmental delay or cognitive impairment\n* Use of sedatives or psychoactive drugs\n* Allergy or contraindication to the study drugs (propofol or sevoflurane)\n* History of previous adverse reactions to anesthesia\n* Patients requiring emergency surgery\n* Significant liver, kidney, or cardiovascular disease\n* Patients whose parents or legal guardians have not given consent","10 Years",{"count":188,"type":21},[24],"Emergence delirium is a common complication in pediatric patients undergoing general anesthesia. The aim of this study is to investigate the incidence of postoperative awakening delirium and agitation in pediatric patients aged 3-10 years (ASA I-II) using two different target-controlled infusion (TCI) methods (Paedfusor and Eleveld) for TIVA, compared to inhalation anesthesia. This study will examine the effect of two different TCI models on postoperative awakening agitation\u002Fdelirium by comparing them with each other and with inhalation anesthesia.",[346,347,348,349],"Emergence Delirium in Pediatric Anesthesia","Pediatric Anesthesia","Postoperative Agitations in Pediatric Patients","Postoperative Nausea and Vomiting (PONV)",[201,351,352,68,353,354],"paedfusor","eleveld","sevoflurane","postoperative agitation","2026-04-11",{"date":357,"type":41},"2026-04-16",{"date":359,"type":41},"2026-01-13",{"date":361,"type":21},"2027-11-30",{"name":47,"class":48},2,{"id":365,"slug":366,"hasResults":11,"nctId":367,"briefTitle":368,"officialTitle":368,"acronym":4,"eligibilityCriteria":369,"healthyVolunteers":57,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":370,"targetDuration":4,"studyType":22,"phases":371,"briefSummary":372,"conditions":373,"keywords":377,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":380,"lastUpdatePostDateStruct":381,"startDateStruct":383,"completionDateStruct":385,"leadSponsor":387,"locationsCount":4},"100616457","comparison-of-the-effects-of-target-controlled-infusion-method-and-manual-propofol-administration-on-respiratory-function-recovery-and-electroencephalogram-in-endoscopic-submucosal-dissection-cases-100616457","NCT07305857","Comparison of the Effects of Target-Controlled Infusion Method and Manual Propofol Administration on Respiratory Function, Recovery, and Electroencephalogram in Endoscopic Submucosal Dissection Cases","Inclusion Criteria:\n\n* Age: 18-75 years old\n* ASA (American Society of Anaesthesiologists) physical status class I-III\n* Patients with indications for ESD\n* BMI \\\u003C 35 kg\u002Fm²\n* Patients who are cooperative and can be monitored\n\nExclusion Criteria:\n\n* Those with cardiac or pulmonary insufficiency,\n* Those with neurological diseases,\n* Those with severe hepatic or renal dysfunction,\n* Those with psychiatric disorders that could affect their level of consciousness,\n* Those with allergies or hypersensitivity to propofol, midazolam, and fentanyl, Patients who refuse to participate in the study will not be included in this clinical trial.",{"count":59,"type":21},[24],"Endoscopic submucosal dissection (ESD) has become widely used as a minimally invasive alternative for the resection of early-stage gastrointestinal neoplasms. Due to the lengthy procedure time and intense pain caused by stretching, cutting, and dissecting the gastric wall during ESD, a deeper level of sedation is recommended compared to traditional endoscopic procedures (1). While ensuring adequate patient immobilisation during ESD, preserving respiratory function and rapid recovery are important clinical goals.\n\nTotal intravenous anaesthesia (TIVA) is an alternative method to inhalation anaesthesia, achieved through the combination of agents such as propofol and remifentanil. TIVA applications can be performed using manual or target-controlled infusion (TCI) systems. TCI systems aim to achieve and maintain the targeted plasma or effect site concentration based on pharmacokinetic models. These systems have been shown to provide advantages such as more stable depth of sedation during endoscopy, less haemodynamic fluctuation, and faster recovery (2-4).\n\nPreserving spontaneous breathing is preferred during ESD procedures, which requires careful monitoring of respiration. The Capnostream® device records four variables (SpO₂, RR, non-invasive EtCO₂, heart rate) every 30 seconds via a nasal cannula and integrates them into a single, dimensionless value called the integrated pulmonary index (IPI). The IPI can range from 1 to 10, with 4 and below requiring intervention and 8 to 10 representing the normal range. Furthermore, the use of the bispectral index (BIS) enables objective monitoring of anaesthesia depth by analysing EEG waves and can increase the safety of the recovery process (5).\n\nThis study aims to compare the effects of manual TIVA and TCI applications on recovery time, BIS, and respiratory parameters during ESD procedures in the stomach or colon region performed under sedation in the endoscopy unit. The findings will contribute to the safer and more effective planning of sedation applications.\n\nReferences;\n\n1. Sasaki T, Tanabe S, Azuma M, Sato A, Naruke A, Ishido K, et al. Propofol sedation with bispectral index monitoring is useful for endoscopic submucosal dissection: a randomised prospective phase II clinical trial. Endoscopy. 2012 Jun;44(6):584-9.\n2. Chang YT, Tsai TC, Hsu H, Chen YM, Chi KP, Peng SY. Sedation for gastrointestinal endoscopy with the application of target-controlled infusion. Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2015 Sep;26(5):417-22.\n3. Sarraj R, Theiler L, Vakilzadeh N, Krupka N, Wiest R. Propofol sedation in routine endoscopy: A case series comparing target controlled infusion vs manually controlled bolus concept. World J Gastrointest Endosc. 2024 Jan 16;16(1):11-7.\n4. García Guzzo ME, Fernandez MS, Sanchez Novas D, Salgado SS, Terrasa SA, Domenech G, et al. Deep sedation using propofol target-controlled infusion for gastrointestinal endoscopic procedures: a retrospective cohort study. BMC Anaesthesiol. 10 August 2020;20(1):195.\n5. Sandler NA, Hodges J, Sabino M. Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2001 Jun;59(6):603-11; discussion 611-612.\n6. Ding Y, White PF. Simplified quality of anaesthesia scoring system. Anaesthesia. 1992 Oct;47(10):906-7.",[374,65,375,376],"Endoscopic Submucosal Dissection","Endoscopy Unit","Respiratory Complications",[378,379],"endoscopic submucosal dissection","target controlled infusion of propofol","2025-12-12",{"date":382,"type":41},"2025-12-26",{"date":384,"type":21},"2026-01-01",{"date":386,"type":21},"2027-03-01",{"name":47,"class":48},{"id":389,"slug":390,"hasResults":11,"nctId":391,"briefTitle":392,"officialTitle":392,"acronym":4,"eligibilityCriteria":393,"healthyVolunteers":57,"sex":17,"minAge":394,"maxAge":395,"enrollmentInfo":396,"targetDuration":4,"studyType":60,"phases":4,"briefSummary":398,"conditions":399,"keywords":403,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":408,"lastUpdatePostDateStruct":409,"startDateStruct":411,"completionDateStruct":413,"leadSponsor":414,"locationsCount":4},"100592519","comparison-of-the-effects-of-endotracheal-intubation-and-laryngeal-mask-applications-on-optic-nerve-diameter-in-pediatric-patients-100592519","NCT06994481","Comparison of the Effects of Endotracheal Intubation and Laryngeal Mask Applications on Optic Nerve Diameter in Pediatric Patients","Inclusion Criteria:\n\n1. Classified as American Society of Anesthesiologists (ASA) physical status I or II,\n2. Aged between 1 and 11 years,\n3. Scheduled to receive general anesthesia,\n4. Planned to be ventilated via endotracheal intubation or laryngeal mask airway (LMA).\n\nExclusion Criteria:\n\n1. Families who do not provide informed consent,\n2. Patients with a tracheostomy,\n3. History of previous intracranial surgery (e.g., tumor resection or shunt placement),\n4. History of preoperative seizures,\n5. Presence of craniofacial deformities that may prevent accurate optic nerve sheath diameter (ONSD) measurement,\n6. Infection, wound, or any other condition in the measurement area that may interfere with ONSD assessment,\n7. Presence of conditions that may increase intracranial pressure and affect ONSD measurement (e.g., tumor, encephalitis, meningitis, or intracranial infection),\n8. Patients who require a change in the endotracheal tube or laryngeal mask airway (LMA) size during the operation, or who undergo a second intubation or insertion attempt,\n9. Patients who withdraw from the study.","1 Year","11 Years",{"count":397,"type":21},200,"This clinical study aims to investigate the effects of breathing tubes, which we use to connect children aged 1-11 to a respiratory device under general anesthesia in the operating room, on intracranial pressure after they are inserted. No changes will be made to routine anesthesia practices for this purpose, and eye examinations will be performed with an USG device. This study has no undesirable effects or risks. This study does not include any invasive procedures. You have the right to refuse to participate in the study. You have the right to withdraw from the study at any time. If you decide not to participate in the study for any reason, there will be no disruption to your treatment. You will not be liable for any financial loss if you participate in the study, and you will not be paid. Your identity will be kept confidential if you participate in the study.",[400,347,401,402],"Optic Nerve Sheath Diameter","Intubation","Laryngeal Mask Airways",[404,405,406,407],"optic nerve sheath diameter","pediatric patients","intubation","laryngeal mask airway","2025-05-20",{"date":410,"type":41},"2025-05-29",{"date":412,"type":21},"2025-06-01",{"date":271,"type":21},{"name":47,"class":48},""]