Clinical Trial Details
— Status: Not yet recruiting
Administrative data
NCT number |
NCT06414330 |
Other study ID # |
Delnido cardioplegia |
Secondary ID |
|
Status |
Not yet recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
June 1, 2024 |
Est. completion date |
November 1, 2024 |
Study information
Verified date |
April 2024 |
Source |
Assiut University |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Low chloride solutions were proved to be better in resuscitation of emergency cases and
decrease the resulting hyperchloremic metabolic acidosis in the last decade. In ringers'
acetate solutions, there is acetate, which is metabolized in muscles to produce bicarbonate
molecules, so neutralizing the ongoing lactic and hyperchloremic metabolic solutions. Both
solutions were proved to be superior to normal saline as a fluid therapy plan in most studies
with much less ongoing hyperchloremic metabolic acidosis and inflammatory response. In this
protocol, modified Del Nido formula will be involved using ringers' acetate instead of
plasmalyte solutions and comparing the effects on myocardial protection versus HTK solutions
Description:
First, fulfilling all inclusion criteria and consent acceptance for study are to be
confirmed. Preoperative evaluation is done for full laboratory investigations including CBC,
coagulation, renal and liver functions, CRP and troponin, full clinical examination for chest
and heart, coronary angiography, Echocardiography, carotid doppler and upper and lower venous
and arterial doppler are to be done. All patients will be scheduled for on pump CABG surgery.
Low dose of midazolam will be given before surgery. Intraoperative monitoring will involve
invasive blood pressure, ECG, peripheral pulse oximetry, capnogram.
After induction of anaesthesia and median sternotomy, patients will be randomly allocated
into two groups:
Group (D) will receive modified Del Nido cardioplegia (Ringer acetate 1000ml, mannitol 20% 17
ml, magnesium sulphate 10% 20ml, sodium bicarbonate 8.4% 16ml, potassium chloride 7.5% 13ml
and lidocaine 2% 8 ml). Crystalloid to blood ratio will be 80% to 20% respectively. Dose will
be 15 - 20 ml/kg in first dose then 8 - 10 ml/kg every 60 minutes.
Group (C ) will receive HTK (Histidine, Tryptophan and Ketoglutarate solution) consisting of
(1000ml distilled water, sodium 15mmol/L, potassium 9mmol/L, magnesium 4mmol/L, calcium 0.015
mmol/L, histidine 129mmol/L, tryptophan 2mmol/L, ketoglutarate 1mmol/L, mannitol 30mmol and
pH 7.02 - 1.2). Dose will be 10 - 20 ml/kg and can be repeated once after 120 minutes.
All patients will receive hypothermia 29 - 32 ℃ and cardioplegia will be injected between the
aortic valve and aortic cross clamp in a pressure not less than 50 mmHg above systolic
pressure. After removal of aortic cross clamping, the heart will be monitored for ventricular
arrhythmias, early recovery, and postoperative 24 hours serum troponin and new changes in
echocardiography.