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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT03876067
Other study ID # AssuitUlotfallah
Secondary ID
Status Not yet recruiting
Phase Phase 2/Phase 3
First received
Last updated
Start date April 1, 2019
Est. completion date December 2022

Study information

Verified date March 2019
Source Assiut University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

forty patients with age ranged between 40-70 years undergoing elective coronary artery bypass graft surgery with cardiopulmonary bypass will be included, they will divided into two groups.

Ozone Group: in which Ozone will be added to cold blood cardioplegia. Control Group: in which in which only cold blood cardioplegia

Primary outcome:

Pattern of recovery of myocardium after declamping of Aorta

1. Time of cardiac rhythm return after declamping.

2. type of cardiac rhythm after declamping and rate of DC use.

Secondary outcome:

A-cardiac parameters

- Post operative inotropic score

- Incidence of post operative cardiac dysrhythmias

- postoperative ejection fraction (EF)

- Postoperative parameters of myocardial ischaemia

- a- Troponin levels

- b-Pro BNP

- • Histopathology of myocardial sample for detection of myocyte cellular edema as a marker of ischemic changes.

B-non cardiac parameters:

1. inflammatory markers 1. CRP 2. L\N 3. P\N

2. ICU stay

3. hospital stay

4. morbidity and mortality


Description:

Ozone Administration Protocol

Our procedures for O3T application in CBP surgery conform to international guidelines of the ''Madrid Declaration on Ozone Therapy'' 32 . M-O3T will be carried out as follows:

50mL of blood drawn by vacuum from the patient central catheter into a sterile blood transfusion bag in which 10 mL of 3.8% Na citrate solution (Galenica Senese Industries, Siena, Italy) as an anticoagulant will be previously added so that the blood/citrate volume ratio was 9:1. After blood withdrawal, the bag will momentarily disconnected leaving the venous access open by a saline infusion 33 . A corresponding volume (50 mL) of gas was immediately added with an O3 concentration of 20-50 micrograms/mL gas. Ozone was produced by Medozon compact generator (Herrmann Apparatebau GmbH, Germany).

The gas is immediately and continuously mixed with the blood in the bag for at least 5 min and with gentle rotating movement to avoid foaming. Due to the blood viscosity, the gas mixture does not instantaneously come into contact with the whole blood mass, thus this mixing time is necessary. During these 5 min of mixing, the ozone totally reacted with both the potent antioxidants of plasma and the unsaturated lipids bound to albumin, generating asmall amount of hydrogen peroxide and alkenals. These two messengers were responsible for eliciting crucial biochemical reactions on both erythrocytes and within cells. At this point, the hyper-oxygenated ozonated blood will be mixed with the cold cardioplegia (Thomsons cardioplegia) this amount of ozonated blood will be added to each 500 ml of cardioplegic solution

Exclusion Criteria:

The patient will be excluded from the study if he has any of the following:

- left ventricular ejection fraction< 40%

- diabetic or other metabolic disorders,

- use of left ventricular assist devices,

- Renal failure or on hemodialysis

- Hepatic dysfunction

- Hypothyroidism

- implanted pacemaker


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 40
Est. completion date December 2022
Est. primary completion date March 2022
Accepts healthy volunteers No
Gender All
Age group 40 Years to 70 Years
Eligibility Inclusion Criteria:

- patients undergoing elective CABG surgery

Exclusion Criteria:

- • left ventricular ejection fraction< 40%

- diabetic or other metabolic disorders,

- use of left ventricular assist devices,

- Renal failure or on hemodialysis

- Hepatic dysfunction

- Hypothyroidism

- implanted pacemaker

Study Design


Intervention

Drug:
Ozone
Our procedures for O3T application in CBP surgery conform to international guidelines of the ''Madrid Declaration on Ozone Therapy'' 32 . M-O3T will be carried out as follows: 50mL of blood drawn by vacuum from the patient central catheter into a sterile blood transfusion bag in which 10 mL of 3.8% Na citrate solution (Galenica Senese Industries, Siena, Italy) as an anticoagulant will be previously added so that the blood/citrate volume ratio was 9:1. After blood withdrawal, the bag will momentarily disconnected leaving the venous access open by a saline infusion 33 . A corresponding volume (50 mL) of gas was immediately added with an O3 concentration of 20-50 micrograms/mL gas. Ozone was produced by Medozon compact generator (Herrmann Apparatebau GmbH, Germany). At this point, the hyper-oxygenated ozonated blood will be mixed with the cold cardioplegia (Thomsons cardioplegia) this amount of ozonated blood will be added to each 500 ml of cardioplegic solution
Cardioplegic Solutions
in which in which only cold blood cardioplegia

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Assiut University

Outcome

Type Measure Description Time frame Safety issue
Primary Time of cardiac rhythm Time of cardiac rhythm return after declamping. one hour
Primary type of cardiac rhythm type of cardiac rhythm after declamping and rate of DC use one hour
Secondary Post operative inotropic score Post operative inotropic score two weeks
Secondary post operativecardiac dysrhythmias Incidence of post operativecardiac dysrhythmias two weeks
Secondary postoperative ejection fraction (EF) postoperative ejection fraction (EF) one month
Secondary Postoperative parameters of myocardial ischaemia Troponin levels two weeks
Secondary ICU stay ICU stay two weeks
Secondary mortality mortality two weeks
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