End Stage Chronic Obstructive Airways Disease Clinical Trial
Official title:
Examination of the Pulmonary Vascular Barrier in Patients During Lung Transplantation
Lung transplantation is a well established method for surgical therapy for patients with end
stage pulmonary disease.
The investigators seek to determine to which extent the pulmonary vascular barrier gets
harmed during lung transplantation and whether pulmonary edema after reperfusion can be
monitored with measurement of extravascular lung water index (ELWI).
Additionally the investigaors are going to evaluate the correlation between ELWI and
shedding of the endothelial glycocalyx.
The study is designed as a prospective observational cohort study.
This study is designed as a single center prospective observational cohort study including
only patients who are undergoing lung transplantation due to endstage pulmonary disease.
It is well known that pulmonary edema is one of the major problems following reperfusion of
the new organ.
The glycocalyx is located on the apical surface of vascular endothelial cells which line the
vascular lumen. The endothelial glycocalyx consists of mainly proteoglycans that covers,
among others, leukocyte and thrombocyte receptors and fulfills its principal role in
maintaining plasma and vessel wall homeostasis.
In patients undergoing cardiac surgery studies showed regional as well as global ischemia
causing an increase of syndecan-1 and heparansulphate in plasma during reperfusion.
The extent of the pulmonary vascular barrier's damage might serve as predictor for
postoperative complications as reperfusion edema of the lungs.
To quantify the extent of damage the investigators seek to evaluate the correlation between
ELWI and the damage to the vascular barrier. ELWI will be assessed using transpulmonary
thermodilution. Components of the vascular barrier will be quantified using ELISA-technique.
10 ml full blood will be drawn at 7 different predifined measurement points named T0-T7 as
follows:
- T0 before induction of anesthesia
- T1 before reperfusion of the first lung
- T2 5 min after reperfusion of the first lung
- T3 before reperfusion of the second lung
- T4 5 min after reperfusion of the second lung
- T5 before admission to the intensive care unit
- T6 6h after reperfusion of the last lung
- T7 12h after reperfusion of the last lung
For statistical analysis Student's t-test, Friedman or Wilcoxon rank test will be used, as
indicated.
Expected length of the study is 2 years enrolling 30 patients undergoing lung
transplantation.
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Observational Model: Cohort, Time Perspective: Prospective
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Active, not recruiting |
NCT02858778 -
Timing of Acute Palliative Care Consultation in Critically Ill Patients
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N/A |