Postoperative Complications Clinical Trial
Official title:
Comparison of the Predictive and Prognostic Value of Cellular Dysoxia Markers in the Postoperative Period of Cardiac Surgery With Extracorporeal Circulation
Verified date | October 2018 |
Source | University Hospital, Lille |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The study consist of evaluation in cardiac surgery with cardiopulmonary bypass (CPB) setting the ability of PCO2 derived variables (ΔPCO2, ΔPCO2/C(a-v)O2 ratio), compared to lactate and ScVO2 to predict major postoperative adverse events.
Status | Completed |
Enrollment | 330 |
Est. completion date | December 2017 |
Est. primary completion date | December 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - 18 years old or more - Cardiac surgery with cardiopulmonary bypass - Tip of a central venous catheter positioned in superior vena cava or right atria - Arterial catheter correctly positioned Exclusion Criteria: - KDIGO 3 AKI prior to surgery - Hepatic insufficiency prior to surgery - Extracorporeal life support prior to surgery ` - Live expectancy lower than 48 hours - pregnancy |
Country | Name | City | State |
---|---|---|---|
France | Service d'Anesthésie-Réanimation CCV Hôpital Cardiologique Centre Hospitalier et Universitaire de Lille | Lille | Nord |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Lille |
France,
Balzer F, Sander M, Simon M, Spies C, Habicher M, Treskatsch S, Mezger V, Schirmer U, Heringlake M, Wernecke KD, Grubitzsch H, von Heymann C. High central venous saturation after cardiac surgery is associated with increased organ failure and long-term mor — View Citation
Futier E, Robin E, Jabaudon M, Guerin R, Petit A, Bazin JE, Constantin JM, Vallet B. Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery. Crit Care. 2010;14(5):R193. — View Citation
Gasparovic H, Gabelica R, Ostojic Z, Kopjar T, Petricevic M, Ivancan V, Biocina B. Diagnostic accuracy of central venous saturation in estimating mixed venous saturation is proportional to cardiac performance among cardiac surgical patients. J Crit Care. — View Citation
Laine GA, Hu BY, Wang S, Thomas Solis R, Reul GJ Jr. Isolated high lactate or low central venous oxygen saturation after cardiac surgery and association with outcome. J Cardiothorac Vasc Anesth. 2013 Dec;27(6):1271-6. doi: 10.1053/j.jvca.2013.02.031. Epub — View Citation
Mallat J, Lemyze M, Meddour M, Pepy F, Gasan G, Barrailler S, Durville E, Temime J, Vangrunderbeeck N, Tronchon L, Vallet B, Thevenin D. Ratios of central venous-to-arterial carbon dioxide content or tension to arteriovenous oxygen content are better mark — View Citation
Ospina-Tascón GA, Umaña M, Bermúdez W, Bautista-Rincón DF, Hernandez G, Bruhn A, Granados M, Salazar B, Arango-Dávila C, De Backer D. Combination of arterial lactate levels and venous-arterial CO2 to arterial-venous O 2 content difference ratio as markers — View Citation
Robin E, Futier E, Pires O, Fleyfel M, Tavernier B, Lebuffe G, Vallet B. Central venous-to-arterial carbon dioxide difference as a prognostic tool in high-risk surgical patients. Crit Care. 2015 May 13;19:227. doi: 10.1186/s13054-015-0917-6. — View Citation
Shahbazi S, Khademi S, Shafa M, Joybar R, Hadibarhaghtalab M, Sahmeddini MA. Serum Lactate Is not Correlated with Mixed or Central Venous Oxygen Saturation for Detecting Tissue Hypo Perfusion During Coronary Artery Bypass Graft Surgery: A Prospective Obse — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Relation of thenar StO2 with vascular occlusion test derived variables and cellular dysorexia and perfusion markers, and their predictive value in postoperative complication after cardiac surgery. | 2 and 7 days following surgery | ||
Other | Association of PCO2 derived variables, lactate, ScVO2, StO2 derived variables with VO2, VCO2 and respiratory quotient (measured using indirect calorimetry). | 24 hours following surgery | ||
Primary | Performances of PCO2 derived perfusion markers (?PCO2 and ?PCO2/C(a-v)O2 ratio) measured 2 hours after CPB to predict major postoperative adverse events (MPAE) in the 48 hours following cardiac surgery. | Composite outcome defined as: Acute kidney injury (AKI) with KDIGO score of 2 or more Acute myocardial infarction according to the universal definition of acute myocardial ischemia ARDS according to Berlin definition or respiratory failure (P/F ratio < 300 mmHg + need of mechanical ventilation) Stroke or generalized seizure Cardiogenic or distributive shock defined as hypotension (SAP <90 mmHg, MAP< 65 mmHg) and reduced of cardiac index, ejection fraction or worsening of previously known reduce cardiac index or ejection fraction. Revision surgery Hemorrhagic shock Death |
First 2 days after surgery | |
Secondary | Performances of PCO2 derived perfusion marker measured ICU admission, 6 and 24 hours after CPB to predict major postoperative adverse events (MPAE) in the 2 and 7 days following cardiac surgery. | 2 and 7 days following cardiac surgery | ||
Secondary | Performances of PCO2 derived perfusion marker measured ICU admission, 6 and 24 hours after CPB to predict organ failure (any organ failure with specific SOFA of 2 or more) in the 2 and 7 days after surgery. | 2 and 7 days following surgery | ||
Secondary | Kinetics and relation of PCO2 derived variables, lactate and ScVO2 in the 24 hours following surgery. | 24 hours following surgery | ||
Secondary | Association of CO2 derived variables with lactate clearance, vasopressive score and outcome variables (ICU and hospital length of stay, ICU and hospital mortality). | 24 hours following surgery |
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