Anesthesia Clinical Trial
— TECHNO-MULTIOfficial title:
The Clinical Significance of Portal Hypertension After Cardiac Surgery
Verified date | February 2021 |
Source | Montreal Heart Institute |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Portal flow pulsatility detected by Doppler ultrasound is an echographic marker of cardiogenic portal hypertension from right ventricular failure and is associated with adverse outcomes based on previous studies performed at the Montreal Heart Institute. This multicenter prospective cohort study aims to determine if portal flow pulsatility after cardiopulmonary bypass separation is associated with a longer requirement of life support after cardiac surgery.
Status | Completed |
Enrollment | 360 |
Est. completion date | February 20, 2021 |
Est. primary completion date | February 20, 2021 |
Accepts healthy volunteers | |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Adult patients (=18 years old) and able to give informed consent undergoing cardiac surgery with the use of CPB for whom peri-operative TEE is planned. - High surgical risk defined as at least one of the following: 1. Multiple surgical procedures planned 2. EuroSCORE II = 5% 3. Known pulmonary hypertension (mPAP>25mmHg or sPAP>40mmHg). Exclusion Criteria: - Patient with a critical pre-operative state defined as vasopressor requirement, mechanical circulatory support, dialysis, mechanical ventilation or cardiac arrest necessitating resuscitation. - Patient with known condition that could interfere with portal flow assessment or interpretation (liver cirrhosis, portal vein thrombosis) - Planned cardiac transplantation - Planned ventricular assist device implantation |
Country | Name | City | State |
---|---|---|---|
Canada | Montreal Heart Institute | Montreal | Quebec |
Lead Sponsor | Collaborator |
---|---|
Montreal Heart Institute |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Duration of invasive life support after cardiac surgery. (Tpod) | Defined as the time of Persistent Organ Dysfunction (POD) or Death | Up to 28 days | |
Secondary | All cause death | Death from any cause | Up to 28 days | |
Secondary | Acute kidney injury according to KDIGO serum creatinine criteria | Stage 1: =50% or 27 umol/L increases in serum creatinine Stage 2: =100% increase in serum creatinine Stage 3 =200% increase in serum creatinine or an increase to a level of =254 umol/L or dialysis initiation. | Up to 28 days | |
Secondary | Major bleeding defined by the Bleeding Academic Research Consortium (BARC) | Perioperative intracranial bleeding within 48h Reoperation after closure of sternotomy for the purpose of controlling bleeding Transfusion of =5 units of whole blood of packed red blood cells within a 48 hours period Chest tube output =2L within a 24 hours period | Up to 28 days | |
Secondary | Surgical reintervention for any reasons | Re-operation after the initial surgery for any cause | Up to 28 days | |
Secondary | Deep sternal wound infection or mediastinitis | Diagnosis of a deep incisional surgical site infection or mediastinitis by a surgeon or attending physician. | Up to 28 days | |
Secondary | Delirium | Defined as a intensive care delirium screening checklist (ICDSC) score of =4 in the week following surgery or positive result for the Confusion Assessment Method for the ICU (CAM-ICU) | Up to 28 days | |
Secondary | Stroke | A central neurologic deficit persisting longer than 72 hours | Up to 28 days | |
Secondary | Total duration of ICU stay in hours | Number of hours passed in the ICU | Up to 28 days | |
Secondary | Duration of hospital stay (in days) | Number of days hospitalized from the day of surgery to discharge | Up to 28 days | |
Secondary | Duration of mechanical ventilation (in hours) | Number of hours of mechanical ventilation | Up to 28 days | |
Secondary | A composite outcome of major morbidity or mortality (41): including death, prolonged ventilation, stroke, renal failure (Stage =2), deep sternal wound infection and reoperation for any reason. | Composite endpoint after cardiac proposed by the Society of Thoracic Surgeons | Up to 28 days |
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