View clinical trials related to Cardiopulmonary Bypass Surgery.
Filter by:Preventing pre-surgical stress can help patients achieve positive outcomes on health and well-being. However, very few patients receive adequate stress relief support prior to a surgical procedure. Provision of education and information about the surgery can be a crucial component of the preoperative experience and is inversely related to levels of preoperative anxiety. However, resource constraints make face-to-face education sessions untenable, given cost considerations and time investment by trained health personnel. Interventions based on mobile health (mHealth) technologies, geared towards increasing familiarity with surgical procedures and hospital environments have been shown to help patients feel informed about possible benefits and risks of available treatment options. mHealth apps and Virtual Reality (VR) can offer patients experience in the perioperative environment that can be helpful in empowering patients and enhancing a more positive experience, while reducing stress. However, available applications focus only on providing informative content, neglecting the importance of patient empowerment with a more robust educational curriculum. According to this, the Software as a Medical Device (SaMD) CARINAE, aims to support patients and caregivers during the whole perioperative process. SaMD CARINAE consists of an mHealth mobile application for patients and caregivers, a Virtual Reality headset for patients, and a web application for healthcare professionals.
This study is to understand the changes occurring in a blood clotting protein, von Willebrand factor (VWF), in patients undergoing cardiac surgery who receive the blood thinner called Heparin. These patients are given Heparin through their veins, to prevent blood clot formation as it passes through the heart bypass machine. At the end of the operation, the effect of Heparin is reversed by another drug, Protamine Sulphate. Heparin prevents blood clots forming mainly by inactivating thrombin, a crucial protein needed for blood clotting. This effect of Heparin is monitored through blood tests called the 'Anti Factor-Xa' and the 'APTT'. Heparin has another effect on clotting: it can block the attachment of special blood cell fragments called platelets to damaged blood vessels, but this effect is not usually measured. Following blood vessel injury, the large VWF sticks to the damaged surface and captures platelets to form a 'plug' which stops bleeding. The platelet plug is then stabilised by other clotting proteins. This stops blood loss and allows vessel repair underneath. Heparin blocks the ability of VWF to capture platelets at the site of blood vessel injury. The higher the dose of Heparin, the greater this blocking effect is. This secondary effect of Heparin cannot be readily monitored and may explain why bleeding complications occur in patients receiving Heparin despite the monitoring with blood tests used. This study will look at the blood levels of Heparin, VWF and platelets before, during and after surgery and how well VWF functions in the presence of heparin, including its ability to attach to platelets. The investigators will determine if all of the heparin related changes in blood clotting can be detected using a method that looks at all of the different steps in forming a blood clot.