Extracorporeal Circulation Clinical Trial
Official title:
Removal of Cytokines in Patients Undergoing Cardiac Surgery With CPB (The REMOTE Study)
In a lot of cases during cardiac surgery cardiopulmonary bypass initiates SIRS due to
release of cytokines during immunological response.
They are induced by different types of inductors ( intrinsic and extrinsic). High levels of
inflammation markers like TNF-a, IL 6 and IL 10 as well as TGF-ß are detectable after 2
hours of surgery.
Beside the inflammation acute phase parameters like fibrinogen, ferritin are increased.
These changes lead to rheology impairments.
These strong reactions lead to dysfunction of different organs possibly culminating in a
multi organ failure.
There is a correlation between amounts of cytokines and mortality. Often AKI occurs after
CPB with a rate of about 30%. Dysfunctions of organ function are often connected with
increased mortality, prolonged mechanical ventilation , septic complications, increased
catecholamine dosages and prolonged length of ICU stay.
Use of cytokine adsorption within the extracorporeal circuit during CBP can affect the
circulating cytokine levels during and after CPB and lead to a diminished inflammatory
response, acute phase reaction as well as reduction of organ failure.
In a lot of cases during cardiac surgery cardiopulmonary bypass initiates SIRS due to
release of cytokines during immunological response.
They are induced by different types of inductors ( intrinsic and extrinsic). High levels of
inflammation markers like TNF-a, IL 6 and IL 10 as well as TGF-ß are detectable after 2
hours of surgery.
Beside the inflammation acute phase parameters like fibrinogen, ferritin are increased.
These changes lead to rheology impairments.
These strong reactions lead to dysfunction of different organs possibly culminating in a
multi organ failure.
There is a correlation between amounts of cytokines and mortality. Often AKI occurs after
CPB with a rate of about 30%. Dysfunctions of organ function are often connected with
increased mortality, prolonged mechanical ventilation , septic complications, increased
catecholamine dosages and prolonged length of ICU stay.
Use of cytokine adsorption within the extracorporeal circuit during CBP can affect the
circulating cytokine levels during and after CPB and lead to a diminished inflammatory
response, acute phase reaction as well as reduction of organ failure.
Official Title: Removal of Cytokines in patients undergoing cardiac surgery with CPB ( The
REMOTE Study)
Study type: Interventional Study design: randomized, controlled Endpoint Classification:
Efficacy study Interventional Model: Parallel assignment Masking: Single blinding ( Subject)
Primary purpose: Treatment
Patients who have an elective cardiac surgery with an expected CPB duration > 75 min ( e.g.
valve surgery, CABG, combined procedures, redo) will be enrolled into the study after a
giving informed consent.
Selection of patients are directed by randomization. Patient which drop out will be
replaced.
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