Endothelial Dysfunction Clinical Trial
Official title:
Evaluation of the Association Between Pre-existing Endothelial Dysfunction and the Onset of Vasoplegia During Cardiac Surgery With Cardiopulmonary Bypass
Cardiac surgery patients have many risk factors for endothelial dysfunction (hypertension,
atherosclerosis, dyslipidemia, chronic renal failure ...).
It is likely that a significant number of patients suffering from a preexisting endothelial
dysfunction. This endothelial dysfunction can be assessed by a molecular approach
(determination of NO, ICAM1, VCAM1, IL8, endothelial microparticles ...). Extracorporeal
circulation with ischemia-reperfusion causes a breach of particularly important glycocalyx as
ischemia-reperfusion injury is. No studies have evaluated the time course of the
infringement, and its association with the immediate post-operative complications (SIRS,
coagulopathy, vasoplegic syndrome, renal failure). Only one study has regained an association
between endothelial dysfunction during cardiac bypass surgery and postoperative cardiac
surgery vasoplegic syndrome. A study in noncardiac surgery has regained an association
between endothelial dysfunction (assessed by a vasoplegia test) and postoperative acute renal
failure. Thus there is some data in the literature to suggest that the occurrence of
postoperative complications (SIRS, coagulopathy, capillary leak syndrome, acute circulatory
failure vasoplegic and acute renal failure) may result from the interaction between a
pre-existing endothelial dysfunction and "operative" aggression (extracorporeal circulation).
The onset of complications result from an interaction that depends on the importance of
endothelial dysfunction at baseline.
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