Fluid Management in Patients Undergoing Cardiac Surgery (Hemacetat)

November 2, 2017 updated by: University Hospital Inselspital, Berne

Fluid Management in Patients Undergoing Cardiac Surgery - Effects of an Acetate Versus Lactate Buffered Balanced Infusion Solution on Hemodynamic Stability, a Randomized Controlled Double-blind Trial

Background: Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intra- and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. Despite continuing evaluation no superiority of one particular type of fluid has been reached so far. To the best of the investigators' knowledge no study in humans has ever assessed whether the type of crystalloid fluid given for fluid resuscitation in patients undergoing cardiac surgery has an impact on hemodynamic stability and cardiac function so far. Nonetheless in the animal model it was shown that the choice of crystalloid fluid may greatly influence cardiac performance

Primary Aim: In this study the investigators want to clarify whether a balanced type acetate-buffered fluid solution in patients undergoing cardiac surgery is associated with better hemodynamic stability and cardiac function than a lactate-buffered crystalloid solute.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Switzerland
      • Bern, Switzerland, 3010
        • Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Elective single heart valve replacement
  • Elective double valve replacement
  • Elective single or double valve replacement and coronary artery bypass grafting

Exclusion Criteria:

  • Patients unable to give informed consent
  • Patients younger than 18 years of age or older than 80 years
  • Pregnancy or breastfeeding
  • Ejection fraction (EF) of less than 30% preoperatively
  • Preexisting renal insufficiency with a glomerular filtration rate below 30ml/min
  • Patients transferred form the intensive care unit to the operating theater
  • Emergency operation
  • Reoperation
  • Patients planned for fast-track surgery
  • Patients planned for minimal extracorporal circuits
  • Preexisting anemia requiring immediate perioperative blood transfusion
  • Chronic inflammatory diseases
  • Any signs of infection or sepsis
  • Limitation of full therapy (e.g. Jehowa's witnesses)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Ringer lactate
Fluid resuscitation will be performed with lactated Ringers during the perioperative period. Perioperative hemodynamic management will be performed according to a specified treatment protocol.
Procedure: perioperative hemodynamic management with vasoactive medications (norepinephrine, adrenaline ect)
Perioperative hemodynamic management will be performed according to a specified treatment protocol.
Active Comparator: Ringer acetate
Fluid resuscitation will be performed with acetated Ringers during the perioperative period. Perioperative hemodynamic management will be performed according to a specified treatment protocol.
Procedure: perioperative hemodynamic management with vasoactive medications (norepinephrine, adrenaline ect)
Perioperative hemodynamic management will be performed according to a specified treatment protocol.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Cumulative dose of inopressors (norepinephrine and epinephrine) per kg bodyweight/hour during the perioperative period
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))

Secondary Outcome Measures

Outcome Measure
Time Frame
Time on inopressors
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Cumulative dose of inodilators
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Time on inodilators
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Cumulative dose of vasodilatators
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Time on vasodilatators
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Total amount of fluid
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Changes in acid-base status
Time Frame: Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))
Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours))

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital Inselspital, Berne

Investigators

  • Principal Investigator: Carmen A Pfortmueller, MD, Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2016

Primary Completion (Actual)

October 19, 2017

Study Completion (Actual)

October 19, 2017

Study Registration Dates

First Submitted

August 30, 2016

First Submitted That Met QC Criteria

September 5, 2016

First Posted (Estimate)

September 12, 2016

Study Record Updates

Last Update Posted (Actual)

November 6, 2017

Last Update Submitted That Met QC Criteria

November 2, 2017

Last Verified

November 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 20160804.1.3

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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