- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05109715
The Effect of Mechanical Ventilation on the Occurrence of Myocardial Ischemia: a Pilot Study (VENTMICS)
The Effect of Mechanical Ventilation on the Occurrence of Myocardial Ischemia in Patients Undergoing Endoscopic Coronary Artery Bypass Grafting (Endo-CABG): a Pilot Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
CABG is the most effective therapy for patients suffering from coronary artery disease, a condition which annually affects 126 million people worldwide. During this surgery, cardiopulmonary bypass (CPB) takes over the function of the heart and lungs. As a result of the emergence of minimally invasive cardiac surgery (MICS) (e.g. endoscopic-CABG), peripheral CPB with femoral arterial cannulation became the most commonly utilized strategy. However, the use of retrograde arterial perfusion is not without risk. It may result in the upper body and coronary arteries being perfused with deoxygenated blood. The hypoxemia will induce myocardial ischemia and this can harm the cardiac myocytes. A solution for this inconvenience is still lacking. Literature reports that establishing adequate ventilation support should help overcome this phenomenon. However, this approach has not yet been investigated in a clinical trial. In general, this phenomenon is not well recognized in the typical surgical setting, and limited research has been done.
The goal of the proposed pilot study is to determine which method can detect myocardial ischemia at the predefined timepoints during endo-CABG. Additionally, the investigators want to examine the influence of mechanical ventilation on the occurrence of myocardial ischemia in patients undergoing endo-CABG.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Limburg
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Hasselt, Limburg, Belgium
- Jessa Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 18 years old
- Patients undergoing their first elective endo-CABG procedure
- Patients capable of signing the informed consent
- Patients able to speak Dutch or French
Exclusion Criteria:
- Ongoing participation in another trial
- Ejection fraction < 50%
- Lung diseases (COPD, asthma)
- Use of corticosteroids
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Control group
Ventilation is discontinued after going on CPB and lungs are exposed to atmospheric pressure. Blood will be drawn:
|
Ventilation is discontinued after going on CPB and lungs are exposed to atmospheric pressure
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EXPERIMENTAL: Ventilation group
Ventilation is continued from going on CPB until clamping of the ascending aorta. Blood will be drawn:
|
Ventilation is continued from going on CPB until clamping of the ascending aorta with tidal volume 3ml/kg ideal body weight, Fraction of inspired oxygen (FiO2) 50%, respiratory rate 5/min and Inspiratory:Expiratory (I/E) ratio 1/2.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The detection of myocardial ischemia using Cardiac Troponin T (cTn-T)
Time Frame: Until 72 hours after clamping the aorta
|
If the value of Cardiac Troponin T (cTn-T) exceeds 14 ng/L, then cTn-T is able to detect myocardial ischemia at the predefined time points.
|
Until 72 hours after clamping the aorta
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The detection of myocardial ischemia using Heart-type Fatty Acid Binding Protein (hFABP)
Time Frame: Until 5 hours after clamping the aorta
|
If the value of Heart-type Fatty Acid Binding Protein (hFABP) exceeds 6 ng/L, then hFABP is able to detect myocardial ischemia at the predefined time points.
|
Until 5 hours after clamping the aorta
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The detection of myocardial ischemia using Creatine Kinase Myocardial Band (CK-MB)
Time Frame: Until 48 hours after clamping the aorta
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If the value of Creatine Kinase Myocardial Band (CK-MB) exceeds 6.2 µg/L, then CK-MB is able to detect myocardial ischemia at the predefined time points.
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Until 48 hours after clamping the aorta
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The detection of myocardial ischemia using Reactive Oxygen Species (ROS)
Time Frame: Until unclamping the aorta (on average until 64 minutes after clamping the aorta)
|
Reactive Oxygen Species (ROS) measurements include a malondialdehyde assay to assess the lipid peroxidation, an Oxystat test to analyse the total peroxide levels and a protein carbonyl assay to assess the protein damage due to cardiomyocyte dysfunction.
Additionally a biopsy will be taken to analyze pro- and anti-oxidants.
If a significant increase in lipid peroxidation, total peroxide levels, protein damage and/or pro- and anti-oxidants in the ventilation group compared to the control group is present, then ROS is able to detect myocardial ischemia at the predefined time points.
|
Until unclamping the aorta (on average until 64 minutes after clamping the aorta)
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The occurence of hypoxemia using blood gas measurement
Time Frame: Until the end of surgery (on average until 203 minutes after the start of the surgery)
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If the partial pressure of oxygen (PaO2) is lower than 60 mmHg, then hypoxemia is present.
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Until the end of surgery (on average until 203 minutes after the start of the surgery)
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Abdullah Kaya, PhD, Jessa Hospital
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- f/2021/118
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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