- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01276444
Comparison of Goal-directed Algorithms of Hemodynamic Therapy After Combined Valve Repair
Comparison of Goal-directed Algorithms of Hemodynamic Therapy After Combined Valve Repair: a Randomized Clinical Trial
Valvular repair and repair surgery is rapidly progressing yet rather challenging aspect of current cardiosurgical practice.
Several approaches were introduced into the clinical practice to alleviate systemic inflammatory response induced by cardiopulmonary bypass and organ-specific injury including meticulous haemodynamic monitoring, pharmacological heart preconditioning, systemic use of anti-inflammatory agents, prevention of coagulopathy, and induced topical and systemic hypothermia. An in-depth monitoring of haemodynamics, oxygen transport, and vascular permeability is of a great clinical value to control the efficacy of these approaches.
Therefore, the aim of this study was to compare two algorithms of goal-directed therapy aimed to achieve a postoperative haemodynamic optimization in combined valve repair surgery.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Forty-three adult patients scheduled for elective two valve replacement/repair were enrolled into randomised single-centre study. All interventions were performed in cardiosurgical department of City hospital #1 (Arkhangelsk, Russian Federation) by the same surgical team. Three patients were excluded from the analysis; two - due to protocol violation and one - due to inadequate surgical correction diagnosed by intraoperative transoesophageal echocardiography.
Day before surgery patients were asked for informed consent and randomized in two groups. In the first group postoperative haemodynamic optimization was targeted on parameters provided by pulmonary artery catheter (the PAC-group, n = 20): pulmonary arterial occlusion pressure, cardiac index (LifeScope monitor, Nihon Kohden, Japan) and hemoglobin blood level. In the second group haemodynamics was managed using parameters given by transpulmonary thermodilution (the COMPLEX-group), that included cardiac index, global end-diastolic volume index, extravascular lung water index, continuous central venous oxygen saturation, and oxygen delivery index as measured with PiCCO2 monitor (Pulsion Medical Systems, Munich, Germany. In addition, mean arterial pressure, heart rate, and hemoglobin concentration were included into both PAC- and PiCCO2-driven protocols.
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
-
Arkhangelsk, Den Russiske Føderation, 163000
- City hospital # 1 / Northern State Medical University,
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Two valve repair / replacements
- Age above 18
- Informed consent
Exclusion Criteria:
- pulmonary hypertension
- insulin-dependent diabetes mellitus
- severe atherosclerosis of femoral arteries
- severe respiratory failure
- pregnancy
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: Pulmonary artery catheter (PAC)
PAC was used to guide hemodynamic therapy after combined valve repair
|
the data s=derived from PAC included pulmonary artery occlusion pressure etc
Andre navne:
|
|
Aktiv komparator: COMPLEX
An combination of transpulmonary thermodilution and continuous monitoring of central venous saturation was used to guide hemodynamic therapy after combined valve repair surgery.
|
Described in details above
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Mortality
Tidsramme: Day 28
|
Mortality rate at Day 28
|
Day 28
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Fit for discharge
Tidsramme: non actual
|
Formal 'fit for discharge from ICU' criteria
|
non actual
|
|
Vasoactive support
Tidsramme: 7 days
|
Duration of vasopressor and or inotrope support
|
7 days
|
|
Duration of respiratory support
Tidsramme: Day 7
|
The total duration of the respiratory support
|
Day 7
|
Samarbejdspartnere og efterforskere
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Mikhail Y. Kirov, MD, PhD, Northern State Medical University
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- SCVO2-2008
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Valvulær hjertesygdom
-
Fondation Hôpital Saint-JosephRekruttering
-
Assiut UniversityIkke rekrutterer endnuBallonpulmonal valvuloplastik ved pulmonal valvular stenose
-
Region SkaneTilmelding efter invitationHjertesvigt New York Heart Association (NYHA) klasse II | Hjertesvigt New York Heart Association (NYHA) klasse IIISverige
-
Medical University of BialystokMedical University of Lodz; Poznan University of Medical Sciences; Nicolaus... og andre samarbejdspartnereAfsluttetHjertesvigt, systolisk | Hjertesvigt med reduceret udstødningsfraktion | Hjertesvigt New York Heart Association Klasse IV | Hjertesvigt New York Heart Association Klasse IIIPolen
-
University of WashingtonAmerican Heart AssociationAfsluttetHjertesvigt, Kongestiv | Mitokondriel ændring | Hjertesvigt New York Heart Association Klasse IVForenede Stater
-
Portuguese Association of Interventional CardiologyMedtronicRekrutteringSvær Symptomatisk Aortastenose (Defineret som New York Heart Association (NYHA) klasse ≥ II)Portugal
-
Novartis PharmaceuticalsAfsluttetPatienter, der med succes afslutter den 12-måneders behandlingsperiode i kernestudiet (de Novo Heart-modtagere), som var interesserede i at blive behandlet med EC-MPS
-
University Hospital, GasthuisbergUkendtTransient Left Ventricular Ballooning SyndromeBelgien
-
NYU Langone HealthRekrutteringTako-tsubo kardiomyopati | Takotsubo kardiomyopati | Broken Heart SyndromeForenede Stater
-
French Cardiology SocietyAfsluttet
Kliniske forsøg med Swan-Ganz catheter
-
RenJi HospitalAfsluttetIndføringsdybde af centralt venekateterKina
-
Vanderbilt UniversityEdwards LifesciencesAfsluttetHjertekirurgi | Thoraxkirurgi | Hjerteoperation | Hjertetransplantation
-
Bach Mai HospitalHanoi Medical UniversityRekrutteringHæmodynamisk overvågning | Kardiogent stød | Nødsituation | Akut myokardieinfarkt (AMI) | Kritisk pleje, intensiv pleje | Kardiovaskulær sygdom | Hæmodynamisk optimering | Hæmodynamisk styring | Pulmonalarteriekateter BølgeformfortolkningVietnam
-
Huazhong University of Science and TechnologyWuhan Asia Heart HospitalIkke rekrutterer endnuPostoperative komplikationer
-
National Heart, Lung, and Blood Institute (NHLBI)AfsluttetEvalueringsundersøgelse af kongestiv hjertesvigt og lungearteriekateteriseringseffektivitet (ESCAPE)Hjertesygdomme | Hjertefejl | Hjertesvigt, kongestiv
-
Johannes Gutenberg University MainzAfsluttet
-
Cairo UniversityAfsluttetPulmonal arteriel hypertensionEgypten
-
Novosibirsk Scientific Research Institute for Circulatory...UkendtKronisk tromboembolisk pulmonal hypertensionDen Russiske Føderation
-
Edwards LifesciencesAfsluttet
-
Edwards LifesciencesRekruttering