- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02143544
Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery (IABCS)
Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery: a Randomized Controlled Trial
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
High-risk patients undergoing cardiac surgery are at high risk for myocardial ischemia, arrhythmia, cardiogenic shock and other clinical complications. Different therapeutic options are available to support these patients in the perioperative period including inotropes, vasopressors, and vasodilators, and also assist devices such as intra-aortic balloon pump (IABP) and others.
IABP increases myocardial oxygen supply by increasing diastolic coronary perfusion pressure and decreases myocardial oxygen demand by reducing left ventricular afterload. Additionally, IABP can also improve cardiac output and systemic perfusion. The hypothesis of this randomized and controlled trial is that the placement of IABP immediately before the cardiac surgery reduces clinical complications in high-risk patients.
Undersøgelsestype
Tilmelding (Forventet)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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SP
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Sao Paulo, SP, Brasilien, 05403000
- Rekruttering
- Heart Institute
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Kontakt:
- Graziela Ferreira, Dr
- Telefonnummer: 11-26615367
- E-mail: gsrf@uol.com.br
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Kontakt:
- Ludhmila A Hajjar, PhD
- Telefonnummer: 11-26615232
- E-mail: ludhmila@usp.br
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Ledende efterforsker:
- Ludhmila A Hajjar, PhD
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age equal to or higher than 18 years old
- EuroSCORE equal to or higher than 6 or ejection fraction equal to or lower than 40%
- Written informed consent
Exclusion Criteria:
- Cardiogenic shock
- Acute myocardial infarction (AMI) < 48 hours
- Mechanical complications of AMI
- Peripheral vascular disease (aorta, iliac or femoral)
- Severe aortic regurgitation
- Neoplasm
- Pregnancy
- Tachyarrhythmia
- Procedures of the aorta
- Coagulopathy
- Thrombocytopenia
- Cardiac transplantation, congenital heart disease or endocarditis
- Refusal to consent
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Aktiv komparator: Preoperative intra-aortic balloon pump.
Intervention: Preoperative placement of the intra-aortic balloon pump.
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Preoperative placement of the intra-aortic balloon pump.
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Ingen indgriben: Control
No preoperative placement of the intra-aortic balloon pump.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Composite 30-day mortality or major morbidity (mechanical ventilation > 24 hours, mediastinitis, surgical reexploration, stroke, cardiogenic shock, acute renal failure)
Tidsramme: 30 days
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Composite outcome of 30-day mortality or incidence of patients presenting a major complication according to modified Society of Thoracic Surgeons (STS): mechanical ventilation > 24 hours, deep sternal wound infection/mediastinitis, surgical reexploration, stroke, cardiogenic shock and acute renal failure.
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30 days
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Duration of mechanical ventilation
Tidsramme: 30 days
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Number of days during mechanical ventilation.
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30 days
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IABP complications
Tidsramme: 30 days
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Number of patients presenting one of the following: lower limb ischemia, mesenteric ischemia or bleeding.
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30 days
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Use of vasoactive agents
Tidsramme: 30 days
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Number of days and dose of inotropes and vasopressors.
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30 days
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Evaluation of hemodynamic data
Tidsramme: 48 hours
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Comparison of the following hemodynamic data between groups: heart rate, arterial pressure and cardiac output.
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48 hours
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Levels of biomarkers
Tidsramme: 7 days
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Comparison of the following biomarker levels between groups: pro-BNP (Brain natriuretic peptide), troponin I and Neutrophil gelatinase-associated lipocalin (NGAL), Heart-type Fatty Acid Binding Protein (H-FABP)
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7 days
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Echocardiographic parameters
Tidsramme: 7 days
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Comparison of the following echocardiographic parameters between groups: left ventricular ejection fraction, cardiac output, left ventricular diastolic diameter, left ventricular systolic diameter and wall motion abnormalities.
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7 days
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30-day mortality
Tidsramme: 30 days
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Death during hospital stay or death after hospital discharge until 30 days following the procedure
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30 days
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60-days mortality
Tidsramme: 60 days
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Death until 60 days following the procedure
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60 days
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1-year mortality
Tidsramme: 1 year
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Death until 1 year following the procedure
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1 year
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Costs
Tidsramme: 30 days
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Comparison of overall costs between groups.
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30 days
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Acute Kidney Injury
Tidsramme: 30 days
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Incidence of acute kidney injury according the Acute Kidney Injury Network (AKIN) classification.
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30 days
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Cardiovascular complications
Tidsramme: 30 days
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Arrhythmias or myocardial ischemia within 30 days after randomization
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30 days
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Infectious complications
Tidsramme: 30 days
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New infection or septic shock within 30 days after randomization
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30 days
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Delirium
Tidsramme: 30 days
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Acute cognitive dysfunction diagnosed with the use of the CAM-ICU scale within 30 days after randomization
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30 days
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Bleeding
Tidsramme: 24 hours
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Blood losses exceeding 100-300 mL per hour following ICU admission
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24 hours
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Samarbejdspartnere og efterforskere
Sponsor
Publikationer og nyttige links
Generelle publikationer
- Caldas JR, Panerai RB, Bor-Seng-Shu E, Ferreira GSR, Camara L, Passos RH, Salinet AM, Azevedo DS, de-Lima-Oliveira M, Galas FRBG, Fukushima JT, Nogueira R, Taccone FS, Landoni G, Almeida JP, Robinson TG, Hajjar LA. Intra-aortic balloon pump does not influence cerebral hemodynamics and neurological outcomes in high-risk cardiac patients undergoing cardiac surgery: an analysis of the IABCS trial. Ann Intensive Care. 2019 Nov 27;9(1):130. doi: 10.1186/s13613-019-0602-z.
- Caldas JR, Panerai RB, Bor-Seng-Shu E, Ferreira GSR, Camara L, Passos RH, de-Lima-Oliveira M, Galas FRBG, Almeida JP, Nogueira RC, Mian N, Gaiotto FA, Robinson TG, Hajjar LA. Dynamic cerebral autoregulation: A marker of post-operative delirium? Clin Neurophysiol. 2019 Jan;130(1):101-108. doi: 10.1016/j.clinph.2018.11.008. Epub 2018 Nov 22.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Forventet)
Studieafslutning (Forventet)
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
Andre undersøgelses-id-numre
- Heart Institute
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Kliniske forsøg med Intra-aortic balloon pump.
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magAssist, Inc.Aktiv, ikke rekrutterende