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Endothelial Dysfunction As A Predictor Of Perioperative Outcome

20 de septiembre de 2019 actualizado por: M.D. Anderson Cancer Center

Endothelial Dysfunction As A Predictor Of Perioperative Outcome In Major Thoracic Surgery - An Observational Study

The goal of this clinical research study is to learn whether the inability of certain blood vessel cells (endothelial cells) to function properly may help researchers to predict who is at risk for complications after surgery and whether this dysfunction contributes to complications after surgery. This study will use a blood test to quantify the number of cells that are destined to become endothelial cells.

Descripción general del estudio

Estado

Terminado

Descripción detallada

A small group of patients (about 12 out of every 100) are at risk of developing complications, for example lung infection, after their surgery. Researchers do not always know which patient is at risk or the reason why some patients develop these complications. Your participation in this study may help researchers to understand who is at risk and also the mechanism of some of the complications.

The inner layer of cells of blood vessels are called endothelial cells. This layer of cells plays a vital role in the normal function of blood vessels, including blood clotting and inflammation. Certain conditions, such as aging, smoking, high cholesterol, and some chemotherapies cause these cells to not function properly. Researchers can test whether these cells function properly by doing two simple tests - one is a blood test and the other uses ultrasound and temperature probes on the finger to look at the ability of arm blood vessels to dilate (expand).

The way your cells function will be tested within a month before your scheduled chemotherapy / radiation (if applicable), and again within a month before your major chest surgery. This will be done on those patients with surgery planned or scheduled.

About 2 tablespoons of blood will be drawn to measure the number of circulating blood cells that become endothelial cells.

During your scheduled surgery, the researcher will also collect just over a teaspoon of blood at the beginning of the surgery for an additional endothelial risk assessment and a small sample of lung tissue, if available. Tissue removed during long surgery is usually thrown away if it is not needed for diagnosis and or treatment purposes. The lung tissue sample collected for this research study will only be taken from lung tissue that is to be discarded. The lung tissue will be used to determine the amount of a naturally occurring substance thought to play a role in recruiting blood cells to repair injured lung tissue.

Blood samples (about 2 tablespoons) will also be collected after exercise, during your surgery, 24 hours after your surgery, and at 5 days after surgery or the time you discharge from the hospital (which ever is shorter). These blood samples will also be collected at your routinely schedule post operative clinic visits at 1 month, 6 months, and 1 year after surgery. The samples will be used to determine the amount of endothelial cells in the blood stream.

For healthy volunteers, blood samples (about 2 tablespoons) will be collected at baseline (prior to exercising), 15-30 minutes past peak exercise, 3 hours past peak exercise and at 24 hours past past peak exercise.

Data will be collected on you for 30 days after your surgery, and during the 1 year follow-up. These data will then be matched with the amount of cell function as measured before surgery to see if these tests may be used to help predict which patients are at increased risk for complications. No other measurements will be done and this study will not change your surgical procedure or lengthen your hospital stay.

This is an investigational study. About 90 patients will take part in this study. All will be enrolled at The University of Texas (UT) MD Anderson Cancer Center (MDACC).

Tipo de estudio

De observación

Inscripción (Actual)

90

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Texas
      • Houston, Texas, Estados Unidos, 77030
        • University of Texas MD Anderson Cancer Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Método de muestreo

Muestra no probabilística

Población de estudio

Study participants is scheduled to have major chest (lung or esophagus) surgery or is a healthy volunteer.

Descripción

Inclusion Criteria:

  1. Patients scheduled for major thoracic surgery (lobectomy, pneumonectomy, esophagectomy).
  2. Patients 18 years of age or older.
  3. Patients who have signed the consent form to participate in the study.
  4. Patients must have been evaluated in the Preanesthesia Clinic or by a staff Anesthesiologist preoperatively.
  5. All laboratory and diagnostic evaluations required or used to evaluate the patient in the Preanesthesia Clinic must be completed. All patients must be approved for surgery by the standards of the Preanesthesia Clinic.

Exclusion Criteria:

  1. Refusal to participate in the study.
  2. Patient is under age 18.
  3. Patient is unwilling to sign consent.
  4. Patient is unable to exercise (bedridden or wheel chair bound).
  5. Patient is enrolled in another study deemed by the investigator to affect oxygen metabolic efficiency and not presently the standard of care at MDACC.
  6. Any patient whose condition is deemed unsatisfactory for surgery after the preanesthetic evaluation.
  7. Surgery canceled for any reason. The patient may reenter the study if surgery is rescheduled.
  8. Patient has had a myocardial infarction within 3 months of visiting the Preanesthesia Clinic or presents with new or unstable angina.
  9. Patient has a history of cerebrovascular accident or transient ischemic attacks within 3 months of visiting the Preanesthesia Clinic.
  10. Patient has a history of pulmonary embolic event within 3 months of visiting the Preanesthesia Clinic.
  11. Patient known to have acute or chronic deep vein thrombosis.
  12. Pregnant patients.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

Cohortes e Intervenciones

Grupo / Cohorte
Endothelial Dysfunction
Participants are scheduled for major chest (lung or esophagus) surgery or are a healthy volunteer. A blood test will quantify the number of cells that are destined to become endothelial cells.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
Number of Patient Major Pulmonary Events (MPE)
Periodo de tiempo: Baseline (entry in study) to end of study (estimated 1 year post-operative)
Baseline (entry in study) to end of study (estimated 1 year post-operative)

Medidas de resultado secundarias

Medida de resultado
Periodo de tiempo
Patient's Duration of intensive care unit / hospital length of stay
Periodo de tiempo: Baseline to final day of hospitalization
Baseline to final day of hospitalization

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Reza-John Mehran, MD, M.D. Anderson Cancer Center

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

1 de marzo de 2006

Finalización primaria (Actual)

5 de junio de 2019

Finalización del estudio (Actual)

5 de junio de 2019

Fechas de registro del estudio

Enviado por primera vez

5 de octubre de 2006

Primero enviado que cumplió con los criterios de control de calidad

5 de octubre de 2006

Publicado por primera vez (Estimar)

6 de octubre de 2006

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

24 de septiembre de 2019

Última actualización enviada que cumplió con los criterios de control de calidad

20 de septiembre de 2019

Última verificación

1 de septiembre de 2019

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • 2003-0434

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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