Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery (IABCS)
Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery: a Randomized Controlled Trial
研究概览
详细说明
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.
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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SP
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Sao Paulo、SP、巴西、05403000
- 招聘中
- Heart Institute
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接触:
- Graziela Ferreira, Dr
- 电话号码:11-26615367
- 邮箱:gsrf@uol.com.br
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接触:
- Ludhmila A Hajjar, PhD
- 电话号码:11-26615232
- 邮箱:ludhmila@usp.br
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首席研究员:
- Ludhmila A Hajjar, PhD
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器: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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无干预:Control
No preoperative placement of the intra-aortic balloon pump.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Composite 30-day mortality or major morbidity (mechanical ventilation > 24 hours, mediastinitis, surgical reexploration, stroke, cardiogenic shock, acute renal failure)
大体时间: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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Duration of mechanical ventilation
大体时间:30 days
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Number of days during mechanical ventilation.
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30 days
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IABP complications
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间:1 year
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Death until 1 year following the procedure
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1 year
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Costs
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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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合作者和调查者
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- Heart Institute
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