Cytokine adsorption for vasoplegic syndrome after cardiothoracic surgery - CYTATIO

Medisch Universitair Ziekenhuis Maastricht0 个研究点目标入组 40 人开始时间: 待定最近更新: 2024年4月15日

适应症

试验速览

暂无简介。

•1. >= 18 year
•2. Post elective cardiac surgery
•3. Vasoplegic syndrome occurring within 12 hours after surgery, defined as:
•a. High vasopressor dose (norepinephrin > 0.25 mcg/kg/min) needed for adequate
•MAP (> 65 mmHg) despite adequate crystalloid fluid resuscitation (> 30 ml/kg
•IBW), persisting more than one hour.
•b. Echocardiographic evidence of adequate cardiac output, defined as cardiac
•index > 2,5L/min/m2. Stroke volume is calculated as the product of Aortic
•velocity time integral and left ventricular outflow tract diameter. Cardiac
•output is calculated by multiplying stroke volume with heart rate. This is then
•divided by body surface area to obtain cardiac index. , c. IF; a pulmonary
•artery catheter was already inserted perioperatively:
•- Cardiac index > 2,5l/min/m2 AND low systemic vascular resistance (SVRI < 1600
•dynes/sec/cm5/m2 , SVR < 800 dynes/sec/cm5)
•- OR; normalized vascular resistance at due to high-dose vasopressor use
•(norepinephrin > 0.25 mcg/kg/min).

•- Severe coagulopathy resulting in hemodynamic instability
•- Significant bleeding defined as 400 ml/1st hour, 200 ml/ 2nd hour, 100 ml/h;
•necessitating rethoractomy or transfusion
•- Severe thrombocytopenia (< 80)
•- Cardiac tamponade
•- Active infectious disease (non-profylactic antibiotics)
•- Active inflammatory disorders or chronic use of immunosuppressive medication
•- Need for extracorporeal life support system
•- Severe renal dysfunction pre-operation (GFR <30) or prior kidney transplant
•- Contra-indications for PiCCO: Atrial or ventricular arrhythmia at time of
•inclusion, Intra-Aortic Balloon pump, Aortic aneurysm, Pneumonectomy, Pulmonary
•embolism, Intracardiac shunt
•- Allergy for: polystyrene/divinylbenzene, polycarbonate, polypropylene,
•silicone and polyester
•- Acute liver failure with blood transaminases values >1000 IU/L
•- Pregnancy

发起方

Medisch Universitair Ziekenhuis Maastricht