Evaluation of the Prognostic Value of Preoperative Quadriceps and Respiratory Muscle Thickness by Ultrasound Measurement in Cardiac and Thoracic Surgery Patients: a Prospective Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 301
- 试验地点
- 1
- 主要终点
- Occurrence of a cardiovascular complication
研究概览
简要总结
Cardiac and thoracic surgery are major procedures. In order to estimate the operative risk, many scores have been developed, including the Euroscore 2 in cardiac surgery. However, the Euroscore has limitations since it does not assess all the parameters that may influence postoperative complications, such as the patient's general condition or the status of his or her functional reserves.
However, it has been shown that the preoperative functional reserves have a significant impact on the patient's risk of developing postoperative complications following major surgery. In addition, there is a strong association between cardiac failure and a well-described decrease in peripheral muscle lean mass (sarcopenia) in patients older than 65 years.
Usually, a nutritional assessment is performed during the pre-anesthesia consultation. This assessment is based on clinical and biological criteria that are not totally predictive of the patient's functional reserve status.
Lean body mass (muscle) is a well-validated marker for the assessment of patients' functional reserves. However, the techniques used to date are complex and require radiation.
This study aims to use ultrasound of muscle groups (respiratory muscles - Quadriceps muscle - Diaphragm) to study the relationship between preoperative muscle mass and postoperative complications in patients over 65 years of age undergoing cardiac or thoracic surgery.
This is a prospective observational study to be conducted at the Dijon University Hospital by the cardiovascular anesthesia-intensive care department. A total of 300 patients will participate in this study, and we have planned to complete the project over a 2-year period. The participating patients (if they do not present any exclusion criteria and are not opposed to inclusion) will be included and undergo a muscle ultrasound in the cardiovascular surgery department or the thoracic and pulmonary surgery department the day before their intervention.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 —(Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patient 65 years or older
- •Patients who have not objected to their inclusion in the study
- •Any patient requiring elective cardiac surgery, with extracorporeal circulation extracorporeal circulation OR
- •Any patient requiring lung surgery with resection of at least one lobe
排除标准
- •pneumectomy
- •Person who is not affiliated to national health insurance
- •Person subject to a measure of legal protection (curatorship, guardianship)
- •Pregnant, parturient or breastfeeding women
- •Major unable to express consent
- •Persons with amputations of the proximal segment of a lower limb
- •Persons suffering from a pre-existing neuromuscular pathology, tetra or paraplegia
- •Person who must undergo emergency surgery
研究组 & 干预措施
Cardiology patient
Patient requiring cardiac surgery with bypass
干预措施: Ultrasound of the abdominal wall muscles (Other)
Cardiology patient
Patient requiring cardiac surgery with bypass
干预措施: Ultrasound quadricipital (Other)
Cardiology patient
Patient requiring cardiac surgery with bypass
干预措施: Ultrasound of the diaphragm (Other)
Cardiology patient
Patient requiring cardiac surgery with bypass
干预措施: Ultrasound of the inter-costal muscles (Other)
Pneumology patient
Patient requiring lung surgery with resection of at least one lobe
干预措施: Ultrasound of the abdominal wall muscles (Other)
Pneumology patient
Patient requiring lung surgery with resection of at least one lobe
干预措施: Ultrasound quadricipital (Other)
Pneumology patient
Patient requiring lung surgery with resection of at least one lobe
干预措施: Ultrasound of the diaphragm (Other)
Pneumology patient
Patient requiring lung surgery with resection of at least one lobe
干预措施: Ultrasound of the inter-costal muscles (Other)
结局指标
主要结局
Occurrence of a cardiovascular complication
时间窗: Within 30 days after surgery
Death
时间窗: Within 30 days after surgery
Onset of acute renal failure
时间窗: Within 30 days after surgery
Occurrence of an infectious complication
时间窗: Within 30 days after surgery
Occurrence of a respiratory complication
时间窗: Within 30 days after surgery
Occurrence of acute respiratory failure in cardiac surgery and occurrence of a severe extra-respiratory complication according to the european perioperative clinical outcome definition in pulmonary surgery
次要结局
未报告次要终点
