Response in Right Ventricular Function to Change in Afterload, Preload and Inspired Oxygen in Patients Undergoing Coronary Artery Bypass Graft Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Change in right ventricular function during CABG assessed with TAPSE
研究概览
简要总结
Postoperative right ventricular (RV) dysfunction increases mortality and risk of cardiac failure after cardiac surgery substantially. A comprehensive understanding of this condition is paramount in order to achieve success in treatment and early diagnosis.
This study has two main aims.
Perioperative aim:
To investigate correlations between changes in echocardiographic measurements and hemodynamic changes at baseline and following coronary artery bypass graft (CABG) surgery.
Postoperative aim:
To evaluate changes in haemodynamics and echocardiographic parameters during separate physiological interventions (increase in preload/afterload, oxygen fraction, pacing modes (AAI/DDD/VVI)).
详细描述
Clinical procedure:
For the operation standard procedures for anaesthesia, surgery and cardiopulmonary bypass will be used. This includes installment of a pulmonary artery catheter and performing a transesophageal echocardiography. For the purpose of this study additional TEE images and a transthoracic echocardiography (TTE) will be obtained in order to correlate different echocardiographic indices with haemodynamic measurements and investigate any differences between TTE and TEE measurements.
Transthoracic echocardiography (TTE):
Basic TTE will be performed after anaesthesia induction, before surgery commences and repeated immediately after arrival at the ICU.
Image acquisitions from TTE:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Elective coronary artery bypass graft patients
- •Normal left ventricular function defined as LVEF over 50 % on TTE preoperatively
排除标准
- •Pre-existing right ventricular malformations
- •Severe right ventricular impairment preoperatively
- •Pre-existing non-sinus rhythm
- •Pre-existing mitral valve stenosis or severe regurgitation
- •Pre-existing pulmonary hypertension
- •Pre-existing tricuspid valve stenosis or severe regurgitation
- •Patients with contraindication to TEE probe placement such as oesophageal stricture or obstruction
- •Patients with contraindication to Swan-Ganz catheter placement
研究组 & 干预措施
All patients
All patients will receive the treatment (CABG) and postoperatively three different interventions:
- Change in preload and afterload
- Change in inspired oxygen
- Change in pacemaker modes
干预措施: Change in preload and afterload (Other)
All patients
All patients will receive the treatment (CABG) and postoperatively three different interventions:
- Change in preload and afterload
- Change in inspired oxygen
- Change in pacemaker modes
干预措施: Inspired oxygen (Other)
All patients
All patients will receive the treatment (CABG) and postoperatively three different interventions:
- Change in preload and afterload
- Change in inspired oxygen
- Change in pacemaker modes
干预措施: Pacemaker mode (Other)
结局指标
主要结局
Change in right ventricular function during CABG assessed with TAPSE
时间窗: During a standard CABG operation
Assessing the change in RV function during CABG surgery
次要结局
- Response in right ventricular function parameter S' to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter Tei index to each intervention(Immediate postoperative period)
- Change in cardiac output measured with Swan-Ganz during CABG(During a standard CABG operation)
- Response in right ventricular function parameter RVFAC to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter strain rate during a standard CABG operation(During a standard CABG operation)
- Response in right ventricular function parameter strain rate to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter RV size to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter RV size during a standard CABG operation(During a standard CABG operation)
- Right ventricular function assessed with TAPSE after each intervention(Immediate postoperative period)
- Change in cardiac output measured with Swan-Ganz after each intervention(Immediate postoperative period)
- Response in right ventricular function parameter RVFAC during a standard CABG operation(During a standard CABG operation)
- Response in left ventricular function parameter MAPSE during a standard CABG operation(During a standard CABG operation)
- Response in right ventricular function parameter pulmonary artery flow velocity to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter RVEF during a standard CABG operation(During a standard CABG operation)
- Change in cardiac output measured with Swan Ganz in response during a standard CABG operation(During a standard CABG operation)
- Response in right ventricular function parameter S' during CABG(During a standard CABG operation)
- Response in right ventricular function parameter Tei index during a standard CABG operation(During a standard CABG operation)
- Response in left ventricular function parameter MAPSE to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter strain % to each intervention(Immediate postoperative period)
- Response in right ventricular function parameter strain % during a standard CABG operation(During a standard CABG operation)
- Response in right ventricular function parameter RVEF during CABG(Immediate postoperative period)
- Response in right ventricular function parameter pulmonary artery flow velocity during a standard CABG operation(During a standard CABG operation)
- Response in right ventricular function parameter RVEF to each intervention(Immediate postoperative period)
- Change in cardiac output measured with Swan Ganz in response to each intervention(Immediate postoperative period)
- Change in hemodynamic pressures in response to each intervention(Immediate postoperative period)
- Change in hemodynamic pressures during a standard CABG operation(During a standard CABG operation)
研究者
Lars Grønlykke
Principal investigator, MD
Rigshospitalet, Denmark