Preoperative Evaluation of Microcirculation for Prediction of Complications After Cardiac Surgery
- Conditions
- Extracorporeal Circulation; Complications
- Interventions
- Procedure: Microvascular reactivity evaluation
- Registration Number
- NCT03631797
- Lead Sponsor
- University Hospital, Angers
- Brief Summary
Cardiac surgery is responsible for many complications. Microcirculation is involved in many of them. The objective of this study is to prospectively investigate the prognostic value of preoperative microcirculatory assessment in patients scheduled for cardiac surgery with CPB for the occurrence of postoperative complications.
Microvascular dysfunction is suspected of being involved in postoperative psycho-cognitive decline. The influence of microcirculation on the evolution of psycho-cognitive assessment is also analyzed in this study.
- Detailed Description
Eligible patients are included during the preoperative assessment. Written consent is signed after complete explanation of the protocol.
Patient characteristics as treatments, medical history, and EuroSCORE II are registered. Moreover, intraoperative data is collected. Psycho-cognitive and functional evaluation is made preoperatively.
Microcirculation is evaluated for each patient before surgery. Complications are registered at the end of hospital stay. Psycho-cognitive and functional evaluation is repeated by call 30 days after the surgery.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
- Valvular ou coronary elective cardiac surgery under cardiopulmonary bypass
- Fair skin phototype
- Ability to understand the study goal, no dementia.
- Affiliation to the French National Healthcare System
- Voluntary patients who have signed an informed consent
- Emergency surgery
- Multiple procedures, combined surgery (valvular and coronary)
- Single aortic surgery
- Patient already included in the study (second surgery)
- Patients protected by decision of law
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Microvascular reactivity evaluation Microvascular reactivity evaluation Patients referred for a preoperative arterial palmar arches assessment before cardiac valvular or coronary surgery. Intervention is measurement of microvascular reactivity with a laser speckle contrast imaging before surgery.
- Primary Outcome Measures
Name Time Method Postoperative complication 30 postoperative days Composite criteria and include microcirculation postoperative complications:
* Late surgical re-intervention (greater than 12 hours) for evacuation of pericardial effusion (seeps),
* Surgical wound disunion or surgical site infection,
* Organ failure: SOFA score greater than 2 at 48h,
* Postoperative confusion: assessed using the Confusion Assessment Method (CAM) or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU),
* Acute renal failure ≥ stage 2 according to the KDIGO classification,
* Acute lung injury defined as PaO2 \<55mmHg in ambient air, PaO2 / FiO2 ratio \<250 or Pulse Oxygen Saturation (SpO2) \<90% and need for oxygen therapy,
* Atrial fibrillation (excluding patients with permanent Atrial Fibrillation preoperatively),
* Hepatocellular injury (Cytolysis \> 10N, Prothrombin rate and Factor V decreased \< 60%).
- Secondary Outcome Measures
Name Time Method Cognitive evolution Inclusion and 30 days after surgery Change of Mc Nair test
Functional evolution Inclusion and 30 days after surgery Change of ADL score
Mood evolution Inclusion and 30 days after surgery Change of brief Geriatric Depression Scale
Evolution of degree of disability Inclusion and 30 days after surgery Change of modified Rankin scale
Trial Locations
- Locations (1)
UH Angers
🇫🇷Angers, France