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Evaluation of Damaging Factors to Endothelial Glycocalyx During Heart Surgery Pilot Study

Conditions
Heart; Surgery, Heart, Functional Disturbance as Result
Interventions
Diagnostic Test: Syndecan-1 concentration evaluation
Registration Number
NCT03491163
Lead Sponsor
Tadas Cesnaitis
Brief Summary

Evaluation of endothelial glycocalyx damage in on-pump conventional coronary artery bypass surgery using a syndecan-1 (CD138) blood test. The study will be carried out in two stages. Pilot study for testing and correcting research methodology and the main study.

Detailed Description

Study tasks:

1. To evaluate changes of syndecan-1 concentration during surgery and postoperative period.

2. Determine the effect of aortic clamping and on-pump duration on endothelial glycocalyx damage.

3. Assess the risk of early postoperative complications and syndecan-1 plasma concentrations.

4. To evaluate the correlation of inflammatory status with glycocalyx damage.

5. To evaluate glycocalyx damage to patients with diabetes vs non-diabetes.

Methods:

Patients undergoing cardiopulmonary bypass surgery are being treated at the Heart, Chest and Vascular Surgery Clinic of the Lithuanian University of Health Sciences Hospital in Kaunas Clinics. After receiving patients written consent a syndecan-1 concentration test will be performed upon arrival at the operating room, before cardiopulmonary bypass (CPB), after CPB, upon arrival in the ICU and after 24 hours.

All needed data for evaluating patients outcome will be taken from medical documentation during patients stay in hospital.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Elective on-pump coronary artery bypass surgery needed.
  • Normal heart function at the time of operation.
  • Patients without infections.
  • Patients who signed study informed consent form
Exclusion Criteria
  • Life saving operation.
  • Renal or hepatic dysfunction.
  • Off-pump heart operation.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PatientsSyndecan-1 concentration evaluationSyndecan-1 concentration evaluation
Primary Outcome Measures
NameTimeMethod
Changes of syndecan-1 concentration during surgery and postoperative period.2 years

Concentration of syndecan-1 will be measured by taking patients blood sample before operation, after aortic cannulation, after CPB, when arriving to ICU and 24 hours after operation. Means of concentration changes will be compared to determine which period of operation has the biggest impact to endothelial glycocalyx shedding.

Glycocalyx damage to patients with diabetes vs non-diabetes during heart surgery.2 years

Compare glycocalyx damage using syndecan-1 concentration changes to diabetic and non-diabetic patents during heart surgery.

Assess the risk of early postoperative complications and find possible correlation to syndecan-1 concentration changes.2 years

All negative events after operation will be recorded and statistically correlated with syndecan-1 concentration changes.

The correlation of inflammatory status with glycocalyx damage.2 years

Leucocytosis and C reactive protein levels will be evaluated before, after heart operation and 24 hours later. Data will be compared to syndecan-1 concentration changes.

The evaluation of aortic clamping and on-pump duration on endothelial glycocalyx damage using syndecan-1 concentration measure.2 years

Concentrations of syndecan-1 will be evaluated considering the duration of aortic clamping and CPB. Optimal duration will be searched for minimal impact to endothelial glycocalyx.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Lithuanian University of Health Sciences

🇱🇹

Kaunas, Lithuania

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