Postoperative Renal Failure in Cardiac Surgery PMSF-PVC Gradient Study
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 130
- 试验地点
- 1
- 主要终点
- Evolution of the gradient Pmsf (arm) -PVC
研究概览
简要总结
Acute renal failure is a frequent and severe postoperative complication of cardiac surgery performed under extracorporeal circulation.
It is an independent risk factor for mortality and significantly increases the length of hospital stay.
The origin of renal insufficiency after extracorporeal circulation is multifactorial (long duration of extracorporeal circulation, hemodynamic instability per and post-extracorporeal circulation, prolonged hypotension, transfusion ...).
Nevertheless, an entirely different pathophysiological mechanism, though not recent, is less often mentioned but shows renewed interest. This is the concept of renal venous congestion which may be responsible for impaired renal function in the absence of cardiac dysfunction. Based on Guyton's circulatory model, the investigators approach this systemic venous hypertension through the measurement of the Pmsf-PVC gradient.
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
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •age> 18 years
- •subject having signed an informed consent
- •scheduled heart surgery:
- •Valve replacement
- •Coronary artery bypass
排除标准
- •Any urgent surgery or redux
- •Severe preoperative chronic renal failure (stage III) defined by GFR <30ml / min
- •Existence of rhythm disorders (permanent ACFA) or serious cardiac conduction disorders, patients with Pacemaker
- •Preoperative alteration of left ventricular ejection fraction with LVEF <40%
- •Major haemodynamic instability with refractory shock defined by dobutamine ≥10μg / kg / min and / or norepinephrine ≥ 1μg / kg / min and / or epinephrine ≥ 0.2μg / kg / min.
- •Intra-aortic versus assisted pelvic balloon
- •Contraindication to femoral arterial catheterization
- •Subject under the protection of justice, subject under guardianship or under tutorship
- •Impossibility of giving the subject informed information (subject in emergency situation, difficulties in understanding the subject)
结局指标
主要结局
Evolution of the gradient Pmsf (arm) -PVC
时间窗: 24 hours
Monitor the evolution of the Pmsf (arm) -PVC gradient at H24 and compare this gradient between the two patient populations (with and without postoperative acute renal failure)
次要结局
未报告次要终点