Cerebral Energy State in Cardiac Surgery

Odense University Hospital

Status: Completed

Conditions: Postoperative; Dysfunction Following Cardiac Surgery

Treatments: Procedure: Microdialysis

Study type: Interventional

Funder types: Other

Identifiers

NCT02846818

S-20130166

Details and patient eligibility

About

Impaired cerebral function remains an important complication of cardiopulmonary bypass (CPB) during cardiac surgery. The aim of the present study is to investigate whether the lactate to pyruvate (LP) ratio obtained by microdialysis (MD) of the cerebral venous outflow reflects a derangement of global cerebral energy state during cardiopulmonary bypass.

Full description

Patients undergoing primary, elective coronary artery bypass grafting were blindly randomized to usual range MAP (40 to 60 mmHg; n = 5) or intervention group MAP (60 to 80 mmHg; n = 5) during CPB. MD catheters were positioned in a retrograde direction in the internal jugular vein and a reference catheter was inserted into the brachial artery. The relations between LP ratio, MAP, data obtained from bi-frontal NIRS and neurological outcome measures were assessed.

Enrollment: 10 patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Elective CABG on CPB

Exclusion criteria

• Acute patients or reoperations
• Patients with epidural catheter
• Previous stroke
• Stenotic carotids
• Ejection fraction (EF) < 50 %
• Estimated per operative risk > 5%

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

10 participants in 2 patient groups

Low mean arterial perfusion pressure

Experimental group

Description:

5 patients undergoing primary, elective coronary artery bypass grafting were randomized to usual range MAP (40 to 60 mmHg) during CPB. Microdialysis catheters were positioned in a retrograde direction in the internal jugular vein.

Treatment:

Procedure: Microdialysis

High mean arterial perfusion pressure

Experimental group

Description:

5 patients undergoing primary, elective coronary artery bypass grafting were blindly randomized to intervention group MAP (60 to 80 mmHg) during CPB. Microdialysis catheters were positioned in a retrograde direction in the internal jugular vein.

Treatment:

Procedure: Microdialysis