Endothelial Damage in Major Spine Surgery, Measured by Circulating Syndecan-1: an Observational Study.(GlycOrtho)

Istituto Ortopedico Rizzoli

Status: Enrolling

Conditions: Spinal Fusion

Study type: Observational

Funder types: Other

Identifiers

NCT06119542

1064/2021/Oss/IOR

Details and patient eligibility

About

The goal of this observational study is to learn about endothelial damage in major spine surgery, expressed as rise in circulating Syndecan-1.

The main questions it aims to answer are:

• What is the extent of endothelial glycocalyx shedding in major spine surgery?
• Are there differences in different type of surgical populations? (adolescent idiopathic scoliosis, adult degenerative spine disease, oncologic surgery)

To do so, blood samples will be drawn from participants at the following timepoints:

• basal
• after surgery
• if transfusion of Fresh Frozen Plasma: before and after transfusion
• Post-Operative Day 1-2-4

Full description

The aim of this study is to gain information about endothelial damage in major spine surgery, expressed as shedding of glycocalyx component Syndecan-1, and subsequent rise of its plasma levels.

This phenomenon has been extensively described in shock states (sepsis, trauma, cardiac arrest ..) but little is known about endothelial damage in elective major surgery.

This study was designed to study the magnitude of Syndecan-1 rise after spine surgery, divided in three main categories: adolescent idiopathic scoliosis, adult degenerative and oncologic surgery.

The investigators were also interested in the effect of Fresh Frozen Plasma transfusion on Syndecan-1 levels, since previous studies have indicated a potential benefit on endothelial integrity.

The results of this study will be used to inform subsequent clinical trials designed to investigate the effect of different intraoperative conducts on endothelial damage.

Enrollment: 30 estimated patients

Sex: All

Ages: 12 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Undergoing Major Spine Surgery with estimated blood loss> 25% of total blood volume
• American Society of Anesthesiology status 1-2-3
• Able to comprehend and sign informed consent.
• If age <18 years: parent or legal representative able to comprehend and sign informed consent

Exclusion criteria

• Surgery outside of laboratory opening hours
• Patients undergoing spine surgery for genetic syndromes/neuromuscular scoliosis