Evaluation of Microcirculatory Function and Mitochondrial Respiration After Cardiovascular Surgery (MicroRESUS)

University of Pennsylvania

Status: Completed

Conditions: Shock; Critical Illness; Cardiovascular Diseases

Treatments: Procedure: coronary artery bypass grafting, valve repair/replacement

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT05330676

KL2TR001879 (U.S. NIH Grant/Contract)

843614

Details and patient eligibility

About

This study will examine the differences in microcirculatory function and mitochondrial respiration in patients with shock after cardiovascular surgery.

Full description

Post-cardiotomy shock (PCS) occurs in up to 5% of cardiovascular surgeries and has an in-hospital mortality rate as high as 75%. It is unclear if patients with PCS despite achieving standard resuscitation goals have impairments in oxygen delivery or oxygen utilization. This study will examine the difference in microcirculatory function and mitochondrial respiration in patients with shock to better understand the driving mechanism of bioenergetic failure in patients with PCS.

Enrollment: 142 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (>18 years old)
• Receiving elective coronary artery bypass graft (CABG)
• Receiving valvular surgery requiring cardiopulmonary bypass

Exclusion criteria

• Unable to tolerate sublingual microcirculatory flow imaging (e.g., non-intubated patients dependent upon oxygen by facemask, poor mouth opening)
• receiving an emergent procedure
• have an actively treated malignancy
• mitochondrial disorder
• receiving surgery requiring deep hypothermic circulatory arrest.

Trial design

142 participants in 2 patient groups

No shock

Description:

Patients who have no evidence of clinical malperfusion or require vasoactive agents after cardiac surgery.

Treatment:

Procedure: coronary artery bypass grafting, valve repair/replacement

Shock

Description:

Patients who have evidence of clinical malperfusion or require vasoactive agents after cardiac surgery.

Treatment:

Procedure: coronary artery bypass grafting, valve repair/replacement