Haemodynamic Response to Aortic Surgery

Sygehus Lillebaelt

Status: Completed

Conditions: Acute Kidney Injury; Aortic Aneurysm, Abdominal; Aortic Diseases

Study type: Observational

Funder types: Other

Identifiers

NCT01704391

S-20110154

Details and patient eligibility

About

Open elective abdominal aortic surgery is a high risk procedure involving clamping of the aorta. Indications include abdominal aortic aneurysm (AAA) or aortic occlusive disease (AOD) causing lower limb ischaemia.

These patients are often regarded as one entity in postoperative study settings. However, previous studies indicate that risk profiles, inflammatory activity, and haemodynamic capacity may differ between these groups. The first aim of this study was to evaluate postoperative ICU-requirements after open elective abdominal aortic surgery, hypothesising that AAA-patients had longer ICU-stays and needed more mechanical ventilation or acute dialysis than did patients with AOD.

The investigators see a relatively high incidence of postoperative acute kidney injury (AKI) following aortic surgery. Neutrophil Gelatinase Associated Lipocalcin (NGAL) may be useful in the early diagnosis of postopeative AKI. However, NGAL is also known as a marker of inflammatory activation. The ischaemia-reperfusion injury and subsequent inflammatory response to aortic cross clamping may per se induce a rise in NGAL despite intact renal function. Therefore NGAL may not be a reliable marker of AKI after AAS.

The second aim of this study is to describe the changes in NGAL after AAS in patients with and without postoperative dialysis-dependent AKI.

Enrollment: 18 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• CT verified aortic aneurysm or aortic occlusive disease

Exclusion criteria

• age<18 y
• contraindications to the use of oesophagus doppler monitor, eg mycosis, perforation, stenosis.

Trial design

18 participants in 2 patient groups

Aortic aneurysm patients

Description:

10 patients with a CT verified diagnosis of aortic aneurysm demanding open elective surgical correction with insertion of vascular prosthesis

Aortic occlusive disease patients

Description:

10 patients with CT verified aortic occlusive disease demanding open elective surgical correction with insertion of vascular prosthesis