Impact of Variable Types of Preconditioning Upon the Inotrope Score in Adult Patients, Undergoing Cardiac Surgery

Assiut University

Status: Completed

Conditions: Myocardial Ischemia

Treatments: Drug: A pharmacologic cardiac preconditioning (Sevoflurane); Procedure: B ischeamic preconditioning

Study type: Interventional

Funder types: Other

Identifiers

NCT02715869

IRB00009901

Details and patient eligibility

About

Preconditioning (PC) of the heart occurs when brief exposure to a stimulus protects the heart from subsequent ischemia. PC stimulus may be (ischemic ; pharmacologic or Physical).

Full description

Preconditioning (PC) of the heart occurs when brief exposure to a stimulus protects the heart from subsequent ischemia. PC stimulus may be ( ischemic ; pharmacologic or Physical)

Pharmacological PC may be induced by variable agents e.g. (Sevoflurane ;isoflorane, opioids etc)

Ischemic PC includes local; remote and the idea is temporary interruption of blood supply to the organ so that liberation of protective mediators occurs. The liberated mediators have favorable effects not only upon the myocardium, but it extend to protect other organs against inflammatory activation; ischemia reperfusion injury

Inotropic score (IS) is already an evident predictor of postoperative cardiac morbidity and mortality

Aim of the work:

Is to validate the impact of Sevoflurane versus ischemic & Sevoflurane PC upon postoperative inotropic score in adult patient undergoing open heart surgery

Enrollment: 100 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18-60 years old
• American Society of Anesthesiologists physical status II and III
• Patients scheduled for open heart surgery

Exclusion criteria

• Emergency surgery
• Clinically significant kidney or liver disease
• Patients allergic to local anesthetic
• Patients with prolonged cardiopulmonary bypass time (>120 min)
• Patients required intra-aortic balloon pump
• Postoperative hemodynamic instability (including the occurrence of serious arrhythmia) or bleeding that required surgical re-exploration

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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100 participants in 2 patient groups

A pharmacologic cardiac preconditioning

Active Comparator group

Description:

Sevoflurane as a pharmacologic preconditioner for the heart

Treatment:

Drug: A pharmacologic cardiac preconditioning (Sevoflurane)

B ischeamic preconditioning

Active Comparator group

Description:

ischemic preconditioning by inflation the cuff of blood pressure

Treatment:

Procedure: B ischeamic preconditioning