Anesthetic Management and Remote Reperfusion Injuries

NCT00745810 | Completed

• 1 other identifier: 200705022R
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Ischemia- reperfusion ( IR ) injuries were not only seen in the transplanted organs but also the remote organs such as lungs that brings major postoperative complications. Severe complications such as pulmonary infiltration and pulmonary edema following reperfusion were frequently associated with liver transplantation. Cardiac surgery performed with the use of cardiopulmonary bypass ( CPB ) provokes a systemic inflammatory response syndrome that affects postoperative pulmonary, myocardiac and renal functions. Previous study about the reperfusion injuries was focused on the leukocyte and endothelial activation and the following oxidative injuries, however, the alteration on pulmonary function such as dynamic compliance and the oxidative/antioxidative balance in erythrocytes and the following effects in CPB have not been fully studied. Erythrocytes' reaction to oxidative stress including cytoplasma and cell membrane should be studied because RBCs are the major circulating blood cells having different types of antioxidant system to capture reactive oxygen species ( ROS ) thus RBC may be severely injured by ROS or protected ROS injuries during CPB. In these three-year study, we plan to explore the extent and pattern of remote oxidative injuries in lungs by massive ROS production and the following products released from reperfused organs. In the first year, the remote pulmonary injuries from hepatic IR will be focused. We plan to establish an animal model for pulmonary function and pulmonary injury assessments including dynamic compliance (Cdyn), pulmonary edema wet-to-dry ratio (W/D), malondialdehyde (MDA) and histopathological findings under hepatic IR challenge. In the second year, the IR effects during and after CPB on circulating blood cells will be fully studied. We plan to investigate the magnitude, subtypes and timing on ROS production, the changes of oxidative and antioxidant activities of erythrocytes including cytoplasma and cell membrane, the changes on leukocytes and plasma to explore the roles of circulating erythrocytes on oxidative stress in CPB. In the third year, we plan to try propofol, stated having antioxidant in vivo and in vitro, on the remote pulmonary injuries following hepatic IR and CPB.

Conditions

Heart Valve Diseases

Keywords

cardiopulmonary bypass; oxidative injuries

Study Arms (1)

1

sequential changes before and after cardiopulmonary bypass including ROS, antioxidant status, leukocyte elastase, complements, inflammatory cytokines

Other: Cardiopulmonary bypass

Interventions

Cardiopulmonary bypass OTHER

sequential changes of oxidative injuries before and after cardiopulmonary bypass

Also known as: oxidative injuries, inflammatory cytokines, complements, leukocyte elastase

1

Eligibility Criteria

• Age: 20 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

patients who receive an open heart surgery under cardiopulmonary bypass

You may qualify if:

• age \> 20 y/0, need cardiopulmonary bypass

You may not qualify if:

• severe anemia, hematologic diseases, hormone therapy, previous valvular surgery, blood transfusion in recent 3 months

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

National Taiwan University Hospital

Taipei, Taipei, 100, Taiwan

Location

Biospecimen

Retention: NONE RETAINED

whole blood and plasma

MeSH Terms

Conditions

Heart Valve Diseases

Interventions

Cardiopulmonary Bypass; Oxidative Stress; Complement System Proteins; Leukocyte Elastase

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Extracorporeal Circulation; Surgical Procedures, Operative; Metabolism; Stress, Physiological; Physiological Phenomena; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Pancreatic Elastase; Serine Endopeptidases; Endopeptidases; Peptide Hydrolases; Hydrolases; Enzymes; Enzymes and Coenzymes; Serine Proteases

Study Officials

• ya-jung cheng, PhD

  Department of anesthesia, national taiwan university hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 31, 2008
• First Posted: September 3, 2008
• Study Start: August 1, 2008
• Primary Completion: November 1, 2010
• Study Completion: December 1, 2010
• Last Updated: October 17, 2011

Record last verified: 2011-06

Locations

TW (1)