NCT01463917

Brief Summary

This is a comparison between Hypertonic versus isotonic solution in a double blind randomized trial for off pump Coronary Artery Bypass Graft (CABG) surgery targeting the left marginal branch. Hypertonic solution should provide better tolerance for heart mobilization with less volume expansion and less drugs.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
20

participants targeted

Target at below P25 for phase_4 coronary-artery-disease

Timeline
Completed

Started Sep 2011

Shorter than P25 for phase_4 coronary-artery-disease

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2011

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

October 19, 2011

Completed
14 days until next milestone

First Posted

Study publicly available on registry

November 2, 2011

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2012

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2012

Completed
Last Updated

November 2, 2011

Status Verified

October 1, 2011

Enrollment Period

6 months

First QC Date

October 19, 2011

Last Update Submit

October 31, 2011

Conditions

Keywords

Coronary Artery BypassOff-PumpSaline SolutionHypertonic

Outcome Measures

Primary Outcomes (1)

  • Use of vasoactive drugs in left marginal branch off pump CABG surgery

    Comparison between hypertonic and isotonic solutions for need of vasoactive drugs with heart mobilization during left marginal branch off pump CABG surgery. Data will be collected respectively at 1, 5 and 10 minutes after beggining the left branch coronary anastomosis. Data will be type of drug need and dosage until the end os the anastomosis.

    time related to left branch coronary anastomosis for drug need.

Secondary Outcomes (1)

  • Fluid balance

    Operative period and first operative day

Study Arms (2)

Hypertonic

ACTIVE COMPARATOR

Use of Hypertonic solution during left marginal branch CABG surgery.

Drug: Hypertonic solution

Isotonic

PLACEBO COMPARATOR

Use of Isotonic solution during left marginal branch CABG surgery.

Drug: Isotonic

Interventions

Use of Hypertonic solution 4 ml/Kg during left marginal branch CABG surgery.

Hypertonic

Use of Isotonic solution 4 ml/Kg during left marginal branch CABG surgery.

Isotonic

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Off pump CABG targeting the left marginal branch

You may not qualify if:

  • On pump surgery

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital Pitangueiras

Jundiaí, São Paulo, 1295, Brazil

RECRUITING

Related Publications (19)

  • Velasco IT, Pontieri V, Rocha e Silva M Jr, Lopes OU. Hyperosmotic NaCl and severe hemorrhagic shock. Am J Physiol. 1980 Nov;239(5):H664-73. doi: 10.1152/ajpheart.1980.239.5.H664.

    PMID: 6776826BACKGROUND
  • Rocha e Silva M, Braga GA, Prist R, Velasco IT, Granca ES. Isochloremic hypertonic solutions for severe hemorrhage. J Trauma. 1993 Aug;35(2):200-5. doi: 10.1097/00005373-199308000-00005.

    PMID: 7689115BACKGROUND
  • Wade CE, Kramer GC, Grady JJ, Fabian TC, Younes RN. Efficacy of hypertonic 7.5% saline and 6% dextran-70 in treating trauma: a meta-analysis of controlled clinical studies. Surgery. 1997 Sep;122(3):609-16. doi: 10.1016/s0039-6060(97)90135-5.

    PMID: 9308620BACKGROUND
  • Mazzoni MC, Borgstrom P, Intaglietta M, Arfors KE. Capillary narrowing in hemorrhagic shock is rectified by hyperosmotic saline-dextran reinfusion. Circ Shock. 1990 Aug;31(4):407-18.

    PMID: 1697790BACKGROUND
  • Ramires JA, Serrano Junior CV, Cesar LA, Velasco IT, Rocha e Silva Junior M, Pileggi F. Acute hemodynamic effects of hypertonic (7.5%) saline infusion in patients with cardiogenic shock due to right ventricular infarction. Circ Shock. 1992 Jul;37(3):220-5.

    PMID: 1423912BACKGROUND
  • Auler JO Jr, Pereira MH, Gomide-Amaral RV, Stolf NG, Jatene AD, Rocha e Silva M. Hemodynamic effects of hypertonic sodium chloride during surgical treatment of aortic aneurysms. Surgery. 1987 May;101(5):594-601.

    PMID: 3576451BACKGROUND
  • DeFoe GR, Ross CS, Olmstead EM, Surgenor SD, Fillinger MP, Groom RC, Forest RJ, Pieroni JW, Warren CS, Bogosian ME, Krumholz CF, Clark C, Clough RA, Weldner PW, Lahey SJ, Leavitt BJ, Marrin CA, Charlesworth DC, Marshall P, O'Connor GT. Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group. Ann Thorac Surg. 2001 Mar;71(3):769-76. doi: 10.1016/s0003-4975(00)02393-6.

    PMID: 11269449BACKGROUND
  • Boldt J, Zickmann B, Ballesteros M, Herold C, Dapper F, Hempelmann G. Cardiorespiratory responses to hypertonic saline solution in cardiac operations. Ann Thorac Surg. 1991 Apr;51(4):610-5. doi: 10.1016/0003-4975(91)90320-p.

    PMID: 2012420BACKGROUND
  • Boldt J, Zickmann B, Herold C, Ballesteros M, Dapper F, Hempelmann G. Influence of hypertonic volume replacement on the microcirculation in cardiac surgery. Br J Anaesth. 1991 Nov;67(5):595-602. doi: 10.1093/bja/67.5.595.

    PMID: 1721516BACKGROUND
  • Oliveira SA, Bueno RM, Souza JM, Senra DF, Rocha-e-Silva M. Effects of hypertonic saline dextran on the postoperative evolution of Jehovah's Witness patients submitted to cardiac surgery with cardiopulmonary bypass. Shock. 1995 Jun;3(6):391-4.

    PMID: 7544684BACKGROUND
  • Sirieix D, Hongnat JM, Delayance S, D'Attellis N, Vicaut E, Berrebi A, Paris M, Fabiani JN, Carpentier A, Baron JF. Comparison of the acute hemodynamic effects of hypertonic or colloid infusions immediately after mitral valve repair. Crit Care Med. 1999 Oct;27(10):2159-65. doi: 10.1097/00003246-199910000-00014.

    PMID: 10548199BACKGROUND
  • Tollofsrud S, Noddeland H. Hypertonic saline and dextran after coronary artery surgery mobilises fluid excess and improves cardiorespiratory functions. Acta Anaesthesiol Scand. 1998 Feb;42(2):154-61. doi: 10.1111/j.1399-6576.1998.tb05101.x.

    PMID: 9509195BACKGROUND
  • Rocha-E-Silva R, Caneo LF, Lourenco Filho DD, Jatene MB, Barbero-Marcial M, Oliveira SA, Rocha-E-Silva M. First use of hypertonic saline dextran in children: a study in safety and effectiveness for atrial septal defect surgery. Shock. 2003 Nov;20(5):427-30. doi: 10.1097/01.SHK.0000094037.09886.d2.

    PMID: 14560106BACKGROUND
  • Kvalheim VL, Farstad M, Steien E, Mongstad A, Borge BA, Kvitting PM, Husby P. Infusion of hypertonic saline/starch during cardiopulmonary bypass reduces fluid overload and may impact cardiac function. Acta Anaesthesiol Scand. 2010 Apr;54(4):485-93. doi: 10.1111/j.1399-6576.2009.02156.x. Epub 2009 Oct 29.

    PMID: 19878097BACKGROUND
  • Mustafa I, Leverve XM. Metabolic and hemodynamic effects of hypertonic solutions: sodium-lactate versus sodium chloride infusion in postoperative patients. Shock. 2002 Oct;18(4):306-10. doi: 10.1097/00024382-200210000-00003.

    PMID: 12392272BACKGROUND
  • Chang WI, Kim KB, Kim JH, Ham BM, Kim YL. Hemodynamic changes during posterior vessel off-pump coronary artery bypass: comparison between deep pericardial sutures and vacuum-assisted apical suction device. Ann Thorac Surg. 2004 Dec;78(6):2057-62. doi: 10.1016/j.athoracsur.2004.05.059.

    PMID: 15561035BACKGROUND
  • Ozay B, Sargin M, Abay G, Ketenci B, Kut S, Enc Y, Orhan G, Teskin O, Demirtas M. The severity of positional mitral regurgitation during off-pump coronary artery bypass grafting. Heart Surg Forum. 2008;11(3):E145-51. doi: 10.1532/HSF98.20071191.

    PMID: 18583284BACKGROUND
  • Mishra M, Malhotra R, Mishra A, Meharwal ZS, Trehan N. Hemodynamic changes during displacement of the beating heart using epicardial stabilization for off-pump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2002 Dec;16(6):685-90. doi: 10.1053/jcan.2002.128418.

    PMID: 12486647BACKGROUND
  • Rocha-e-Silva M, Negraes GA, Soares AM, Pontieri V, Loppnow L. Hypertonic resuscitation from severe hemorrhagic shock: patterns of regional circulation. Circ Shock. 1986;19(2):165-75.

    PMID: 3719918BACKGROUND

MeSH Terms

Conditions

Coronary Artery Disease

Interventions

Hypertonic Solutions

Condition Hierarchy (Ancestors)

Coronary DiseaseMyocardial IschemiaHeart DiseasesCardiovascular DiseasesArteriosclerosisArterial Occlusive DiseasesVascular Diseases

Intervention Hierarchy (Ancestors)

SolutionsPharmaceutical Preparations

Study Officials

  • ROBERTO R Silva, MD PHD

    Hospital Pitangueiras

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Roberto R Silva, MD PHD

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Chief, Adult Heart Surgery, MD PHD in Cardiovascular Surgery

Study Record Dates

First Submitted

October 19, 2011

First Posted

November 2, 2011

Study Start

September 1, 2011

Primary Completion

March 1, 2012

Study Completion

April 1, 2012

Last Updated

November 2, 2011

Record last verified: 2011-10

Locations