Hypertonic Solution in Off Pump Coronary Artery Bypass Graft Surgery
Use of Hypertonic Versus Isotonic Solutions in Off Pump Coronary Artery Bypass Graft Surgery Targeting the Left Marginal Branch
1 other identifier
interventional
20
1 country
1
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
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_4 coronary-artery-disease
Started Sep 2011
Shorter than P25 for phase_4 coronary-artery-disease
1 active site
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
CompletedFirst Submitted
Initial submission to the registry
October 19, 2011
CompletedFirst Posted
Study publicly available on registry
November 2, 2011
CompletedPrimary Completion
Last participant's last visit for primary outcome
March 1, 2012
CompletedStudy Completion
Last participant's last visit for all outcomes
April 1, 2012
CompletedNovember 2, 2011
October 1, 2011
6 months
October 19, 2011
October 31, 2011
Conditions
Keywords
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 COMPARATORUse of Hypertonic solution during left marginal branch CABG surgery.
Isotonic
PLACEBO COMPARATORUse of Isotonic solution during left marginal branch CABG surgery.
Interventions
Use of Hypertonic solution 4 ml/Kg during left marginal branch CABG surgery.
Eligibility Criteria
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
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: 6776826BACKGROUNDRocha 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: 7689115BACKGROUNDWade 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: 9308620BACKGROUNDMazzoni 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: 1697790BACKGROUNDRamires 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: 1423912BACKGROUNDAuler 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: 3576451BACKGROUNDDeFoe 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: 11269449BACKGROUNDBoldt 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: 2012420BACKGROUNDBoldt 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: 1721516BACKGROUNDOliveira 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: 7544684BACKGROUNDSirieix 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: 10548199BACKGROUNDTollofsrud 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: 9509195BACKGROUNDRocha-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: 14560106BACKGROUNDKvalheim 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: 19878097BACKGROUNDMustafa 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: 12392272BACKGROUNDChang 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: 15561035BACKGROUNDOzay 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: 18583284BACKGROUNDMishra 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: 12486647BACKGROUNDRocha-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
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
ROBERTO R Silva, MD PHD
Hospital Pitangueiras
Central Study Contacts
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