NCT03302195

Brief Summary

Standard Heparin management, based on total body weight, is not well established for obese patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The purpose of this study is to assess the safety and efficacy of using lean body mass (LBM) to determine pump flow rate and/or Heparin dosage in obese patients undergoing CPB.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
410

participants targeted

Target at P75+ for not_applicable

Timeline
21mo left

Started Aug 2015

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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 Progress87%
Aug 2015Dec 2027

Study Start

First participant enrolled

August 21, 2015

Completed
2.1 years until next milestone

First Submitted

Initial submission to the registry

September 28, 2017

Completed
7 days until next milestone

First Posted

Study publicly available on registry

October 5, 2017

Completed
7.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2024

Completed
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2027

Expected
Last Updated

March 10, 2023

Status Verified

March 1, 2023

Enrollment Period

9.4 years

First QC Date

September 28, 2017

Last Update Submit

March 9, 2023

Conditions

Keywords

HeparinAllogeneic blood product transfusionsBleedingCardiac surgeryObesity

Outcome Measures

Primary Outcomes (1)

  • Allogeneic transfusions of red blood cells

    Percentage of subjects avoiding any allogeneic transfusions of red blood cells

    Seven days post-operatively or until discharge, whichever comes first

Secondary Outcomes (5)

  • Allogeneic transfusions of blood products

    Seven days post-operatively or until discharge, whichever comes first

  • Units of blood product transfusions

    Seven days post-operatively or until discharge, whichever comes first

  • Massive red blood cell transfusions

    Seven days post-operatively or until discharge, whichever comes first

  • Post-operative complications

    Post-operatively from day 0 up to first hospital discharge

  • Bleeding

    Peroperative, 4 and 24 hours post-operative

Study Arms (4)

Control group

ACTIVE COMPARATOR

Heparin dose and cardiopulmonary bypass pump flow rate are calculated using total body weight. An initial 400 IU/Kg Heparin dose will be administered, with an additional dose of 75 IU/kg if the activated clotting time remains below the 425 seconds target value. The cardiopulmonary bypass pump flow rate of 2.4 L/min/m2 of body surface area will be calculated.

Drug: HeparinProcedure: cardiopulmonary bypass pump flow rate

Intervention group A

EXPERIMENTAL

Heparin dose is adjusted for lean body weight and cardiopulmonary bypass pump flow rate is calculated using total body weight. An initial 400 IU/Kg Heparin dose will be administered, with an additional dose of 75 IU/kg if the activated clotting time remains below the 425 seconds target value. The cardiopulmonary bypass pump flow rate of 2.4 L/min/m2 of body surface area will be calculated.

Drug: HeparinProcedure: cardiopulmonary bypass pump flow rate

Intervention group B

EXPERIMENTAL

Heparin dose is calculated using total body weight and cardiopulmonary bypass pump flow rate is adjusted for lean body weight. An initial 400 IU/Kg Heparin dose will be administered, with an additional dose of 75 IU/kg if the activated clotting time remains below the 425 seconds target value. The cardiopulmonary bypass pump flow rate of 2.4 L/min/m2 of body surface area will be calculated.

Drug: HeparinProcedure: cardiopulmonary bypass pump flow rate

Intervention group C

EXPERIMENTAL

Heparin dose and cardiopulmonary bypass pump flow rate are adjusted for lean body weight. An initial 400 IU/Kg Heparin dose will be administered, with an additional dose of 75 IU/kg if the activated clotting time remains below the 425 seconds target value. The cardiopulmonary bypass pump flow rate of 2.4 L/min/m2 of body surface area will be calculated.

Drug: HeparinProcedure: cardiopulmonary bypass pump flow rate

Interventions

Based on patient body weight (UI/kg)

Control groupIntervention group AIntervention group BIntervention group C

Based on patient body weight (L/min/m2)

Control groupIntervention group AIntervention group BIntervention group C

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Obese patients (BMI ≥ 30kg/m2)
  • Planned cardiac surgery
  • Age ≥ 18 years

You may not qualify if:

  • Permanent pacemaker
  • Known intolerance to protamine
  • Known or suspected allergy to the used antifibrinolytic agent
  • Refusal to receive blood products
  • Planned off pump coronary artery bypass
  • Planned peri-operative use of desmopressin
  • Known Heparin-induced thrombocytopenia
  • Known deficiency in protein C, protein S, antithrombin or homozygous factor V Leiden
  • Known congenital bleeding disorders
  • Current endocarditis
  • Planned hypothermic circulatory arrest (\<28C)
  • Two or more cardiac surgery procedures
  • Emergency cardiac surgery procedures (medically required within 24hours of presenting with acute symptoms)
  • Planned CPB priming with red blood cells
  • Any known autoimmune disease
  • +15 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hopital Laval

Québec, Quebec, G1V 4G5, Canada

RECRUITING

MeSH Terms

Conditions

ObesityHemorrhage

Interventions

Heparin

Condition Hierarchy (Ancestors)

OverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsPathologic Processes

Intervention Hierarchy (Ancestors)

GlycosaminoglycansPolysaccharidesCarbohydrates

Study Officials

  • Pierre Voisine, MD

    University Laval

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Hugo Tremblay, Bachelor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Participant is blinded to group assignment
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized control prospective trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Cardiac surgeon

Study Record Dates

First Submitted

September 28, 2017

First Posted

October 5, 2017

Study Start

August 21, 2015

Primary Completion

December 31, 2024

Study Completion (Estimated)

December 31, 2027

Last Updated

March 10, 2023

Record last verified: 2023-03

Data Sharing

IPD Sharing
Will not share

Locations