Remote Ischaemic Preconditioning for Heart Surgery (RIPHeart-Study)
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Purpose
The purpose of this study is to evaluate the effects of Remote Ischaemic Preconditioning on perioperative ischaemic injury in patients undergoing cardiac surgery compared to control intervention.
| Condition | Intervention | Phase |
|---|---|---|
|
Myocardial Injury Mortality |
Procedure: Remote Ischemic Preconditioning Procedure: Control/sham procedure (blood pressure cuff) |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Remote Ischaemic Preconditioning for Heart Surgery |
- Composite of all-cause mortality, non-fatal myocardial infarction, any new stroke, and/or acute renal failure [ Time Frame: In-hospital ] [ Designated as safety issue: No ]Time frame until hospital discharge
- Occurence of any component of the composite outcome [ Time Frame: Postoperative hospital discharge, 3 months, 12 months ] [ Designated as safety issue: No ]
- length of stay on the intensive care unit [ Time Frame: Postoperative during hospital stay ] [ Designated as safety issue: No ]
- total hospital stay [ Time Frame: hospital discharge ] [ Designated as safety issue: No ]
- new onset of atrial fibrillation [ Time Frame: In-hospital ] [ Designated as safety issue: No ]
- Delirium [ Time Frame: Postoperative 24, 48, 72, 96 hrs ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 2070 |
| Study Start Date: | December 2010 |
| Estimated Study Completion Date: | April 2016 |
| Estimated Primary Completion Date: | April 2016 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: RIPC |
Procedure: Remote Ischemic Preconditioning
RIPC will be induced during anesthesia by four 5-min cycles of upper limb ischemia and 5-min reperfusion using a blood-pressure cuff inflated to a pressure 200 mm Hg, whereas the pressure has to be at least 20 mm Hg greater than the systolic arterial pressure measured via the arterial line.
|
| Sham Comparator: CONTROL |
Procedure: Control/sham procedure (blood pressure cuff)
Sham placement of the blood pressure cuff around a dummy arm inflated to a pressure of 200 mm Hg with four cycles of 5 min inflation and 5 min deflation.
|
Detailed Description:
Cardiac surgery with cardiopulmonary bypass is associated with a predictable incidence of myocardial, neurological and renal dysfunction. This significant morbidity and mortality is at least partly due to perioperative ischaemia. Remote ischaemic preconditioning (RIPC) is a novel, simple, non-invasive and inexpensive intervention by which ischaemia of non-vital tissue (skeletal muscles) protects remote organs (heart, brain and kidney) from a subsequent sustained episode of ischaemia. The investigators perform a multicenter randomized controlled study to evaluate that RIPC reduces teh severity of perioperative ischaemic injury in patients undergoing cardiac surgery, and results in about 1/3 risk reduction in the occurence of major adverse events.
Eligibility| Ages Eligible for Study: | 18 Years to 90 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients undergoing heart surgery on cardiopulmonary bypass
Exclusion Criteria:
- age < 18
- Emergency cases
- left ventricular ejection fraction less than 30%
- current atrial fibrillation
- Inability to give informed consent
- preoperative use of inotropics or mechanical assist device
- severe liver, renal and pulmonary disease
- recent myocardial infarction (within 7 days)
- recent systemic infection or sepsis (within 7 days)
- severe stroke (within 2 months)
- peripheral vascular disease affecting upper limbs
- previous serious psychiatric disorders (e.g. schizophrenia, dementia)
- concomitant carotid endarterectomy
- rare surgeries: cardiac transplantation, correction of complicated congenital anomalies, pulmonary thromboembolectomy, off-pump surgery, minimal-invasive operation without sternotomy
Contacts and Locations| Contact: Patrick Meybohm, MD | meybohm@anaesthesie.uni-kiel.de |
| Germany | |
| University Hospital Aachen (RWTH) | Recruiting |
| Aachen, Germany | |
| Contact: Christian Stoppe | |
| University Hospital Charite | Recruiting |
| Berlin, Germany | |
| Contact: Michael Sander | |
| University Hospital Bonn | Recruiting |
| Bonn, Germany | |
| Contact: Pascal Knuefermann | |
| University Hospital Frankfurt/M | Recruiting |
| Frankfurt/M, Germany | |
| Contact: Patrick Meybohm | |
| Principal Investigator: Kai Zacharowski | |
| University Hospital Goettingen | Recruiting |
| Goettingen, Germany | |
| Contact: Ivo Brandes | |
| University Hospital Schleswig-Holstein | Recruiting |
| Kiel, Germany | |
| Contact: Berthold Bein | |
| Principal Investigator: Patrick Meybohm | |
| Sub-Investigator: Berthold Bein | |
| Sub-Investigator: Jochen Cremer | |
| University Hospital of Schleswig-Holstein | Recruiting |
| Luebeck, Germany | |
| Contact: Matthias Heringlake | |
| University Hospital Magdeburg | Recruiting |
| Magdeburg, Germany | |
| Contact: Thomas Hachenberg | |
| University Hospital Rostock | Recruiting |
| Rostock, Germany | |
| Contact: Jan Roesner | |
| University Hospital Wuerzburg | Recruiting |
| Wuerzburg, Germany | |
| Principal Investigator: | Patrick Meybohm, MD | University of Schleswig-Holstein |
| Principal Investigator: | Berthold Bein, MD, DESA | University of Schleswig-Holstein |
| Principal Investigator: | Jochen Cremer, MD | University of Schleswig-Holstein |
| Principal Investigator: | Kai Zacharowski, MD, PhD | University Hospital Frankfurt am Main |
More Information
No publications provided by University of Schleswig-Holstein
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Patrick Meybohm, PD Dr Patrick Meybohm, University of Schleswig-Holstein |
| ClinicalTrials.gov Identifier: | NCT01067703 History of Changes |
| Other Study ID Numbers: | ME 3559/1-1 |
| Study First Received: | February 10, 2010 |
| Last Updated: | February 28, 2013 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by University of Schleswig-Holstein:
|
remote ischaemic preconditioning, cardiac surgery |
ClinicalTrials.gov processed this record on May 23, 2013