Tissue Oxygenation During Heart Surgery
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Purpose
The goal of this study is to determine if off-pump CABG surgery is associated with better cerebral tissue oxygenation when compared with on-pump CABG. In addition, the investigators would like to compare the results of two different monitors of brain tissue oxygenation with each other, and assess the correlation between brain tissue oxygenation and oxygenation measurements in renal and muscular tissue, as well as with conventional hemodynamic and metabolic variables, such as central venous oxygen saturation (ScvO2). Finally, the investigators aim to determine if duration and extent of cerebral oxygen desaturation predict outcome variables such as postoperative cognitive performance.
| Condition | Intervention |
|---|---|
|
Coronary Artery Bypass Grafting |
Device: measurements of brain tissue oxygenation |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Comparison of Cerebral Tissue Oxygen Desaturation in Patients Undergoing On-pump or Off-pump Coronary Artery Bypass Grafting |
- incidence of significant brain tissue oxygen desaturation, defined as AUC40 > 600 %.sec (a function of both duration (in seconds) and severity (saturation < 40%) of desaturation). [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
- Oxygenation measurements: Peripheral muscle StO2, cerebral and renal StO2, ScvO2, SaO2, arteriovenous oxygen difference, pO2 Acid-base status: pH, pCO2, HCO3-, ABE, lactate [ Time Frame: 3 months ] [ Designated as safety issue: No ]
- To determine if oxygenation measurements obtained in peripheral (thenar) muscle, renal tissue and in cerebral tissue correlate with each other
- To determine if oxygenation measurements obtained in peripheral (thenar) muscle, renal tissue and in cerebral tissue correlate with conventional hemodynamic and metabolic variables such as central venous oxygen saturation (ScvO2).
| Enrollment: | 60 |
| Study Start Date: | June 2011 |
| Study Completion Date: | December 2011 |
| Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
on pump
Coronary artery bypass grafting (CABG)with with cardiopulmonary bypass
|
Device: measurements of brain tissue oxygenation
different monitors((the Hutchinson InSpectra™ StO2 Tissue Oxygenation Monitor) and in cerebral (ForeSight® Cerebral Oximeter and the Somanetics INVOS® Cerebral Oximeter ) and renal tissue (the Somanetics INVOS® Cerebral Oximeter)of brain tissue oxygenation with each other, and assess the correlation between brain tissue oxygenation and oxygenation measurements in renal and muscular tissue, as well as with conventional hemodynamic and metabolic variables, such as central venous oxygen saturation
|
|
off pump
off-pump CABG surgery
|
Device: measurements of brain tissue oxygenation
different monitors((the Hutchinson InSpectra™ StO2 Tissue Oxygenation Monitor) and in cerebral (ForeSight® Cerebral Oximeter and the Somanetics INVOS® Cerebral Oximeter ) and renal tissue (the Somanetics INVOS® Cerebral Oximeter) of brain tissue oxygenation with each other, and assess the correlation between brain tissue oxygenation and oxygenation measurements in renal and muscular tissue, as well as with conventional hemodynamic and metabolic variables, such as central venous oxygen saturation
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
60 consecutive adult patients scheduled for elective CABG surgery will be randomized to have the surgery performed either on-pump (n=30) or off-pump CABG (n=30).
Inclusion Criteria:
- Age ≥18 years
- Informed patient consent
- Coronary artery disease suitable for both on-pump and off-pump CABG surgery.
Exclusion Criteria:
- History of head trauma or stroke causing significant active neurologic disease
- History of neurosurgery
- Severe or symptomatic carotid artery disease
- Requirement for valve surgery in addition to CABG
- Pre-existing acute or chronic renal dysfunction
- Urgent or emergency surgery
- Difficulty with cognitive testing: impaired hearing or eyesight, poor Dutch language comprehension, disability impairing the usage of the hand or arm.
Contacts and Locations| Netherlands | |
| University Medical Center Groningen | |
| Groningen, Netherlands | |
| Principal Investigator: | Thomas W.L. Scheeren, Prof.dr | University Medical Centre Groningen |
More Information
No publications provided
| Responsible Party: | MMRF Struys, Prof.dr., University Medical Centre Groningen |
| ClinicalTrials.gov Identifier: | NCT01347827 History of Changes |
| Other Study ID Numbers: | TO-CABG |
| Study First Received: | April 27, 2011 |
| Last Updated: | January 9, 2013 |
| Health Authority: | Netherlands: Medical Ethics Review Committee (METC) |
Keywords provided by University Medical Centre Groningen:
|
Coronary artery bypass surgery Oximetry Brain metabolism |
ClinicalTrials.gov processed this record on May 16, 2013