Preoperative Parenteral Thiamine Supplementation in Patients Undergoing Heart Surgery
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Purpose
The objective of this study is to determine whether preoperative parenteral thiamin supplementation does prevent the intra and early postoperative increase of lactate and whether this effect is related to the extent of thiamine deficiency in patients undergoing heart surgery. In addition the prevalence of major thiamin deficiency in patient undergoing heart surgery will be determined.
| Condition | Intervention | Phase |
|---|---|---|
|
Heart Failure Acidosis, Lactic Thiamine Deficiency |
Drug: Vitamin B1-ratiopharm Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Supportive Care |
| Official Title: | Preoperative Parenteral Thiamine Supplementation in Patients Undergoing Heart Surgery - a Pilot Study |
- Thiamine status and lactate levels [ Time Frame: perioperative ] [ Designated as safety issue: No ]Thiamine status: functional parameter - erythrocyte transketolase (α-ETK) expressed as TPP (thiamine pyrophosphate); quantity of vitamin B1 in urine and blood concentrations Lactate levels: lactate levels will be determined by blood gas analysis (BGA) within the routine check.
- Prevalence of thiamine deficiency, identification of body composition and length of hospital and ICU stay [ Time Frame: 2-3 weeks ] [ Designated as safety issue: No ]Thiamine status: functional parameter - erythrocyte transketolase (α-ETK) expressed as TPP (thiamine pyrophosphate); Body composition: measuring with bioelectrical impedance analysis (BIA) Length of ICU and hospital stay;
| Estimated Enrollment: | 100 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Supplementation
6 ml Vitamin-B1-ratiopharm in 100 ml normal saline, intravenous, preoperative
|
Drug: Vitamin B1-ratiopharm
300 mg Thiaminchloridhydrochlorid, once, intravenous, preoperative
Other Name: Vitamin B1-ratiopharm®
|
|
Placebo Comparator: Placebo
100 ml normal saline, intravenous, preoperative
|
Drug: Placebo
100 ml normal saline, intravenous, preoperative
|
Detailed Description:
Thiamine (vitamin B1) is a water-soluble vitamin and is involved in several stages of intermediate metabolism which are important for producing energy. Severe thiamin deficiency has been associated with severe lactic acidosis and clinical symptoms of life threatening heart failure.
To date, no study has evaluated thiamine levels in patients undergoing heart surgery and the prevalence of thiamine deficiency is not known. Furthermore it is unknown whether moderately reduced thiamin levels are associated with mild forms of perioperative cardiac failure necessitating prolonged inotropic support.
In this prospective double blind randomised controlled trial of the effect of a parenteral infusion of thiamin before induction of anaesthesia we will investigate the effect on perioperative lactate increase as primary outcome and extent and duration of inotropic support after cardiac surgery. In addition the pharmacokinetics of a intravenous infusion of 300 mg of thiamin on erythrocyte thiamin content and the amount of thiamine excreted in the 24 hours via the urine will be determined.
Baseline thiamin levels in erythrocytes before surgery, as well as nutrition history and body composition will be evaluated as effect modifier.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age 18 - 100 years
- planned heart surgery
- signed informed consent
Exclusion Criteria:
- pregnancy and lactation
- known allergic reaction to the drugs used
- mental condition rendering the patient unable to give informed consent
- inability or contraindications to perform study procedures
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Michael Hiesmayr, Prof. MD, Michael Hiesmayr, Medical University of Vienna |
| ClinicalTrials.gov Identifier: | NCT01524315 History of Changes |
| Other Study ID Numbers: | 2011-004080-70, 2011-004080-70 |
| Study First Received: | January 30, 2012 |
| Last Updated: | May 14, 2013 |
| Health Authority: | Austria: Ethikkommission Austria: Agency for Health and Food Safety |
Keywords provided by Medical University of Vienna:
|
Thiamine Vitamin B1 Thiamine Deficiency |
Thiamine supplementation Cardiac surgery Lactic Acid |
Additional relevant MeSH terms:
|
Acidosis Acidosis, Lactic Heart Failure Thiamine Deficiency Beriberi Acid-Base Imbalance Metabolic Diseases Heart Diseases Cardiovascular Diseases Vitamin B Deficiency Avitaminosis |
Deficiency Diseases Malnutrition Nutrition Disorders Thiamine Vitamin B Complex Vitamins Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013