Esmolol or Nitroglycerin Infusion for Blood Pressure Control Prior to Cardiopulmonary Bypass (CPB) in Cardiac Surgery

This study has been completed.
Information provided by (Responsible Party):
Richard Applegate, Loma Linda University Identifier:
First received: September 23, 2010
Last updated: September 9, 2014
Last verified: September 2014
This is an investigator initiated, sponsored, open label, prospective randomized controlled trial to be performed in adult patients undergoing scheduled cardiac surgery. Patients will be randomized to esmolol infusion or nitroglycerin infusion for control of hypertension that occurs during cardiac surgery from induction of anesthesia to initiation of cardiopulmonary bypass (CPB).

Condition Intervention
Drug: nitroglycerin
Drug: esmolol

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Esmolol or Nitroglycerin Infusion for Blood Pressure Control Prior to Cardiopulmonary Bypass(CPB) in Cardiac Surgery: a Randomized, Controlled Trial

Resource links provided by NLM:

Further study details as provided by Loma Linda University:

Primary Outcome Measures:
  • Esmolol or Nitroglycerin Infusion for Blood Pressure Control Prior to Cardiopulmonary Bypass in cardiac surgery: a randomized, clinical trial [ Time Frame: Participation could last up to 2 weeks, representing the day of surgery until discharge from the hospital. ] [ Designated as safety issue: No ]
    The extent of diastolic hypotension below the clinical target range (measured as area under the curve below the lower diastolic pressure expressed in mmHg*min/hr

Secondary Outcome Measures:
  • Title: Systolic or diastolic hypertension; systolic hypotension [ Time Frame: Duration: during infusion of study drug ] [ Designated as safety issue: No ]
    drug dose; time to BP control; infusion duration; need to stop study drug; tachycardia; postbypass HR; pacemaker placement; drug infusion to support separation from bypass; time to extubation; ICU and hospital length of stay; new atrial fibrillation or organ dysfunction

Enrollment: 70
Study Start Date: December 2010
Study Completion Date: June 2014
Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Nitroglycerin Drug: esmolol
esmolol will be administered by infusion following a step up / step down protocol to control hypertension.
Active Comparator: Esmolol Drug: nitroglycerin
nitroglycerin administered as an infusion following a step up/step down protocol to treat hypertension in patients undergoing cardiac surgery.


Ages Eligible for Study:   18 Years to 85 Years   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • adult patients scheduled for cardiac surgery at LLUMC University Hospital will be eligible for participation in this study.

Exclusion Criteria:

  1. severe LV (left ventricle)dysfunction (EF < 35%).
  2. emergency procedures.
  3. procedures with combined carotid artery surgery.
  4. patients at high risk for stroke.
  5. hemodynamically significant dysrhythmias.
  6. pre-existing atrial fibrillation or high degree AV (atrioventricular block).
  7. pacemaker dependency.
  8. known sensitivity to beta blockers.
  9. patient refusal.
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Please refer to this study by its identifier: NCT01212874

United States, California
Loma Linda University
Loma Linda, California, United States, 92354
Sponsors and Collaborators
Loma Linda University
Principal Investigator: Richard L Applegate II, MD Loma Linda University
  More Information

Responsible Party: Richard Applegate, Principal Investigator, Loma Linda University Identifier: NCT01212874     History of Changes
Other Study ID Numbers: 5100218 
Study First Received: September 23, 2010
Last Updated: September 9, 2014
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Vasodilator Agents
Adrenergic beta-1 Receptor Antagonists
Adrenergic beta-Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs processed this record on July 21, 2016