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Innovative Technologies for the Treatment of Pulmonary and Heart Failure

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05090930
Recruitment Status : Recruiting
First Posted : October 25, 2021
Last Update Posted : October 25, 2021
Sponsor:
Collaborator:
Ministry of Education and Science, Republic of Kazakhstan
Information provided by (Responsible Party):
Yuriy Pya, National Research Center for Cardiac Surgery, Kazakhstan

Brief Summary:

The purpose of the program. Formulation of new treatments for heart and pulmonary failure through using organ-replacing technologies.

Formulation of a clinical protocol and implementation of treatment methods into clinical practice heart and pulmonary failure using organ-replacing technologies.

New methods were created for rehabilitating the function of affected organs after implantation of the LVAD, a total artificial heart, an extracorporeal life-sustaining system will be of great importance, both for Kazakhstan and for states with similar problems of donor organ deficiency, will also improve the effectiveness of surgical treatment and reduce the level of complications and mortality of patients on the extracorporeal life-sustaining system and septic patients.


Condition or disease Intervention/treatment Phase
Cardiogenic Shock Ventricular Arrythmia Cardiac Arrest With Successful Resuscitation Sepsis Multiple Organ Failure Pulmonary Failure Decompensated Heart Failure Acute Heart Failure Device: HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection Device: CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber Not Applicable

Detailed Description:

Objectives of the program. Task 1. Assessment of the results of the use of extracorporeal life support systems in the treatment of pulmonary and/or heart failure.

Subtask 1.1. Assessment of the restoration of organ function during extracorporeal life support systems using extracorporeal hemocorrection.

Subtask 1.2. Assessment of the normalization of the body's immune response and restoration of organ function during extracorporeal life support systems using an extracorporeal cytokine adsorber.

Task 2. Studying the restoration of organ function during implantation of the left ventricular assist device as an organ-replacing aid in heart failure.

Subtask 2.1. Assessment of the restoration of organ function during implantation of the left ventricular assist device with the use of extracorporeal hemocorrection.

Subtask 2.2. Assessment of the normalization of the body's immune response and restoration of organ function upon implantation of the left ventricular assist device using an extracorporeal cytokine adsorber.

Task 3. Studying the restoration of organ function during the implantation of the total artificial heart as an organ-replacing aid in case of heart failure.

Task 3.1. Assessment of normalization of organ function restoration during implantation of the total artificial heart with the use of extracorporeal hemocorrection.

Task 4. Studying the restoration of organ function during operations in conditions of the long-term cardiopulmonary bypass.

Task 4.1. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest, with the use of extra corporeal hemocorrection.

Task 4.2. Assessment of the restoration of organ function during operations with long-term cardiopulmonary bypass, hypothermia, and circulatory arrest using an extracorporeal cytokine adsorber.

Task 5. Improvement of the method of implantation of organ-replacing technologies to reduce complications in the treatment of heart and pulmonary failure.

Study design. Study type: interventional (clinical study) Set of participants: 100 participants Distribution: randomized Interventional model: parallel Masking: no Primary Goal: Treatment

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 100 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:

Intervention team # 1 using an extracorporeal hemoperfusion device Jafron (Zhuhai Jafron Biomedical, China) (50 patients) in subgroups: A (n = 10) - patients on extracorporeal life support systems with heart failure; B (n = 10) - patients on extracorporeal life support systems with pulmonary failure; C (n = 5) - patients with implantation of a left ventricular accessory device; D (n = 25) - during operations with prolonged artificial circulation, hypothermia and circulatory arrest.

Intervention team # 2 using extracorporeal cytokine, CytoSorb (CytoSorbents Corporation, Monmouth Junction, NJ, USA) (50 patients) in subgroups: A (n = 10) - patients on extracorporeal life support systems in heart failure; B (n = 10) - patients on extracorporeal life support systems with pulmonary failure; C (n = 5) - patients with implantation of a left ventricular accessory device; D (n = 25) - during operations with prolonged artificial circulation, hypothermia and circulatory arrest.

Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Development of Innovative Technologies for the Treatment of Pulmonary and Heart Failure to Prolong Human's Life
Actual Study Start Date : January 1, 2021
Estimated Primary Completion Date : July 1, 2023
Estimated Study Completion Date : December 1, 2023

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Arm Intervention/treatment
Active Comparator: Intervention team (1/1 group)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for heart failure...

(10 patients)

Device: HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (1/2 group)
An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for pulmonary failure (10 patients).
Device: HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (1/3 group)
An extracorporeal hemoperfusion device will be installed in patients before/during the implantation of a left ventricular accessory (5 patients).
Device: HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (1/4 group)
An extracorporeal hemoperfusion device will be installed in patients during operations with prolonged artificial circulation, hypothermia, and circulatory arrest. (25 patients).
Device: HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection
HA330 - Jafron Biomedical Co., Ltd., China - extracorporeal hemocorrection, which is based on the removal of cytokines from whole blood by sorption on a special hemoadsorbent due to the peculiarities of its porous structure and inner surface, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (2/1 groups)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for heart failure.

(10 patients)

Device: CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (2/2 groups)

An extracorporeal hemoperfusion device will be installed in the device of the extracorporeal life support system for pulmonary failure.

(10 patients)

Device: CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (2/3 groups)
An extracorporeal hemoperfusion device will be installed in patients before/during the implantation of a left ventricular accessory (5 patients)
Device: CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated

Active Comparator: Intervention team (2/4 groups)
An extracorporeal hemoperfusion device will be installed in patients during operations with prolonged artificial circulation, hypothermia, and circulatory arrest. (25 patients)
Device: CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber
CytoSorb (CytoSorbents Corp., USA) - an extracorporeal cytokine adsorber is a biocompatible polymer with high adsorption capacity, which is indicated in conditions where cytokine levels are extremely elevated




Primary Outcome Measures :
  1. Extracorporeal life support system with pulmonary and / or heart failure: Cytokine response [ Time Frame: 24-48 hours ]
    The level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor alpha-factor) before the start, 2 hours after the start of ECMO support, when ECMO is turned off, 24 hours after ECMO is turned off.

  2. Extracorporeal life support system with pulmonary and / or heart failure: SOFA-Score [ Time Frame: 24, 48, 72 hours ]
    Sequential Organ Failure Assessment Score at 24, 48, 72 h (values from 6 to 24, where the higher values explain higher disease severity)

  3. Extracorporeal life support system with pulmonary and / or heart failure [ Time Frame: Time: first 72 hours ]
    Doses of vasopressors and / or inotropes (µg / h / kg bodyweight)

  4. Patients with left ventricular assist device implantation: Difference of Cytokine response [ Time Frame: 24-48 hours ]
    Level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor necrosis factor-alfa, procalcitonin)

  5. Patients with left ventricular assist device implantation:vasopressors and / or inotropes [ Time Frame: first 72 hours ]
    Doses of vasopressors and / or inotropes (µg / h / kg bodyweight)

  6. Patients with left ventricular assist device implantation:Renal function [ Time Frame: first 72 hours ]
    creatinine level

  7. Patients with left ventricular assist device implantation:Lactate level [ Time Frame: first 72 hours ]
    Lactate level

  8. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of Cytokine response [ Time Frame: 24-48 hours ]
    Level of pro- and anti-inflammatory cytokines (IL-1, IL-6, IL-8, IL-10, tumor necrosis factor-alfa, procalcitonin, C-reactive protein)

  9. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: SOFA-Score [ Time Frame: 24, 48, 72 hours ]
    Sequential Organ Failure Assessment Score at 24, 48, 72 h (values from 6 to 24, where the higher values explain higher disease severity)

  10. Extracorporeal life support system with pulmonary and / or heart failure:Difference of mean arterial pressure [ Time Frame: 24, 48, 72 hours ]
    Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron)

  11. Extracorporeal life support system with pulmonary and / or heart failure: Difference of CVP [ Time Frame: 24, 48, 72 hours ]
    Comparison of CVP at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron)

  12. Extracorporeal life support system with pulmonary and / or heart failure: Serum lactate [ Time Frame: 24, 48, 72 hours ]
    Level of serum lactate at 24, 48, 72 h

  13. Extracorporeal life support system with pulmonary and / or heart failure:Days on ventilator, vasopressor and renal replacement therapy [ Time Frame: until day 30 post-surgery ]
    Total days on ventilator, vasopressor and renal replacement therapy within 30 days post-surgery will be assessed

  14. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of mean arterial pressure [ Time Frame: 24, 48, 72 hours ]
    Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron)

  15. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Difference of CVP [ Time Frame: 24, 48, 72 hours ]
    Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron)

  16. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Level of Serum lactate [ Time Frame: 24, 48, 72 hours ]
    Comparison of mean arterial pressure at 24, 48, 72 hours between between two interventions (CytoSorb and Jafron)


Secondary Outcome Measures :
  1. Extracorporeal life support system with pulmonary and / or heart failure:The level of C-reactive protein (CRP) [ Time Frame: 24-48 hours ]
    The level of C-reactive protein (CRP) before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation.

  2. Extracorporeal life support system with pulmonary and / or heart failure: Level of leukocyte [ Time Frame: 24-48 hours ]
    Level of leukocyte cells in the bloodstream at 24, 48 hours

  3. Extracorporeal life support system with pulmonary and / or heart failure:Application and dosage of vasopressors [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery

  4. Patients with left ventricular assist device implantation: The level of C-reactive protein (CRP) [ Time Frame: 24-48 hours ]
    The level of C-reactive protein (CRP) before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation

  5. Patients with left ventricular assist device implantation: Application and dosage of vasopressors [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery

  6. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: The level of C-reactive protein (CRP) [ Time Frame: 24-48 hours ]
    The level of C-reactive protein (CRP) before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass.

  7. For operations with prolonged artificial circulation, hypothermia and circulatory arrest:Leukocyte function [ Time Frame: first 48 hours ]
    Leukocyte function: heterogeneity of the population of leukocyte cells in the bloodstream

  8. For operations with prolonged artificial circulation, hypothermia and circulatory arrest: Application and dosage of vasopressors [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of vasopressors on days 2 and 3 after surgery

  9. Extracorporeal life support system with pulmonary and / or heart failure:The level of leukocytes [ Time Frame: 24-48 hours ]
    The level of leukocytes before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation

  10. Extracorporeal life support system with pulmonary and / or heart failure:The level of procalcitonin [ Time Frame: 24-48 hours ]
    The level of procalcitonin before the start of ECMO, 2 hours after the implantation of ECMO, during ECMO, 24 hours after ECMO explantation.

  11. Extracorporeal life support system with pulmonary and / or heart failure:Application and dosage of inotropes [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery

  12. Patients with left ventricular assist device implantation: The level of leukocytes [ Time Frame: 24-48 hours ]
    The level of leukocytes before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation

  13. Patients with left ventricular assist device implantation: The level of procalcitonin [ Time Frame: 24-48 hours ]
    The level of procalcitonin before the start of the operation, 2 hours after the start of the operation, when the operation is turned off, 24 hours after the shutdown of the operation

  14. Patients with left ventricular assist device implantation: Application and dosage of inotropes [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery

  15. For operations with prolonged cardio pulmonary bypass, hypothermia and circulatory arrest: The level of leukocytes [ Time Frame: 24-48 hours ]
    The level of leukocytes before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass.

  16. For operations with prolonged cardiopulmonary bypass, hypothermia, and circulatory arrest: The level of procalcitonin [ Time Frame: 24-48 hours ]
    The level of procalcitonin before the cardiopulmonary bypass 2 hours after the cardiopulmonary bypass, when the cardiopulmonary bypass is turned off, 24 hours after the cardiopulmonary bypass.

  17. For operations with prolonged cardiopulmonary bypass, hypothermia, and circulatory arrest: Application and dosage of inotropes [ Time Frame: first 48 hours ]
    Incidence of application and level of dosage of inotropes on days 2 and 3 after surgery


Other Outcome Measures:
  1. Length of stay [ Time Frame: first 48 hours ]
    Length of stay in the intensive care unit

  2. Length of hospital stay [ Time Frame: up to 1 month ]
    Length of hospital stay

  3. 30 day survival rate. [ Time Frame: 30 day ]
    30 day survival rate.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Patients on an extracorporeal life support system with heart failure:

  • Implantation of intravenous ECMO
  • Hemodynamic support with vasopressors and/or tonics;
  • Procalcitonin level ≥ 1 ng/ml;
  • Invasive hemodynamic monitoring;
  • Written informed consent.

Patients on an extracorporeal life support system with pulmonary failure:

  • IV ECMO implantation
  • High levels of venous and arterial CO2 (CO2> 50 mmHg),
  • Low paO2, SvO2, SpO2.
  • Invasive hemodynamic monitoring;
  • Written informed consent.

    -Patients with left ventricular assistive device implantation:

  • LVAD implantation
  • Biventricular heart failure IV
  • INTERMACS I-III
  • Hemodynamic support with vasopressors and/or tonics;
  • Procalcitonin level ≥ 0.1 ng/ml;
  • Invasive hemodynamic monitoring;
  • Written informed consent.

    -Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest:

  • Hemodynamic support with vasopressors and/or tonics;
  • Bypass duration> 120 minutes
  • Hypothermia ≤ 25 0С
  • Circulatory arrest
  • Procalcitonin level ≥ 1 ng/ml;
  • Invasive hemodynamic monitoring;
  • Written informed consent.

Exclusion Criteria:

  • Patients on an extracorporeal life support system with heart failure:

    • Age less than 18 years old
    • Terminal hepatic or renal failure just before the procedure
    • Patient's written refusal to participate in the study
  • Patients on an extracorporeal life support system with pulmonary failure:

    • Age less than 18 years old
    • Terminal hepatic or renal failure just before the procedure
    • Patient's written refusal to participate in the study
  • Patients with left ventricular assistive device implantation:

    • Age less than 18 years old
    • Acute hepatic or renal failure just before the procedure
    • Patient's written refusal to participate in the study
  • Patients in operations with prolonged artificial circulation, hypothermia and circulatory arrest:

    • Age less than 18 years old
    • Terminal hepatic or renal failure just before the procedure
    • Patient's written refusal to participate in the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05090930


Contacts
Layout table for location contacts
Contact: Yuri Pya, PhD, MD +77172272090 rp.nrcsc@gmail.com
Contact: Timur Lesbekov, MD +77172703100 lesbekovt@mail.ru

Locations
Layout table for location information
Kazakhstan
National Research Center For Cardiac Surgery Recruiting
Astana, Kazakhstan, 010000
Contact: Yuriy Pya, PhD, MD    +77172703100    rp.nrcsc@gmail.com   
Contact: Zhuldyz Nurmykhametova, MD    +77781115377    zhyzik-nur@mail.ru   
Sponsors and Collaborators
National Research Center for Cardiac Surgery, Kazakhstan
Ministry of Education and Science, Republic of Kazakhstan
Investigators
Layout table for investigator information
Principal Investigator: Yuri Pya, PhD, MD National research Center for Cardiac Surgery JSC
  Study Documents (Full-Text)

Documents provided by Yuriy Pya, National Research Center for Cardiac Surgery, Kazakhstan:
Informed Consent Form  [PDF] January 1, 2021

Publications of Results:
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent JL, Wiersinga WJ, Zimmerman JL, Dellinger RP. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377. doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18.
Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018 Mar 20;137(12):e67-e492. doi: 10.1161/CIR.0000000000000558. Epub 2018 Jan 31. Review. Erratum in: Circulation. 2018 Mar 20;137(12 ):e493.

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Responsible Party: Yuriy Pya, Director for Surgery and Science, National Research Center for Cardiac Surgery, Kazakhstan
ClinicalTrials.gov Identifier: NCT05090930    
Other Study ID Numbers: version01
BR10965200 ( Other Grant/Funding Number: Ministry of Education and Science RK )
First Posted: October 25, 2021    Key Record Dates
Last Update Posted: October 25, 2021
Last Verified: October 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Yes: There is a plan to make IPD and related data dictionaries available.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Time Frame: from October 2021 year and will become available till December 2023 year.
Access Criteria: The resulting patient data will be strictly confidential with ensuring privacy through strictly limited access to data, de-identification of data and destruction after the end of the study.
URL: http://heartcenter.kz

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Yuriy Pya, National Research Center for Cardiac Surgery, Kazakhstan:
Anesthesiology
Cardiothoracic surgery
Nephrology
Perfusion
Efferentology
Additional relevant MeSH terms:
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Heart Failure
Shock, Cardiogenic
Multiple Organ Failure
Heart Diseases
Cardiovascular Diseases
Pathologic Processes
Myocardial Infarction
Myocardial Ischemia
Vascular Diseases
Infarction
Ischemia
Necrosis
Shock