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Anesthetic Management and Remote Reperfusion Injuries

This study is ongoing, but not recruiting participants.

Sponsored by: National Taiwan University Hospital
Information provided by: National Taiwan University Hospital
ClinicalTrials.gov Identifier: NCT00745810
  Purpose

Ischemia- reperfusion ( IR ) injuries were not only seen in the transplanted organs but also the remote organs such as lungs that brings major postoperative complications. Severe complications such as pulmonary infiltration and pulmonary edema following reperfusion were frequently associated with liver transplantation. Cardiac surgery performed with the use of cardiopulmonary bypass ( CPB ) provokes a systemic inflammatory response syndrome that affects postoperative pulmonary, myocardiac and renal functions. Previous study about the reperfusion injuries was focused on the leukocyte and endothelial activation and the following oxidative injuries, however, the alteration on pulmonary function such as dynamic compliance and the oxidative/antioxidative balance in erythrocytes and the following effects in CPB have not been fully studied. Erythrocytes' reaction to oxidative stress including cytoplasma and cell membrane should be studied because RBCs are the major circulating blood cells having different types of antioxidant system to capture reactive oxygen species ( ROS ) thus RBC may be severely injured by ROS or protected ROS injuries during CPB. In these three-year study, we plan to explore the extent and pattern of remote oxidative injuries in lungs by massive ROS production and the following products released from reperfused organs. In the first year, the remote pulmonary injuries from hepetic IR will be focused. We plan to establish an animal model for pulmonary function and pulmonary injury assessments including dynamic compliance (Cdyn), pulmonary edema wet-to-dry ratio (W/D), malondialdehyde (MDA) and histopathological findings under hepatic IR challenge. In the second year, the IR effects during and after CPB on circulating blood cells will be fully studied. We plan to investigate the magnitude, subtypes and timing on ROS production, the changes of oxidative and antioxidant activities of erythrocytes including cytoplasma and cell membrane, the changes on leukocytes and plasma to explore the roles of circulating erythrocytes on oxidative stress in CPB. In the third year, we plan to try propofol, stated having antioxidant in vivo and in vitro, on the remote pulmonary injuries following hepatic IR and CPB.


Condition Intervention
Cardiopulmonary Bypass
Other: Cardiopulmonary bypass

MedlinePlus related topics:   Anesthesia   

U.S. FDA Resources

Study Type:   Observational
Study Design:   Cohort, Prospective
Official Title:   The Effects of Anesthetic Management on Oxidative Injuries After Cardiopulmonary Bypass

Further study details as provided by National Taiwan University Hospital:

Biospecimen Retention:   None Retained

Biospecimen Description:

whole blood and plasma


Estimated Enrollment:   110
Study Start Date:   August 2008

Groups/Cohorts Assigned Interventions
1
sequential changes before and after cardiopulmonary bypass
Other: Cardiopulmonary bypass
sequential changes of oxidative injuries before and after cardiopulmonary bypass

  Eligibility
Ages Eligible for Study:   20 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample

Study Population

patients who receive an open heart surgery under cardiopulmonary bypass


Criteria

Inclusion Criteria:

  • age > 20 y/0, need cadiopulmonary bypass

Exclusion Criteria:

  • severe anemia, hematologic diseases, hormone therapy, privious valvular surgery, blood transfusion in recent 3 months
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00745810

Locations
Taiwan
National Taiwan University Hospital    
      Taipei, Taiwan, 100

Sponsors and Collaborators
National Taiwan University Hospital
  More Information


Responsible Party:   National Taiwan university Hospital ( Ya-jung Cheng )
Study ID Numbers:   200705022R
First Received:   August 31, 2008
Last Updated:   August 31, 2008
ClinicalTrials.gov Identifier:   NCT00745810
Health Authority:   Taiwan: Department of Health

Keywords provided by National Taiwan University Hospital:
cardiopulmonary bypass  
oxidative injuries  

Study placed in the following topic categories:
Postoperative Complications
Vascular Diseases
Reperfusion Injury

Additional relevant MeSH terms:
Pathologic Processes
Cardiovascular Diseases

ClinicalTrials.gov processed this record on October 24, 2008




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