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The morbidity rate of Stanford A type Acute Aortic Dissection(AAD) has been increasing, about 5-10/100,000* per year. Emergency surgery has been the main treatment for Acute Aortic Dissection, however perioperative mortality rate can be as high as 15~30%. Acute lung injury (ALI) is one of the main complications that happen during the perioperative period, which by itself covers 30%-50% of the overall mortality rate. Both domestic and foreign countries lack researches on risk factors, pathogenesis, disease progression and outcome of ALI, which happen during the perioperative period of Acute Aortic Dissection patients.
This topic study follow projects in the preoperative of Acute Aortic Dissection'surgery
To discuss risk factors and possible mechanisms of ADD patients with pre-operative ALI and observe their influences on the progress and prognosis of AAD, to explore early intervention in the preoperative for possible risk factors and mechanisms and to evaluate their influences on the prognosis, to achieve the purpose of reducing AAD perioperative mortality of ALI and medical expenses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | no intervention | |
| Tranexamic acid group | Experimental | tranexamic acid ,intravenous 30mg/kg/d,Preoperative |
|
| Edaravone group | Experimental | edaravone, iv, 1mg/kg/d,Preoperative |
|
| Ulinastatin group | Experimental | Ulinastatin ,iv,20,000 U /kg/d,Preoperative |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ulinastatin | Drug |
| ||
| Tranexamic acid |
| Measure | Description | Time Frame |
|---|---|---|
| perioperative outcome and improve of ALI | indicators
| Period from 48 hours before surgery to 12 hours after ICU |
| Measure | Description | Time Frame |
|---|---|---|
| systemic inflammatory response | Indicators
| Period from 48 hours before surgery to 12 hours after ICU |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| WeiPing Cheng, master | Chief Physician,Professor | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31179061 | Derived | Gao Z, Pei X, He C, Wang Y, Lu J, Jin M, Cheng W. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: a prospective observational study. J Thorac Dis. 2019 Apr;11(4):1190-1201. doi: 10.21037/jtd.2019.04.32. | |
| 30174890 | Derived | Pan X, Lu J, Cheng W, Yang Y, Zhu J, Jin M. Independent factors related to preoperative acute lung injury in 130 adults undergoing Stanford type-A acute aortic dissection surgery: a single-center cross-sectional clinical study. J Thorac Dis. 2018 Jul;10(7):4413-4423. doi: 10.21037/jtd.2018.06.140. |
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| ID | Term |
|---|---|
| D000784 | Aortic Dissection |
| D055371 | Acute Lung Injury |
| ID | Term |
|---|---|
| D000094665 | Dissection, Blood Vessel |
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| C028665 | urinastatin |
| D014148 | Tranexamic Acid |
| D000077553 | Edaravone |
| ID | Term |
|---|---|
| D003509 | Cyclohexanecarboxylic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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|
| Edaravone | Drug |
|
| 27759648 | Derived | Cheng Y, Jin M, Dong X, Sun L, Liu J, Wang R, Yang Y, Lin P, Hou S, Ma Y, Wang Y, Pan X, Lu J, Cheng W. Mechanism and early intervention research on ALI during emergence surgery of Stanford type-A AAD: Study protocol for a prospective, double-blind, clinical trial. Medicine (Baltimore). 2016 Oct;95(42):e5164. doi: 10.1097/MD.0000000000005164. |
| D000094683 |
| Acute Aortic Syndrome |
| D001018 | Aortic Diseases |
| D055370 | Lung Injury |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D000983 |
| Antipyrine |
| D047069 | Pyrazolones |
| D011720 | Pyrazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |