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| Name | Class |
|---|---|
| University of Zurich | OTHER |
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Cardiac surgery saves lives when patients suffer from cardiac disease. Local inflammation is important for tissue repair and wound healing after such an operation. Inflammation starts already when the patient is treated in the intensive care unit. When inflammatory proteins (cytokines) are released into the circulation, they cause also a systemic inflammation, which alerts the immune system of the body and activates defence mechanisms (=adaptive response). In some patients, systemic inflammation is out of control thereby causing organ dysfunctions, shock, and in the most severe cases even death (=maladaptive response). The aim of this study is to investigate the early phase of inflammation after the operation. Repeated blood samples will be taken of patients undergoing cardiac surgery to describe the patterns and dynamics of inflammation proteins. A better understanding of these mechanisms will potentially lead to improved treatment of patients after cardiac surgery.
The aim of this project is to understand early inflammation mechanisms after cardiac surgery. Therefore, repeated blood samples of patients undergoing cardiac surgery will be taken. Patients are selected after "open" cardiac surgery (via sternotomy), when when they require postoperative care in the cardiovascular intensive care unit. The blood samples will be analysed in collaboration with the Inflammation Research Unit of the Department of Internal Medicine at the University Hospital Zurich.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Coronary artery bypass surgery off-pump (n=24) |
| |
| 2 | Coronary artery bypass surgery on-pump (n=16) |
| |
| 3 | Coronary artery bypass surgery plus valve surgery (n=20) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blood sampling | Other | Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission |
|
| Measure | Description | Time Frame |
|---|---|---|
| Plasma concentration of Wnt5a (ng/ml) | Measured by a commercially available ELISA | Up to 48 hours after ICU admission |
| Plasma concentration of sFRP1 (ng/ml) | Measured by a commercially available ELISA | Up to 48 hours after ICU admission |
| Plasma concentration of sFRP5 (ng/ml) | Measured by a commercially available ELISA | Up to 48 hours after ICU admission |
| Plasma concentration of WIF-1 (pg/ml) | Measured by a commercially available ELISA | Up to 48 hours after ICU admission |
| Measure | Description | Time Frame |
|---|---|---|
| Daily fluid balance (ml) | Routine parameter taken from charts | Up to 48 hours after ICU admission |
| Occurrence of complications (yes/no): composite endpoint of hemodynamic instability (defined as norepinephrine concentration = or > 0.1mcg/kg/min), delirium (defined as ICDSC score = or > 4), infections |
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Inclusion Criteria:
Exclusion Criteria:
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Patients after open cardiac surgery
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| Name | Affiliation | Role |
|---|---|---|
| Alain Rudiger, MD | University of Zurich | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital | Zurich | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28785436 | Background | Hauffe T, Kruger B, Bettex D, Rudiger A. Shock Management for Cardio-surgical ICU Patients - The Golden Hours. Card Fail Rev. 2015 Oct;1(2):75-82. doi: 10.15420/cfr.2015.1.2.75. | |
| 28785454 | Background | Hauffe T, Kruger B, Bettex D, Rudiger A. Shock Management for Cardio-surgical Intensive Care Unit Patient: The Silver Days. Card Fail Rev. 2016 May;2(1):56-62. doi: 10.15420/cfr.2015:27:2. |
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| ID | Term |
|---|---|
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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Blood
Routine parameter taken from charts |
| Up to 7 days after ICU admission |
| Length of ICU stay (days) | Routine parameter taken from charts | Up to 4 weeks |
| 36440011 | Derived | Kruger BD, Hofer GE, Rudiger A, Spahn GH, Braun J, Bettex D, Schoedon G, Spahn DR. Wingless-related integration site (WNT) signaling is activated during the inflammatory response upon cardiac surgery: A translational study. Front Cardiovasc Med. 2022 Nov 11;9:997350. doi: 10.3389/fcvm.2022.997350. eCollection 2022. |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |