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| Name | Class |
|---|---|
| Uppsala University Hospital | OTHER |
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Investigating the connection between delivered oxygen index and cerebral impact with COx (cerebral oximetry index) och cerebral injury markers during the routine use of cardiopulmonary bypass.
The research subjects are to be treated with CPB with according to local standards (perfusion index 2.4 x body surface area). While measuring impact on cerebral autoregulation with the aid of Near InfraRed Spectroscopy (NIRS) and brain injury markers in blood, research subjects depending on initial hemoglobin value, will divide into two subgroups: one with DO2I of >280 ml/min/m2, and one with DO2I of <280 ml/min/m2.
DO2I will during CPB be calculated using the patient data monitoring system Metavision.
With a correlation analysis between NIRS and MAP (mean arterial pressure) a COx (Cerebral Oxymetry Index) r-value can indicate impact on cerebral autoregulation with values >0.3 - 0.5 during use of CPB 4.
Brain injury markers (Tau, Glial Fibrillary Acidic Protein (GFAP), Neurospecific Enolase (NSE)) are collected during 5 occasions during the first 24 hours and then once per day for 4 days, as well as markers for AKI (S-Creatinine) in some extent.
Registrations during the intensive care regarding delirium, stroke or other neurological impact will also be included in the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group with DO2i <280 ml/min/m2 during cardiopulmonary bypass |
| ||
| Group with DO2i >280 ml/min/m2 during cardiopulmonary bypass |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cerebral injury markers | Diagnostic Test | Blood tests at given time points perioperatively. |
|
| Measure | Description | Time Frame |
|---|---|---|
| COx | COx (Cerebral Oximetry Index; correlation between rSO2 values (INVOS) and mean artery pressure) that indicated impact on cerebral autoregulation on DO2 index values below set limits of 280 ml/m2/min. | 24 hours |
| Brain injury markers; tau, GFAP, NSE | Brain injury markers that indicate cerebral neuronal damage on DO2 index values below set limits of 280 ml/m2/min. | 96 hours |
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Inclusion Criteria:
Exclusion Criteria:
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120 research subjects scheduled for coronary arterial bypass grafting surgery and/or aortic valve replacement in Uppsala University Hospital.
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| Name | Affiliation | Role |
|---|---|---|
| Karl-Henrik Grinnemo, Adj. Prof. | Uppsala University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uppsala University Hospital | Uppsala | Uppsala County | 75135 | Sweden |
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| ID | Term |
|---|---|
| D001161 | Arteriosclerosis |
| D000082862 | Aortic Valve Disease |
| ID | Term |
|---|---|
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006349 | Heart Valve Diseases |
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Cerebral injury markers in blood plasma
| Cerebral oximetry index | Diagnostic Test | Cerebral oximetry index measurements with the aid of Near Infrared Spectroscopy |
|
| D006331 | Heart Diseases |