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This study investigates the question of whether there are differences in the plasma concentration of hormones of the RAAS-axis between patients undergoing on-pump cardiac surgery and those receiving off-pump surgery
In patients undergoing cardiac surgery, the occurrence of vasoplegia or vasoplegic shock is a common and sometimes very severe complication. Although there are multiple factors that may affect the incidence and severity of vasoplegia, it remains unclear which role the use of cardiopulmonary bypass may play in the pathogenesis of this complication. The heart normally pumps blood through the lungs where the blood primarily gets oxygenated. However, it is also known that pulmonary blood flow is also essential for the activation of various hormones, some of which are central to the regulation of vascular tension and blood pressure. If the pulmonary circulation is bypassed, as is the case in on-pump cardiac surgery, it is likely that the resulting differential activity of hormones may cause or contribute to the incidence of vasoplegia. This study aims to show whether cardiopulmonary bypass leads to the differential regulation of hormones of the renin-angiotensin-aldosterone-system which could explain why some patients suffer from vasoplegia or vasoplegic shock following such procedures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| on-pump coronary artery bypass graft surgery | Due to the observational design of the study, no study-specific interventions are performed. Except for the above mentioned laboratory analyses, the treatment of the patients is completely guided by the responsible ICU physicians. Study participation does not influence the determination of surgical procedure (on- vs off-pump). |
| |
| off-pump coronary artery bypass graft surgery | Due to the observational design of the study, no study-specific interventions are performed. Except for the above mentioned laboratory analyses, the treatment of the patients is completely guided by the responsible ICU physicians. Study participation does not influence the determination of surgical procedure (on- vs off-pump). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| on-pump surgery | Procedure | the surgery will be performed "on-pump" |
|
| Measure | Description | Time Frame |
|---|---|---|
| Differences in plasma concentration of Angiotensinogen | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Renin | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Angiotensin I | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Angiotensin converting enzyme (ACE) | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Angiotensin II | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Aldosterone | between induction of anesthesia and immediately after surgical intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in plasma concentration of Angiotensin 1-9 | between induction of anesthesia and immediately after surgical intervention | |
| Differences in plasma concentration of Angiotensin 2-7 | between induction of anesthesia and immediately after surgical intervention |
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Inclusion Criteria:
Exclusion Criteria:
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University Hospital
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alexander Zarbock, MD | Contact | +492518347255 | aki@anit.uni-muenster.de |
| Name | Affiliation | Role |
|---|---|---|
| Alexander Zarbock, MD | University Hospital Muenster, Dept. of Anesthesiology, Intensive Care Therapy and Pain Medicine | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Deutsches Herzzentrum der Charité | Recruiting | Berlin | 13353 | Germany | ||
| University Hospital Münster; Department of Anesthesiology, Intensive Care Medicine and Pain Medicine |
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| ID | Term |
|---|---|
| D056987 | Vasoplegia |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
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blood plasma
| off-pump surgery | Procedure | the surgery will be performed "off-pump" |
|
| Differences in plasma concentration of Dipeptidyl-peptidase 3 (DPP3) | between induction of anesthesia and immediately after surgical intervention |
| Incidence of vasoplegia | within 12 hours post surgery |
| Cumulative dose of vasopressors | within 12 hours post surgery |
| Recruiting |
| Münster |
| 48149 |
| Germany |
|
| D013568 | Pathological Conditions, Signs and Symptoms |