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| ID | Type | Description | Link |
|---|---|---|---|
| 284709 | Other Identifier | Uppsala University Hospital Research Review Board |
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The goal of this observational study is to understand how oxygen consumption after heart surgery relates to blood flow problems and organ injury. The study focuses on patients over 18 years old who are having planned heart surgery with a heart-lung machine (cardiopulmonary bypass).
The main questions the study aims to answer are:
Researchers will measure oxygen consumption after surgery using a technique called indirect calorimetry. They will also track blood flow and oxygen use during surgery and check for signs of organ injury the day after the procedure. The study will include 65 participants. People with certain health conditions, like severe anemia, high lactate levels before surgery, or needing intensive care or extra oxygen supply before surgery, will not be included. By understanding how oxygen consumption relates to blood flow and organ injury, this research may help to better manage patients after heart surgery and reduce complications.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Oxygen consumption measurement | Other | After arrival to the ICU, prior to cessation of iv anaesthetics and extubation, indirect calorimetry will be performed by connecting a metabolic monitor to the ventilator during a minimum of 20 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in oxygen consumption in early postoperative hypoperfusion | Difference in oxygen consumption (VO2I via indirect calorimetry) in ml min-1 m-2 between patients with and without early hyperlactatemia (>2mmol/L) | 0-4 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of hypoperfusion parameters as predictors of postoperative oxygen consumption | Hypoperfusion parameters will be evaluated as a predictors of postoperative oxygen consumption (VO2I, ml min-1 m-2 via indirect calorimetry). Blood gas parameters taken preoperatively and at spaced time-points up to 24 hrs after start of surgery: 1) Central venous oxygen saturation (ScvO2, %, central venous blood gas), 2) Arterial lactate (mmol/L, arterial blood gas), 3) Base excess (BE, mmol/L, arterial blood gas), 4) Venous-to-arterial CO2 difference (ΔPCO2, mmHg, arterial and central venous blood gas) and its ratio with arterial -central venous oxygen content. Clinical variables measured hourly or otherwise specified: 5) Heart rate (beats/min), 6) Mean arterial pressure (MAP, mmHg), 7) Central venous pressure (CVP, mmHg), 8) Vasopressor or inotrope requirement (Y/N, low-intermediate-high), 9) Urine output (mL/24 hours), and 10) net fluid balance (mL/24 hours). Additional explorative data analyses for hypothesis generating purposes can be performed. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients undergoing elective cardiac surgery at a university hospital
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Julia Jakobsson MD PhD | Contact | +46-18-610 00 00 | julia.o.jakobsson@akademiska.se | |
| Olle Lönnemark MD | Contact | +46 -18-610 00 00 | olle.lonnemark@akademiska.se |
| Name | Affiliation | Role |
|---|---|---|
| Laila Hellgren Johanssson, MD PhD Associate Professor | Unit for Cardiothoracic Surgery, Dept. of Surgical Sciences, Uppsala University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uppsala University Hospital | Recruiting | Uppsala | Sweden | Sweden |
Any data will be carefully reviewed to ensure compliance with GDPR and data sharing regulations before being disclosed.
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| ID | Term |
|---|---|
| D010101 | Oxygen Consumption |
| ID | Term |
|---|---|
| D008660 | Metabolism |
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Arterial and central venous blood gases, blood gases from cardiopulmonary bypass circuit Blood samples for organ injury markers
| 0-24 hours after surgery |
| Evaluation of oxygen delivery and consumption during cardiopulmonary bypass as predictors of postoperative oxygen consumption | Oxygen delivery (DO2I, ml min-1 m-2) and oxygen consumption (VO2I ml min-1 m-2) will be measured during cardiopulmonary bypass by continuous blood parameter monitoring or calculated by blood oxygen content and pump flow. Both mean levels and repeated measures will be analysed as predictors for postoperative oxygen consumption. Additional explorative data analyses for hypothesis generating purposes can be performed. | 0-4 hours during and after surgery |
| Evaluation of organ injury biomarkers as predictors of postoperative oxygen consumption | Organ injury markers will be evaluated as predictors for postoperative oxygen consumption. Absolute levels, changes from preoperative values, and above normal predicted value (yes/no) will be used in the analysis. Blood sampling preoperatively and the day after surgery.
| Preoperative and the day after surgery |