None listed
Conditions
Brief summary
Worsening kidney function is common after cardiac surgery. During cardiac surgery, cardiopulmonary bypass (CPB) is commonly utilised to deliver blood around the body However, the use of CPB is known to decrease blood flow to the kidneys compared to normal, putting the kidneys at risk of harm. Increasing overall CPB blood flow to the whole body has minimised kidney harm in small studies. However, the benefit of routinely increased CPB blood flow has not been tested in real-world settings. In order to work towards a large trial that applies high CPB blood flow routinely, we aim to demonstrate the feasibility of targeting different CPB blood flow targets in two different hospitals. Adult non-female patients having cardiac surgery who: require normal temperatures to manage their surgery; have normal oxygen-carrying capacity and without severe kidney disease will randomly receive blood flows at the highest range of acceptable CPB flow or blood flows at the middle of that range. Afterwards, routinely collected data related to kidney outcomes and other outcomes will be collected. An extra blood test will be collected comparing red cell breakdown in both groups. This trial is expected to demonstrate feasibility for a larger trial.
Interventions
Targeted cardiouplmonary bypass flows of 2.8 L/min/m^2 of Body surface area for the entire duration of cardiopulmonary bypass for cardiac surgery, which may vary from less than 45 minutes to more than 180 minutes, depending on surgical complexity.
This will be performed by the perfusionist running the cardiopulmonary bypass machine.
Adherence will be assessed as part of the primary outcome through interrogation of the bypass machine records.
Sponsors
Raymond Hu, Austin Health
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
>18 years of age - Undergoing cardiac surgery involving cardiopuplmonary bypass - Planned temperature >32°C during cardioplmonary bypass - Estimated glomerular filtration rate (eGFR) >30ml/min/1.73m^2 of body surface area (BSA) - Lowest anticipated indexed systemic delivery of oxygen (DO2i) of >280 ml/L/m2 of BSA (based on weight, pre-op haemoglobin and 1500mL prime volume) - Able to consent for participation
Exclusion criteria
- Pregnancy - Failure to meet any inclusion criteria
Outcome results
None listed