Does cardiac surgery alter the response of the body to infection?

Phagocytic Responses and Immune System Monitoring in cardiac surgery: a prospective observational study

Status

Not yet recruiting

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12626000220369

Acronym

PRISM

Enrollment

Registered

2026-02-20

Start date

2026-03-02

Completion date

2026-08-28

Last updated

2026-03-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Cellular immunosuppression – an acquired dysfunction of the cellular component of the immune system which predisposes to nosocomial infection – has been described as part of the inflammatory response to sepsis. While it has been postulated that such a phenomenon might also occur following major surgery (due to the mechanistic similarities between the innate immune response to sepsis and trauma), this hypothesis has not been proven. PRISM is a prospective observational study that will explore the effects of cardiopulmonary bypass on cellular immune function in the immediate postoperative period and the time course of any observed phenomenon. If we can demonstrate that impaired cellular immune function occurs following cardiac surgery on cardiopulmonary bypass, we will have sufficient equipoise to trial new therapies in this population to restore immune function and potentially reduce the risk of postoperative nosocomial infection.

Interventions

Participants will be undergoing cardiopulmonary bypass with a full extracorporeal circuit for elective or urgent cardiac surgery. Participants will not be asked to complete questionnaires or other physical assessments. Participants will be asked to provide blood samples on the day of surgery and the first four days after the operation Participants will be observed on the day of surgery and for the first four days after their operation

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

All adult patients (aged greater than or equal to 18 years) undergoing CABG and/or valve surgery

Exclusion criteria

1. Congenital or acquired immunosuppression (including any drugs with an immunosuppressive effect within the preceding 3 months (i.e. oral steroids, TNF-alpha inhibitors, disease-modifying anti-rheumatic drugs, etc.). 2. Non-prophylactic antibiotic therapy in the 14 days prior to surgery. 3. End-stage renal failure requiring dialysis. 4. Hepatic cirrhosis with or without decompensation. 5. Planned off-pump surgery. 6. Any disorder of bone marrow function (i.e. myelodysplasia, leukaemia, etc.) 7. Solid organ or haematological malignancy within the preceding 12 months. 8. Plan for high-dose intra-operative corticosteroids. 9. Pre-operative C-reactive protein (CRP) > 5 mg/L

Outcome results