Acute Kidney Injury, C.Surgical Procedure; Cardiac, Postoperative Complications, Respiratory Insufficiency, Right-Sided Heart Failure
Conditions
Keywords
Near Infrared Spectroscopy, Ultrasonography, Hepatic vein Doppler, Portal vein Doppler, Lung ultrasound, Positive fluid balance, Mixed venous saturation
Brief summary
The purpose of this prospective observational cohort study is to evaluate multimodal monitoring technologies in the perioperative care of cardiac surgical patients. Right ventricular pressure tracings, near infrared spectroscopy (NIRS) and transthoracic ultrasonography will be studied for their ability to detect and predict complications such as right ventricular failure, renal failure and respiratory failure.
Detailed description
The study has 4 main objectives: 1. To determine if right ventricular pressure tracings correlate with other indices of right ventricular failure and with positive fluid balance, renal failure and increased length of stay in the intensive care unit. 2. To determine the prevalence of portal vein pulsatility in the perioperative period and its association with right ventricular failure and positive fluid balance. 3. To determine if Near InfraRed Spectroscopy (NIRS) values correlate with mixed venous oxygen saturation (SvO2) and with poorer post-operative prognosis. 4. To determine the incidence, risk factors and prognosis of respiratory complications of cardiac surgery using transthoracic ultrasonography.
Interventions
All cardiac surgery procedures
Sponsors
Study design
Eligibility
Inclusion criteria
* Cardiac surgery performed at the Montreal Heart Institute * 18 years old and older
Exclusion criteria
* Urgent surgery * Pre-operative intra-aortic balloon pump, left ventricular assist device or ECMO * Heart transplant * Cirrhosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Right ventricular failure | First 24 hours post cardiac surgery | — |
| Pulmonary complications | 30 days | Composite outcome : pneumonia, prolonged mechanical ventilation (more than 24 hours) or clinically significant atelectasis (requiring \> 2L O2). |
| Acute Renal failure | 30 days | KDIGO : class I and more |
Secondary
| Measure | Time frame |
|---|---|
| Fluid balance | First 24h |
| Maximal blood lactate levels | First 24h |
Countries
Canada