Aortic Dissection
Conditions
Keywords
Aortic dissection, Cerebral and Spinal Protection, Post-conditioning
Brief summary
With more and more people developing hypertension and atherosclerosis, the morbidity rate of Acute Aortic Dissection（AAD） has been increasing. Emergency surgery is the main treatment for Acute Aortic Dissection. However the secondary injury caused by reperfusion of spinal cord could lead to Catastrophic complications,such as paraplegia, hemiplegia or even death. So spinal protection is always the hot topic in clinical research. Xenon is an ideal anesthetic gases with the following features,fast onset of action, stable hemodynamics, clean and non-toxic.The animal researches have showed the protective effects of xenon to alleviate the ischemia-reperfusion injury of the nervous system.Those clues suggest that Xenon may have the potential protection of spinal cord in patients undergoing aortic dissection repair.In order to clarify this hypothesis, the investigators designed this randomized, controlled clinic trial to evaluate the protection of Xenon against spinal cord ischemia-reperfusion injury and the potential mechanisms
Interventions
DRUGxenon
Sponsors
Beijing Anzhen Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients doing selective operation of Bentall and Sun's or partial aortic arch replacement * Patients doing selective operation of the full chest and abdominal aorta replacement
Exclusion criteria
* Emergency patient * Patients with severe mental and neurological dysfunction * Patients with severe hearing and visual impairment * Illiteracy or patients can't cooperate with doing the cognitive function score * Patients with severe cardiac insufficiency * critically ill or dying patients * Patients refuse to sign the informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| plasma myelin basic protein(MBP) | immediately after anesthesia induction |
| plasma glial fibrillary acidic protein (GFAP) | immediately after anesthesia induction |
| Cerebrospinal fluid(CSF) S100β | immediately after anesthesia induction |
| CSF neuron specific enolase(NSE), | immediately after anesthesia induction |
| CSF MBP | immediately after anesthesia induction |
| mini mental state examination | 18h before the surgery |
| NIHSS's score | the 1st day after the surgery |
| ASIA impairment scale（ASIA's score ） | 18h before the surgery |
| males | 18h before the surgery |
| age | 18h before the surgery |
| height | 18h before the surgery |
| weight | 18h before the surgery |
| History of Smoking | 18h before the surgery |
| History of Hypertension | 18h before the surgery |
| History of Diabetes Mellitus | 18h before the surgery |
| New York Heart Association Heart function score | 18h before the surgery |
| duration of cardiopulmonary bypass (CPB) | 1h after the surgery |
| duration of Aortic cross-clamping | 1h after the surgery |
| duration of low flow in CPB | 1h after the surgery |
| duration of stopping the circulation | 1h after the surgery |
| the lowest nasopharyngeal temperature | 1h after the surgery |
| the lowest rectal temperature | 1h after the surgery |
| duration of surgery | 1h after the surgery |
| duration of recovering of consciousness from the end of the surgery | 3 days after the surgery |
| duration of extubation from the end of the surgery | 3 days after the surgery |
| duration in the ICU | 15 days after the surgery |
| days in hospital | 15 days after leaving hospital |
| pulmonary infection | 15 days after the surgery |
| plasma S100β | immediately after anesthesia induction |
| plasma neuron specific enolase, | immediately after anesthesia induction |
| CSF GFAP | immediately after anesthesia induction |
| CSF Tumor Necrosis Factor-α(TNF-α) | immediately after anesthesia induction |
| CSF interleukin-10 (IL-10) | immediately after anesthesia induction |
| CSF IL-6 | immediately after anesthesia induction |
| CSF IL-2 | immediately after anesthesia induction |
| somatosensory evoked potential(SEP) | immediately after anesthesia induction |
| MEP | immediately after anesthesia induction |
| Mini mental state ex amination | the 7th day after the surgery |
| ASIA's score | the 1st day after the surgery |
| plasma MBP | immediately the end of surgery |
| plasma GFAP | immediately the end of surgery |
| CSF S100β | immediately the end of surgery |
| CSF neuron specific enolase, | immediately the end of surgery |
| CSF TNF-α | immediately the end of surgery |
| CSF IL-10 | immediately the end of surgery |
| SEP | immediately after blocking the aorta |
Outcome results
None listed