Congenital Heart Disease
Conditions
Keywords
remote ischemic preconditioning, sevoflurane, total intravenous anesthetic
Brief summary
Remote ischemic preconditioning (RIPC) of the myocardium by limb ischemia/reperfusion may mitigate cardiac damage, but its interaction with the anesthetic regimen is unknown.
Detailed description
The investigators will test if RIPC will be associated with differential effects depending on background anesthesia. Specifically, the investigators hypothesized that RIPC during sevoflurane anesthesia attenuates myocardial injury in patients undergoing congenital cardiac defects repair surgery and that effects may be different during propofol anesthesia.
Interventions
DRUGSevoflurane plus remote ischemic preconditioning
Inhalational anesthesia (Sevoflurane) in addition to remote ischemic preconditioning
DRUGTotal intravenous anesthesia plus remote ischemic preconditioning
Total intravenous anesthesia (propofol plus fentanyl) in addition to remote ischemic preconditioning
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
6 Months to 12 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric scheduled for cardiac surgery requiring the cardioplegic arrest and cardiopulmonary bypass
Exclusion criteria
* Previous cardiac surgery * Urgent or emergent cases * Patient with the following diseases diabetes mellitus ,hypertension ,renal failure, hepatic and pulmonary diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Troponin I levels | within first 24 hours after cardiac surgery | The investigators will obtain blood samples for troponin I level pre-Cardiopulmonary bypass, 6, 12 and 24 hours after the surgery. Troponin I levels, as a marker of myocardial ischemia, have been used in previous adult and pediatric studies on preconditioning. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Highest inotropic score during the first 24 hours after cardiac surgery | within first 24 hours after cardiac surgery | Inotrope score is a useful predictor of morbidity and mortality in children who undergo heart surgery. The inotropic score is calculated as follows: 1 point is assigned for each mcg/kg/min of dopamine and dobutamine, and 10 points is assigned for each 0.1 mcg/kg/min of epinephrine, norepinephrine, and phenylephrine. Inotrope score is a useful predictor of morbidity and mortality in children who undergo heart surgery |
| Mortality at 30 days | 30 days | Proportion of patients who dies within 30 days of their surgical repair |
| Cardiac function | within first 24 hours of cardiac surgery | Cardiac rhythm on return if it will be sinus rhythm or return with ventricular fibrillation |
Countries
Egypt
Outcome results
None listed