Postoperative Pulmonary Complications
Conditions
Brief summary
Postoperative pulmonary complications(PPCs) including, but not limited to ,hypoxemia, pneumonia, ventilator-induced lung injury, and acute respiratory distress syndrome (ARDS),atelectasis,pleural effusion .PPCs may result in increased resources utilization, delayed mobilization, prolonged need of supplemental oxygen or mechanical ventilation,and a longer hospital stay.postoperative pulmonary complications are common after cardiac surgery, often increasing postoperative morbidity and mortality.The extracorporeal circulation,increased oxygen concentration inhaled and the development of massive atelectasis after open-chest surgery commonly activate lung inflammation, amplifying the harm Injury of pulmonary .Currently, plenty of interventions have been studied to prevent PPCs after surgery. Most of the recent research has focused on physical therapy such as lung-protective modes during intraoperative mechanical ventilation, Alveolar Recruitment, and respiratory muscle training.These therapies have a certain effect, but still not satisfactory.Ascorbic acid is an important cofactor in multiple enzymatic reactions where its main function is as a reducing agent.Studies have shown that ascorbic acid can reduce both ischemia-reperfusion injury and oxidative stress. Unfortunately, no studies examined whether Ascorbic acid can reduce PPCs.
Detailed description
The possible mechanisms of ascorbic acid to alleviate ischemia-reperfusion injury are as follows: 1 Ascorbic acid as a first-line antioxidant in plasma can reduce stress by eliminating excess Reactive oxygen species and reduce damage. 2 provides rapid electron transfer to react with superoxide and hydroxyl group to scavenge reactive oxygen released into the circulation. 3 Ascorbic acid can reduce lipid peroxidation and reduce lung injury caused by ischemia-reperfusion by scavenging oxygen free radicals. 4 Vitamin C can promote the production of cytokines by immune cells to reduce local inflammatory reactions and improve tissue microcirculation.The study aims to explore whether daily used Ascorbic acid in the perioperative period has a preventive effect on PPCs in patients undergoing cardiac surgery, and through short-term and long-term follow-up, to investigate the effect on post-hospitalization Prognosis .
Interventions
DRUGAscorbic Acid
Patients in Ascorbic acid group received 2g of intravenous Ascorbic acid at the night before surgery, during the surgery and five days after surgery (once a day).
DRUGSaline
Patients in Control Comparator group received saline 10ml at the night before surgery, during the surgery and five days after surgery (once a day).
Sponsors
Xuzhou Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Age between 18-60 years old 2. Selective cardiac surgery under cardiopulmonary bypass
Exclusion criteria
1. Emergency surgery 2. Previous cardiac surgery 3. Severe lung disease 4. BMI\<18 or \>30 5. Mean pulmonary arterial pressure \>40 mmHg 6. were allergic to ascorbic acid
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| severity of postoperative pulmonary complications | an average of 2 weeks | Use the postoperative pulmonary complications score to record the severity. scored ranging from 0 to 5.Scored the severity once a day, record the highest score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| length of ICU stay and length of hospital stay | an average of 10 days | all patients transfer to ICU after surgery |
| extubation and wake time | an average of 1 day | length of extubation time,length of wake time |
| PaO2/FiO2 | 1 day, 3 days,5 days post surgery | Oxygenation index (PaO2/FiO2) in millimeter mercury column. |
| A-aDO2 | 1 day, 3 days,5 days post surgery | alveolar-arterial oxygen tension difference (A-aDO2) |
| incidence of postoperative pulmonary complications | an average of 10 days | incidence of postoperative pulmonary complications during hospital stay |
| Peak airway pressure | an average of 1 day | Peak airway pressure in centimeter water column |
| positive end expiratory pressure | an average of 1 day | positive end expiratory pressure in centimeter water column |
| lung compliance | an average of 1 day | lung compliance in Milliliter/ centimeter water column |
| post-hospitalization follow-up | once a day till 30 days post-hospitalization | record the incidence of postoperative pulmonary complications after hospital discharged. |
| Plateau pressure | an average of 1 day | Plateau pressure in centimeter water column |
Countries
China
Contacts
Primary ContactJin Dong Liu, M.S
Backup ContactDongyue Wang
Outcome results
None listed