Inflammation, Thoracic Surgery
Conditions
Keywords
Cardia surgery, Cardio-pulmonary bypass, Inflammation, WNT, Cytokines
Brief summary
Cardiac surgery saves lives when patients suffer from cardiac disease. Local inflammation is important for tissue repair and wound healing after such an operation. Inflammation starts already when the patient is treated in the intensive care unit. When inflammatory proteins (cytokines) are released into the circulation, they cause also a systemic inflammation, which alerts the immune system of the body and activates defence mechanisms (=adaptive response). In some patients, systemic inflammation is out of control thereby causing organ dysfunctions, shock, and in the most severe cases even death (=maladaptive response). The aim of this study is to investigate the early phase of inflammation after the operation. Repeated blood samples will be taken of patients undergoing cardiac surgery to describe the patterns and dynamics of inflammation proteins. A better understanding of these mechanisms will potentially lead to improved treatment of patients after cardiac surgery.
Detailed description
The aim of this project is to understand early inflammation mechanisms after cardiac surgery. Therefore, repeated blood samples of patients undergoing cardiac surgery will be taken. Patients are selected after open cardiac surgery (via sternotomy), when when they require postoperative care in the cardiovascular intensive care unit. The blood samples will be analysed in collaboration with the Inflammation Research Unit of the Department of Internal Medicine at the University Hospital Zurich.
Interventions
OTHERBlood sampling
Five Timepoints: baseline (pre-operative), ICU admission, 4 hours after ICU admission, 8 hours after ICU admission, 48 hours after ICU admission
Sponsors
University of Zurich
Alain Rudiger
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Cardiac surgery via sternotomy * Coronary-bypass bypass surgery with or without valve surgery * Postoperative hospitalisation in the cardio-surgical ICU * Available informed consent
Exclusion criteria
* Preoperative infections (e.g. endocarditis) * Preoperative use of steroids or other immunosuppression
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma concentration of Wnt5a (ng/ml) | Up to 48 hours after ICU admission | Measured by a commercially available ELISA |
| Plasma concentration of sFRP1 (ng/ml) | Up to 48 hours after ICU admission | Measured by a commercially available ELISA |
| Plasma concentration of sFRP5 (ng/ml) | Up to 48 hours after ICU admission | Measured by a commercially available ELISA |
| Plasma concentration of WIF-1 (pg/ml) | Up to 48 hours after ICU admission | Measured by a commercially available ELISA |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Daily fluid balance (ml) | Up to 48 hours after ICU admission | Routine parameter taken from charts |
| Occurrence of complications (yes/no): composite endpoint of hemodynamic instability (defined as norepinephrine concentration = or > 0.1mcg/kg/min), delirium (defined as ICDSC score = or > 4), infections | Up to 7 days after ICU admission | Routine parameter taken from charts |
| Length of ICU stay (days) | Up to 4 weeks | Routine parameter taken from charts |
Countries
Switzerland
Outcome results
None listed