Cardiac Surgery With Cardiopulmonary Bypass
Conditions
Keywords
renin-angiotensin system, RAS, hypotension, perfusion, shock, blood pressure
Brief summary
The purpose of this research is to learn more about how renin (a blood test) is affected by cardiopulmonary bypass, the heart-lung machine used during open heart surgery. Renin is a protein that may be elevated in response to low blood pressure or situations where organs do not receive sufficient oxygen. Renin may potentially be used as an indicator for specific treatments aimed to increase the blood pressure. This study will evaluate blood samples for renin concentration throughout the course of open heart surgery.
Detailed description
The investigator hypothesizes that renin concentrations will increase with exposure to cardiopulmonary bypass and that increased renin concentrations will be associated with the development of vasoplegia. Specific Aim 1. To characterize the effects of cardiopulmonary bypass on plasma renin concentrations in adults undergoing cardiac surgery. Specific Aim 2. To test the prognostic value of plasma renin concentrations on outcomes following cardiac surgery.
Interventions
None listed
Sponsors
Mayo Clinic
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult persons 18 years of age or greater. * Scheduled for an elective cardiac surgical procedure involving the use of cardiopulmonary bypass.
Exclusion criteria
* Surgery involving heart or lung transplantation or implant of a durable left ventricular assist device. * Emergency cardiac surgery. * Established diagnosis of any congenital heart disease. * End-stage kidney disease receiving kidney replacement therapy before surgery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Plasma renin concentrations | Up to 24 hours after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Vasoplegia | First 24 hours postoperative | Requirement of any vasopressor to maintain a mean arterial pressure of 65 mmHg or greater despite a cardiac index of at least 2.2 L/min/m2 with or without the need for pharmacologic inotropy |
| Acute kidney injury | 7 days | Assessed by the Kidney Disease Improving Global Outcomes (KDIGO) staging criteria |
| Organ dysfunction | 28 days | The presence of any organ support therapy including vasopressors, renal replacement therapy, and mechanical ventilation |
| Mortality | 28 days | — |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORPatrick M Wieruszewski, Pharm.D.
Mayo Clinic
Outcome results
None listed