To investigate whether during cardiac surgery with cardiopulmonary bypass the lungs are better protected from injury if they receive low frequency ventilation.

ISRCTN ISRCTN75795633
DOI https://doi.org/10.1186/ISRCTN75795633
Secondary identifying numbers CS/2009/3259
Submission date
09/06/2010
Registration date
16/06/2010
Last edited
30/09/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Raimondo Ascione
Scientific

Bristol Heart Institute
Level 7
Bristol Royal Infirmary
Bristol
BS2 8HW
United Kingdom

Study information

Study designSingle-centre parallel-group open randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information leaflet
Scientific titlePulmonary protection with low frequency ventilation during cardiac surgery with cardiopulmonary bypass: a randomised controlled trial
Study acronymPROTECTION 1
Study objectivesDuring conventional open-heart surgery the heart is stopped, most of the blood supply is diverted from the heart and lungs to the heart-lung machine (known as cardiopulmonary bypass) and the lungs are disconnected from the ventilator and left open to air. Cardiopulmonary bypass is known to be associated with major injury to the heart and lungs. The hypothesis for this study is that ventilating the lungs at low frequency rate will prevent significant injury to the lungs.
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedCoronary artery and or valvular disease
InterventionControl group: during cardiopulmonary bypass the lungs will be disconnected from ventilator and left open to air (i.e. usual care).
Intervention group: during cardiopulmonary bypass the lungs will be ventilated at low frequency rate (5/min with air (21% oxygen) at a tidal volume of 6-8 ml/Kg).
Intervention typeProcedure/Surgery
Primary outcome measureRelease of inflammatory mediators:
1. Thromboxane A2
2. TNFα
3. IL-1β
4. IL-6
5. IL-10
Measured in plasma samples taken at post-induction and pre-sternotomy, 10 minutes following CPB weaning, and 2, 6, 12, and 24 hours post CPB weaning.
Secondary outcome measures1. Measurement of oxidative stress from left atrial and right atrial blood sampling post-cannulation, before institution of CPB and on weaning from CPB
2. Pulmonary function tests carried out before surgery, at hospital discharge, and at 6-8 weeks post surgery
3. Pulmonary gas exchange measured post-induction and pre-sternotomy, 10 minutes following CPB weaning, 2 and 6 hours post CPB weaning
4. Respiratory system and lung mechanics measured on arrival on ICU, 2 and 6 hors post CPB weaning
5. Intrapulmonary shunt fraction measured post-induction and pre-sternotomy, 10 minutes following CPB weaning, and before chest closure
6. Pulmonary trapping of white blood cells measured post-cannulation, before institution of CPB and on weaning from CPB
7. A composite endpoint of lung-related complications
8. The time until patients are classified as fit for discharge
Overall study start date01/09/2010
Completion date01/09/2013

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit16 Years
Upper age limit80 Years
SexBoth
Target number of participants60
Total final enrolment63
Key inclusion criteria1. Age >16 and <80 years
2. Undergoing any elective or urgent coronary artery bypass grafting (CABG) with >3 grafts, valve, or CABG+Valve adult cardiac surgery procedure with cardiopulmonary bypass and cardioplegic arrest
3. Left ventricular ejection fraction > 25%
Key exclusion criteria1. Previous pulmonary embolism requiring long term warfarin for > 3 months
2. Previous cardiac surgery
3. Current congestive heart failure (NYHA class IV)/cardiogenic shock
4. Chronic renal failure requiring dialysis
5. Emergency or salvage operation
6. On corticosteroid or immunosuppressive treatment
Date of first enrolment01/09/2010
Date of final enrolment01/09/2013

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Bristol Heart Institute
Level 7
Bristol Royal Infirmary
Bristol
BS2 8HW
United Kingdom

Sponsor information

University Hospitals Bristol NHS Foundation Trust
Hospital/treatment centre

Research and Development Department
Education Centre Level 3
Upper Maudlin Street
Bristol
BS2 8AE
England
United Kingdom

ROR logo "ROR" https://ror.org/04nm1cv11

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 30/09/2024 30/09/2024 Yes No

Editorial Notes

30/09/2024: Publication reference and total final enrolment added.
20/03/2018: No publications found, verifying study status with principal investigator
05/02/2016: No publications found, verifying study status with principal investigator