To investigate whether during cardiac surgery with cardiopulmonary bypass the lungs are better protected from injury if they receive low frequency ventilation.
ISRCTN | ISRCTN75795633 |
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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
Scientific
Bristol Heart Institute
Level 7
Bristol Royal Infirmary
Bristol
BS2 8HW
United Kingdom
Study information
Study design | Single-centre parallel-group open randomized controlled trial |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Hospital |
Study type | Treatment |
Participant information sheet | Not available in web format, please use the contact details to request a patient information leaflet |
Scientific title | Pulmonary protection with low frequency ventilation during cardiac surgery with cardiopulmonary bypass: a randomised controlled trial |
Study acronym | PROTECTION 1 |
Study objectives | During 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) studied | Coronary artery and or valvular disease |
Intervention | Control 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 type | Procedure/Surgery |
Primary outcome measure | Release 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 measures | 1. 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 date | 01/09/2010 |
Completion date | 01/09/2013 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 16 Years |
Upper age limit | 80 Years |
Sex | Both |
Target number of participants | 60 |
Total final enrolment | 63 |
Key inclusion criteria | 1. 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 criteria | 1. 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 enrolment | 01/09/2010 |
Date of final enrolment | 01/09/2013 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
Bristol Heart Institute
Level 7
Bristol Royal Infirmary
Bristol
BS2 8HW
United Kingdom
Bristol Royal Infirmary
Bristol
BS2 8HW
United Kingdom
Sponsor information
University Hospitals Bristol NHS Foundation Trust
Hospital/treatment centre
Hospital/treatment centre
Research and Development Department
Education Centre Level 3
Upper Maudlin Street
Bristol
BS2 8AE
England
United Kingdom
https://ror.org/04nm1cv11 |
Funders
Funder type
Government
National Institute for Health Research
Government organisation / National government
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 | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not 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