Influence of Dextran-70 on Systemic Inflammatory Response and myocardial ischaemia-reperfusion following cardiac operations
| ISRCTN | ISRCTN38289094 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN38289094 |
| Protocol serial number | N/A |
| Sponsor | European Society of Anesthesiologists (ESA) (Belgium) |
| Funder | European Society of Anesthesiologists (ESA) (Belgium) - Clinical Research Grant award |
- Submission date
- 26/09/2006
- Registration date
- 03/01/2007
- Last edited
- 30/10/2008
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Circulatory System
Plain English summary of protocol
Not provided at time of registration
Contact information
Scientific
Hajnal u. 19.
Zalaegerszeg
8991
Hungary
| gomboczk@freemail.hu |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Prospective, randomised, double blind trial |
| Secondary study design | Randomised controlled trial |
| Scientific title | |
| Study acronym | DISIR |
| Study objectives | Cardiac surgery on CardioPulmonary Bypass (CPB) results in a complex immune response which is characterised by the activation of all inflammatory pathways and is strongly related to increased postoperative morbidity and mortality. Animal experiments have confirmed that haemodilution with dextran decreases the endothelial adhesion of neutrophils in the post-ischaemic phase. However there are no exact clinical data in the literature that would support the anti-inflammatory effect of dextran infusion following cardiac surgery. Our hypothesis is that dextran inhibits the inflammatory mediator cascades after cardiac operations and diminishes ischaemia-reperfusion injury. |
| Ethics approval(s) | Ethics approval gained from the Local Ethical Committee of Zala County Hospital on the 2nd February 2001. |
| Health condition(s) or problem(s) studied | Myocardial ischaemia-reperfusion injury |
| Intervention | Two groups were formed following computerised randomisation. Twenty patients were given dextran-70 (6%) infusion (Macrodex, Pharmalink, Inc., Upplands Vasby, Sweden) (group A), whilst in the control group 20 patients were given oxypolygelatin (5.5%) infusion (Gelifundol, Biotest Pharma, Inc., Dreieich, Germany) (group B). Following the induction of anaesthesia, artificial colloid was administered using infusion pumps (Model 591, IVAC, Inc., San Diego, USA). After the application of hapten inhibition by 20 ml dextran-1 (Promit, Fresenius Kabi, Inc., Norge AS, Norway), dextran-70 infusion was used in the dose of 7.5 ml/kg before CPB, and 12.5 ml/kg for 14 hours following the cessation of CPB. Gelatin was infused by the same body-weight based volume as dextran. Arterial blood samples were obtained at six time points: before the operation (t0), ten minutes (t1), two hours (t2), four hours (t3), 24 hours (t4) and 44 hours (t5) after the cessation of CPB. |
| Intervention type | Drug |
| Phase | Not Specified |
| Drug / device / biological / vaccine name(s) | Dextran, oxypolygelatin |
| Primary outcome measure(s) |
We have investigated the inflammatory mediator response determing the plasma concentration of some inflammatory mediators (procalcitonin, C-reactive protein, interleukin 6, interleukin 6r, interleukin 8, interleukin 10, macrophage migration inhibitory factor, soluble endothelial leukocyte adhesion molecule-1, soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1) and those of the ischaemia-reperfusion (cardiac troponin-I) between the dextran treated and the control groups following cardiac surgery. |
| Key secondary outcome measure(s) |
Cardiopulmonary bypass alters vasomotor regulation reducing the endothelium dependent relaxation. We have investigated the effect of dextran on the kinetics of the haemodynamic variables (heart rate, arterial blood pressure, cardiac index, stroke volume index, systemic vascular resistance index, intrathoracic blood volume index, extravascular lung water index). |
| Completion date | 10/01/2004 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Not Specified |
| Sex | All |
| Target sample size at registration | 40 |
| Key inclusion criteria | First time cardiac surgery on Cardiopulmonary Bypass (CPB) (Coronary Artery Bypass Graft [CABG] or aortic valve replacement) |
| Key exclusion criteria | 1. 'Redo' operation 2. Hepatic disease 3. Renal dysfunction 4. Immunological disease 5. Steroid treatment 5. Intake of aspirin or other cyclooxygenase-inhibitor within seven days prior to surgery 6. Known allergy to volume expanders used in the study None of the patients received volatile anaesthetics, steroids or aprotinin and haemofiltration were not used either. No shed mediastinal blood was retransfused during the post-operative period. |
| Date of first enrolment | 26/05/2002 |
| Date of final enrolment | 10/01/2004 |
Locations
Countries of recruitment
- Hungary
Study participating centre
8991
Hungary
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 01/05/2007 | Yes | No |
