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Venous Congestion and Cardiac Surgery-Associated Acute Kidney Injury

Recruitingn/aAges 18 Years - anyAllZhuan Zhang
NCT07232277 on ClinicalTrials.gov โ†—
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In plain words

What the trial is, and whether it could suit you

Venous pressure is often overlooked as an important hemodynamic parameter. Elevated venous pressure and blood stasis in organ tissues can lead to interstitial edema. Intraoperative venous blood stasis can rapidly increase interstitial pressures within organ tissues, especially in organs encapsulated by tissue envelopes, such as the kidney, thereby rapidly reducing effective circulating blood flow to the organ. Systemic venous blood stasis, which tends to occur in patients with right heart failure or pulmonary hypertension, as well as in patients with fluid overload, can lead to intraoperative stasis in multiple organs and tissues, mediating the development of multisystem complications, including acute kidney injury. Therefore, timely, effective, and accurate intraoperative assessment of systemic venous blood stasis is particularly important. When right heart failure and/or volume overlo

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๐Ÿ“‹ Eligibility rules (as published)
Inclusion Criteria: 1. Patients scheduled to undergo elective cardiac surgery; 2. โ‰ฅ 18 years. Exclusion Criteria: 1. Contraindications for TEE; 2. Emergency cardiac surgery; 3. Major vascular surgery; 4. Redo cardiac surgery; 5. Abnormal preoperative renal function; 6. Severe chronic kidney disease (estimated glomerular filtration rate \< 15 ml/min/1.73 m2 or dialysis); 7. History of kidney transplantation; 8. Severe infection requiring continuous antibiotic therapy๏ผ› 9. Severe preoperative heart failure with left ventricular ejection fraction \< 30%; 10. A critical preoperative state (mechanical circulatory support, extracorporeal membrane oxygenation, current renal replacement therapy \[RRT\], mechanical ventilation, or cardiac arrest necessitating resuscitation); 11. Multi-organ dysfunction; 12. Known conditions that may interfere with the assessment or interpretation of hepatic vein, portal vein blood flow (such as liver cirrhosis or portal vein thrombosis) or the renal vein blood flow and renal artery blood flow (such as urinary tract obstruction); 13. Planned cardiac transplantation or ventricular assist device implantation; 14. Pregnancy; 15. Insufficient ultrasonographic imaging; 16. Restarting CPB after first CPB cessation during surgery; 17. Requirement for cardiac assist devices (ECMO, IABP, or ventricular assist device) after CPB intraoperatively.
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What it tests

  • collection of demographic characteristics and comorbidities
  • surgery-related parameters and kidney function assessments
  • collection of biological (laboratory) parameters
  • collection of hemodynamic parameters
  • collection of echocardiographic parameters and venous ultrasound assessments
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Where

1 site
No. 368 Hanjiang Middle Road
Yangzhou, China
๐Ÿค Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible โ€” always decide together with your own doctor.
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