Trial Outcomes & Findings for Inhaled Nitric Oxide and Inhaled Prostacyclin After Cardiac Surgery for Heart Transplant or LVAD Placement (NCT NCT01717209)

NCT ID: NCT01717209

Last Updated: 2017-10-09

Results Overview

Pulmonary hypertension was measured as mean of Mean Pulmonary Artery Pressure for initial 8 hours after admission to the Intensive Care Unit (ICU). MPAP value ≥25 mmHg (resting) indicates pulmonary hypertension state.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

14 participants

Primary outcome timeframe

8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Results posted on

2017-10-09

Participant Flow

Participant milestones

Participant milestones
Measure
Combined Nitric Oxide and Prostacyclin
Inhaled nitric oxide (iNO; 20 ppm continuously) and inhaled prostacyclin (iPGI2; 0.05 micrograms/kg/min continuously)
Overall Study
STARTED
14
Overall Study
COMPLETED
14
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Inhaled Nitric Oxide and Inhaled Prostacyclin After Cardiac Surgery for Heart Transplant or LVAD Placement

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Age, Continuous
57 years
n=93 Participants
Sex: Female, Male
Female
2 Participants
n=93 Participants
Sex: Female, Male
Male
12 Participants
n=93 Participants
Region of Enrollment
United States
14 Participants
n=93 Participants

PRIMARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Pulmonary hypertension was measured as mean of Mean Pulmonary Artery Pressure for initial 8 hours after admission to the Intensive Care Unit (ICU). MPAP value ≥25 mmHg (resting) indicates pulmonary hypertension state.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Pulmonary Hypertension
Following iNO+iPGI2 (1st)
25.9 mmHg
Interval 17.0 to 36.0
Pulmonary Hypertension
Following iPGI2
25.4 mmHg
Interval 15.0 to 38.0
Pulmonary Hypertension
Following iNO+iPGI2 (2nd)
25.4 mmHg
Interval 12.0 to 46.0
Pulmonary Hypertension
At Arrival in ICU
31.4 mmHg
Interval 20.0 to 43.0
Pulmonary Hypertension
Following iNO
29.1 mmHg
Interval 16.0 to 44.0

SECONDARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Right Heart Dysfunction was measured as mean of Right Ventricular Stroke Work Index (RVSWI) for the initial 8 hours after admission to the Intensive Care Unit (ICU). RVSWI is measured as the difference in mean pulmonary artery pressure (MPAP) and central venous pressure (CVP), divided by the cardiac index (CI): \[(MPAP-CVP) / CI\]. Normal range for RVSWI is 5-10 g/m.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Right Heart Dysfunction
At Arrival in ICU
5.2 g/m
Interval 2.64 to 11.15
Right Heart Dysfunction
Following iNO
5.0 g/m
Interval 1.45 to 9.06
Right Heart Dysfunction
Following iNO+iPGI2 (1st)
4.8 g/m
Interval 1.96 to 8.4
Right Heart Dysfunction
Following iPGI2
5.4 g/m
Interval 2.1 to 13.14
Right Heart Dysfunction
Following iNO+iPGI2 (2nd)
4.9 g/m
Interval 1.3 to 10.05

SECONDARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Systemic Vascular Resistance (SVR) was measured as mean of Systemic Vascular Resistance (SVR) for the initial 8 hours after admission to the Intensive Care Unit (ICU). Normal range for SVR is 800-1200 dynes/sec/cm5.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Systemic Vascular Resistance (SVR)
At Arrival in ICU
1193.9 dynes/sec/cm^5
Interval 488.0 to 1542.0
Systemic Vascular Resistance (SVR)
Following iNO
1169.7 dynes/sec/cm^5
Interval 898.0 to 1945.0
Systemic Vascular Resistance (SVR)
Following iNO+iPGI2 (2nd)
1145.9 dynes/sec/cm^5
Interval 783.0 to 1649.0
Systemic Vascular Resistance (SVR)
Following iNO+iPGI2 (1st)
1070.6 dynes/sec/cm^5
Interval 736.0 to 1520.0
Systemic Vascular Resistance (SVR)
Following iPGI2
1132.4 dynes/sec/cm^5
Interval 711.0 to 1640.0

SECONDARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Central Venous Pressure (CVP) was measured as mean of CVP for the initial 8 hours after admission to the Intensive Care Unit (ICU). Normal range for CVP is 3-8 mmHg.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Central Venous Pressure (CVP)
At Arrival in ICU
12.7 mmHg
Interval 4.0 to 19.0
Central Venous Pressure (CVP)
Following iNO
12.6 mmHg
Interval 5.0 to 18.0
Central Venous Pressure (CVP)
Following iNO+iPGI2 (1st)
11.6 mmHg
Interval 6.0 to 15.0
Central Venous Pressure (CVP)
Following iPGI2
10.1 mmHg
Interval 2.0 to 15.0
Central Venous Pressure (CVP)
Following iNO+iPGI2 (2nd)
10.6 mmHg
Interval 4.0 to 14.0

SECONDARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Mean Arterial Pressure (MAP) was measured as mean of MAP for the initial 8 hours after admission to the Intensive Care Unit (ICU). Normal range for MAP is 70-110 mmHg.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Mean Arterial Pressure (MAP)
At Arrival in ICU
86.29 mmHg
Interval 68.0 to 102.0
Mean Arterial Pressure (MAP)
Following iNO
80.86 mmHg
Interval 62.0 to 91.0
Mean Arterial Pressure (MAP)
Following iNO+iPGI2 (1st)
79.00 mmHg
Interval 67.0 to 89.0
Mean Arterial Pressure (MAP)
Following iPGI2
79.43 mmHg
Interval 63.0 to 91.0
Mean Arterial Pressure (MAP)
Following iNO+iPGI2 (2nd)
80.86 mmHg
Interval 61.0 to 103.0

SECONDARY outcome

Timeframe: 8 hours (upon arrival at ICU, and after 4 successive 2 hour treatments with 1. iNO only, 2. iNO+iPGI2 (1st), 3. iPGI2 only, and 4. iNO+iPGI2 (2nd))

Heart Rate was measured as mean of Heart Rate for the initial 8 hours after admission to the Intensive Care Unit (ICU). Normal range for heart rate is generally 60 to 100 beats per minutes in adults, but this can vary.

Outcome measures

Outcome measures
Measure
Combined Nitric Oxide and Prostacyclin
n=14 Participants
iNO (20 ppm continuously) and iPGI2 (0.05 micrograms/kg/min continuously)
Heart Rate
At Arrival in ICU
111.1 beats/minute
Interval 75.0 to 152.0
Heart Rate
Following iNO
112.5 beats/minute
Interval 71.0 to 166.0
Heart Rate
Following iNO+iPGI2 (1st)
108.4 beats/minute
Interval 73.0 to 161.0
Heart Rate
Following iPGI2
106.0 beats/minute
Interval 67.0 to 134.0
Heart Rate
Following iNO+iPGI2 (2nd)
104.6 beats/minute
Interval 73.0 to 119.0

Adverse Events

Combined Nitric Oxide and Prostacyclin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Charles Hill

Stanford University

Phone: (650) 725-1930

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place