Serum Tryptase Levels During Cardiac Surgery, Diagnosis and Treatment Decisions for Allergic Reactions

NCT ID: NCT02644785

Last Updated: 2017-03-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-31

Study Completion Date

2016-02-29

Brief Summary

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The investigators aim to assess tryptase test efficacy for measuring the allergic response to protamine during cardiac bypass surgery. Additionally, the investigators aim to establish a differential diagnosis on the basis of potential allergens or clinical causes.

Detailed Description

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Venous blood samples from cardiac surgery cases will be obtained for tryptase measurement upon admission to the operating room (OR) and immediately prior to and 30 min after protamine infusion initiation. A rapid effect-response-based clinical assessment will be made using clinical and laboratory monitoring data for diagnosis and treatment decisions during protamine infusion, which may complicate the recovery from surgery.

Conditions

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Protamine Allergy Protamine Adverse Reaction

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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protamine

Protamine infusion exposures

Intervention Type DRUG

Other Intervention Names

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promin

Eligibility Criteria

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Inclusion Criteria

* Cardiac by-pass cases

Exclusion Criteria

* Insulin dependent diabetes
* Atopy
* Drug allergy history
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mustafa Kemal University

OTHER

Sponsor Role lead

Responsible Party

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MENEKSE OKSAR

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Menekse Oksar, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mustafa Kemal University Medical School

Locations

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Mustafa Kemal University Hospital

Antakya, Hatay, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Krishna MT, York M, Chin T, Gnanakumaran G, Heslegrave J, Derbridge C, Huissoon A, Diwakar L, Eren E, Crossman RJ, Khan N, Williams AP. Multi-centre retrospective analysis of anaphylaxis during general anaesthesia in the United Kingdom: aetiology and diagnostic performance of acute serum tryptase. Clin Exp Immunol. 2014 Nov;178(2):399-404. doi: 10.1111/cei.12424.

Reference Type RESULT
PMID: 25070464 (View on PubMed)

Malinovsky JM, Decagny S, Wessel F, Guilloux L, Mertes PM. Systematic follow-up increases incidence of anaphylaxis during adverse reactions in anesthetized patients. Acta Anaesthesiol Scand. 2008 Feb;52(2):175-81. doi: 10.1111/j.1399-6576.2007.01489.x. Epub 2007 Nov 13.

Reference Type RESULT
PMID: 18005384 (View on PubMed)

Mertes PM, Laxenaire MC, Alla F; Groupe d'Etudes des Reactions Anaphylactoides Peranesthesiques. Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999-2000. Anesthesiology. 2003 Sep;99(3):536-45. doi: 10.1097/00000542-200309000-00007.

Reference Type RESULT
PMID: 12960536 (View on PubMed)

Related Links

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http://www.ncbi.nlm.nih.gov/pubmed/?term=Krishna+MT%2C+York+M%2C+Chin+T%2C+et+al%3A+Multi-centre+retrospective+analysis+of+anaphylaxis+during+general+anaesthesia+in+the+United+Kingdom%3A+aetiology+and+diagnostic+performance+of+acute+serum+tryptase.+Clin+Exp+Immunol+178%3A399-404%2C+2014

The authors reported that elevated acute serum tryptase (\>141% from baseline or absolute tryptase \>15.7 mg/L) is highly predictive of IgE-mediated anaphylaxis and that these two methods of interpretation are comparable.

http://www.ncbi.nlm.nih.gov/pubmed?term=malinovskyjm,decagnys,wesself,etal.systematicfollow-upincreasesincidenceofanaphylaxisduringadversereactionsinanesthetizedpatientsactaanaesthesiascand52175-181,2008&cmd=correctspelling

Malinovsky et al. reported that tryptase concentrations were elevated in 50% of their patients, and the positive and negative predictive values (PPV and NPV) of tryptase were 100% for both tryptase \>12 and \>25 at the first samples.

http://www.ncbi.nlm.nih.gov/pubmed/?term=Mertes+Anesthesiology+2003%3B99%3A536-45

Krishna et al. reported sensitivities, specificities, PPV and NPV for a tryptase of \>25 mcg/L to be 64, 74, 82 and 52 respectively in 103 patients which were similar to the values reported by Mertes et al.

Other Identifiers

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2014/10

Identifier Type: -

Identifier Source: org_study_id

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