Influence of Lung Ultrasonography on the Prognosis and Postoperative Outcomes in Cardiac Surgical Patients

NCT ID: NCT06377449

Last Updated: 2024-12-09

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

RECRUITING

Clinical Phase

NA

Total Enrollment

186 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-15

Study Completion Date

2026-01-01

Brief Summary

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The goal of this interventional is to assess advantages of the ultrasound examination of the lungs in the early postoperative period in cardiac surgical patients after heart surgeries requiring cardiopulmonary bypass. Evaluation of pulmonary complications and outcomes during mid-term follow-up, as well as comparison of ultrasound examination and traditional roentgenologic methods (X-ray examination and CT of the chest) will be performed. The main question\[s\] it aims to answer are:

* Is ultrasound examination of the lungs a more specific and sensitive method in identification of early postoperative pulmonary complications after on-pump cardiac surgical procedures, in comparison with traditional X-ray methods.
* Does early identification of interstitial pulmonary edema (based on number of visualised B-lines in the early postoperative period), influences mid-term outcomes in this cohort of patients Participants will undergo ultrasound examination of the lungs on postoperative day 1, 3, 5 and 7 after heart surgery. Based on ultrasound findings and degree of interstitial pulmonary edema, medical (diuretics, anti-inflammatory, e.t.c) therapy will be modified.

Researchers will compare this group of patients with control group, in which ultrasound examination will be performed in the same time frames, but no changes in medical management based on ultrasound findings will be made to see if timely administered medical therapy, based on ultrasound findings, can significantly improve symptoms, hospital lengths of stay and outcomes of this patients.

Detailed Description

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Conditions

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Ischemic Heart Disease Aortic Stenosis, Severe Aortic Insufficiency Mitral Stenosis Mitral Insufficiency Mitral Stenosis with Insufficiency Tricuspid Insufficiency Ascending Aortic Aneurysm

Keywords

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Ultrasound examination of the lungs B-lines Coronary artery bypass grafting Heart valve surgery Cardiopulmonary bypass On-pump cardiac surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, randomized, single-center study with 2 groups of patients (investigating and control arms)
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Medical management based on results of ultrasound lungs examination

Based on the degree/ presence of interstitial pulmonary edema (number of B-lines) and presence of postoperative pleural effusion, identified by regularly performed ultrasound examination of the lungs, medical therapy will be modified in each particular patient to improve clinical status and outcome. Administration of the following drug groups can be made/ doses can be adjusted: Diuretics (furosemide/ Hypothiazide/ spironolactone), Non-steroid antiinflammatory (Ibuprofen), Glucocorticoids.

Group Type EXPERIMENTAL

Ultrasound examination of the lungs

Intervention Type DIAGNOSTIC_TEST

Experimental: Standard ultrasound examination of the lungs based on modified BLUE protocol Active Comparator: Standard ultrasound examination of the lungs based on modified BLUE protocol

Medical management based on routine clinical and X-ray diagnostic methods

Ultrasound examination of the lungs will be performed in all patients in this group, but the attending physician will not be informed about it's results and findings. Any changes in medical therapy/ treatment strategy will be based on standard clinical and X-ray diagnostic methods.

Group Type ACTIVE_COMPARATOR

Ultrasound examination of the lungs

Intervention Type DIAGNOSTIC_TEST

Experimental: Standard ultrasound examination of the lungs based on modified BLUE protocol Active Comparator: Standard ultrasound examination of the lungs based on modified BLUE protocol

Interventions

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Ultrasound examination of the lungs

Experimental: Standard ultrasound examination of the lungs based on modified BLUE protocol Active Comparator: Standard ultrasound examination of the lungs based on modified BLUE protocol

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* open heart surgery with cardiopulmonary bypass (CPB) between 15 December 2023 and 15 December 2024
* signed informed consent for participation in the study

Exclusion Criteria

* reoperations on the open heart with CPB
* surgical procedures on lungs and lung cancer in the anamnesis
* chronic obstructive pulmonary disease, stage III
* chronic kidney disease, stages 4 and 5
* patients with low Risk Score profile by the Society of Thoracic Surgeons
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Saint Petersburg State University, Russia

OTHER

Sponsor Role lead

Responsible Party

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Filippov Aleksei, MD, PhD

State Cardiovascular Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Saint Petersburg State University Clinic

Saint Petersburg, Sankt-Peterburg, Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Aleksei A Filippov, MD, PhD

Role: CONTACT

Phone: +79819553639

Email: [email protected]

Sergey M Efremov, MD, PhD

Role: CONTACT

Phone: +79137946090

Email: [email protected]

Facility Contacts

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Sergei M Efremov, MD, PhD

Role: primary

References

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Russell FM, Ehrman RR, Barton A, Sarmiento E, Ottenhoff JE, Nti BK. B-line quantification: comparing learners novice to lung ultrasound assisted by machine artificial intelligence technology to expert review. Ultrasound J. 2021 Jun 30;13(1):33. doi: 10.1186/s13089-021-00234-6.

Reference Type BACKGROUND
PMID: 34191132 (View on PubMed)

Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier P, Rouby JJ. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology. 2004 Jan;100(1):9-15. doi: 10.1097/00000542-200401000-00006.

Reference Type BACKGROUND
PMID: 14695718 (View on PubMed)

Other Identifiers

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UIL-CSP-18052023

Identifier Type: -

Identifier Source: org_study_id