Actively Recruiting
Diaphragmatic Inspiratory Amplitude as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery
Led by London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's · Updated on 2024-10-09
130
Participants Needed
1
Research Sites
108 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Cardiac surgery is a critical intervention for a variety of cardiovascular conditions, yet it can frequently results in a spectrum of postoperative complications. Amongst various morbidities, Post-Operative Pulmonary Complications (POPCs) represent a significant clinical challenge leading to adverse outcomes like increased morbidity, mortality, and raised healthcare expenditures. The diaphragm, as the principal respiratory muscle, plays a pivotal role in maintaining pulmonary function. Diaphragmatic dysfunction (DD) in the perioperative period of Cardiac surgery has an incidence of up to 20%. Understanding the impact of DD on postoperative pulmonary function is imperative for optimizing patient care and clinical outcomes. Its occurrence has been linked to a spectrum of respiratory complications, ranging from pneumonia to difficulty in weaning from mechanical ventilation. In recent years, the advent of point-of-care ultrasonogram (POCUS) has emerged as a promising modality for real-time monitoring of DD. It offers a more accessible and feasible approach compared to traditional methods, providing immediate feedback on diaphragmatic movement, and facilitates timely intervention. Ultrasound has been used to assess Diaphragmatic Inspiratory Amplitude (DIA) (the expansion of the diaphragm when breathing). DIA has been shown to decrease in the post-operative period after cardiac surgery, which has been well-correlated with the occurrence of POPCs, however, its predictive value has not yet been studied in a cohort of cardiac surgical patients. Hence, we aim to address this gap by exploring the utility of DIA measured by ultrasonogram as a predictive tool in anticipating the occurrence of POPCs. We hypothesize that DIA can predict the occurrence of POPC in cardiac surgical patients. We will recruit 130 patients at University Hospital, London Health Science Centre, to this prospective, observational study.
CONDITIONS
Official Title
Diaphragmatic Inspiratory Amplitude as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Patients aged 18 years and older undergoing elective cardiac surgery
You will not qualify if you...
- Redo cardiac surgery
- Pre-existing central nervous system diseases such as Parkinson's disease, brain injury, or psychiatric disorders
- Emergency cardiac surgery
- Surgeries performed via thoracotomy approach
- Pre-surgery intensive care unit stay or use of non-invasive/mechanical ventilation
- Pre-surgery hemodynamic instability requiring vasopressors or intra-aortic balloon pump
- Age under 18 years
- Elevated hemidiaphragm on chest X-ray before surgery
- Pre-existing neuromuscular disorders such as myasthenia gravis
- Planned heart transplantation
- Use of mechanical circulatory support before surgery (e.g., intra-aortic balloon pump, ECMO, ventricular assist device)
- Inability to provide consent
AI-Screening
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Trial Site Locations
Total: 1 location
1
London Health Sciences Centre
London, Ontario, Canada
Actively Recruiting
Research Team
R
Raffael Zamper, MD
CONTACT
How is the study designed?
Study Type
OBSERVATIONAL
Masking
N/A
Allocation
N/A
Model
N/A
Primary Purpose
N/A
Number of Arms
1
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