Evaluation of Microcirculatory Function and Mitochondrial Respiration After Cardiovascular Surgery

Study Overview
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Brief Summary
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This study will examine the differences in microcirculatory function and mitochondrial respiration in patients with shock after cardiovascular surgery.

Detailed Description
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Post-cardiotomy shock (PCS) occurs in up to 5% of cardiovascular surgeries and has an in-hospital mortality rate as high as 75%. It is unclear if patients with PCS despite achieving standard resuscitation goals have impairments in oxygen delivery or oxygen utilization. This study will examine the difference in microcirculatory function and mitochondrial respiration in patients with shock to better understand the driving mechanism of bioenergetic failure in patients with PCS.

Official Title
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The MicroRESUS Study: An Observational Study to Examine the Effects of Circulatory Shock and Resuscitation on Microcirculatory Function and Mitochondrial Respiration After Cardiovascular Surgery.

Conditions
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Shock, Cardiovascular Diseases, Critical Illness

Intervention / Treatment
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* Procedure: coronary artery bypass grafting, valve repair/replacement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients (>18 years old) Receiving elective coronary artery bypass graft (CABG) Receiving valvular surgery requiring cardiopulmonary bypass Exclusion Criteria: Unable to tolerate sublingual microcirculatory flow imaging (e.g., non-intubated patients dependent upon oxygen by facemask, poor mouth opening) receiving an emergent procedure have an actively treated malignancy mitochondrial disorder receiving surgery requiring deep hypothermic circulatory arrest.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No shock<br>Patients who have no evidence of clinical malperfusion or require vasoactive agents after cardiac surgery. | Procedure: coronary artery bypass grafting, valve repair/replacement<br>* cardiovascular surgery with cardiopulmonary bypass<br>|
| Shock<br>Patients who have evidence of clinical malperfusion or require vasoactive agents after cardiac surgery. | Procedure: coronary artery bypass grafting, valve repair/replacement<br>* cardiovascular surgery with cardiopulmonary bypass<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vasopressor and ventilator free days | Number of days patients are free of invasive or non-invasive mechanical ventilation or vasoactive medications. | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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microcirculation, mitochondrial respiration, circulatory shock, cardiovascular surgery, resuscitation