Evaluation of Monitoring TECHNOlogies in the PERI-OPerative Care of Cardiac Surgical Patients

Study Overview
=================
Brief Summary
-----------------
The purpose of this prospective observational cohort study is to evaluate multimodal monitoring technologies in the perioperative care of cardiac surgical patients. Right ventricular pressure tracings, near infrared spectroscopy (NIRS) and transthoracic ultrasonography will be studied for their ability to detect and predict complications such as right ventricular failure, renal failure and respiratory failure.

Detailed Description
-----------------
The study has 4 main objectives: To determine if right ventricular pressure tracings correlate with other indices of right ventricular failure and with positive fluid balance, renal failure and increased length of stay in the intensive care unit. To determine the prevalence of portal vein pulsatility in the perioperative period and its association with right ventricular failure and positive fluid balance. To determine if Near InfraRed Spectroscopy (NIRS) values correlate with mixed venous oxygen saturation (SvO2) and with poorer post-operative prognosis. To determine the incidence, risk factors and prognosis of respiratory complications of cardiac surgery using transthoracic ultrasonography.

Official Title
-----------------
Evaluation of Multimodal Monitoring Technologies in the Peri-operative Care of Cardiac Surgical Patients

Conditions
-----------------
C.Surgical Procedure; Cardiac, Right-Sided Heart Failure, Acute Kidney Injury, Respiratory Insufficiency, Postoperative Complications

Intervention / Treatment
-----------------
* Procedure: Cardiac surgery


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Cardiac surgery performed at the Montreal Heart Institute 18 years old and older Exclusion Criteria: Urgent surgery Pre-operative intra-aortic balloon pump, left ventricular assist device or ECMO Heart transplant Cirrhosis

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cardiac surgical patients<br>Adult patients having a cardiac surgery at the Montreal Heart Institute | Procedure: Cardiac surgery<br>* All cardiac surgery procedures<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Right ventricular failure |  | First 24 hours post cardiac surgery | 
| Pulmonary complications | Composite outcome : pneumonia, prolonged mechanical ventilation (more than 24 hours) or clinically significant atelectasis (requiring > 2L O2). | 30 days | 
| Acute Renal failure | KDIGO : class I and more | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fluid balance |  | First 24h | 
| Maximal blood lactate levels |  | First 24h | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Near Infrared Spectroscopy, Ultrasonography, Hepatic vein Doppler, Portal vein Doppler, Lung ultrasound, Positive fluid balance, Mixed venous saturation