Ketamine and Kidney Injury in Cardiac Surgery

Study Overview
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Brief Summary
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The purpose of this study is to investigate the affects of ketamine use for anesthesia at the beginning of heart surgery on kidneys compared to the use of propofol.

Official Title
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Impact of Ketamine Versus Propofol for Anesthetic Induction on Acute Kidney Injury and Renal Biomarkers in Cardiac Surgery

Conditions
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Cardiac Surgery

Intervention / Treatment
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* Drug: Ketamine
* Drug: Propofol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Presenting for cardiac surgery at the Mayo Clinic in Rochester, Minnesota. Scheduled to undergo complex cardiac surgery with the use of cardiopulmonary bypass. Complex cardiac surgery will be defined as surgery involving more than one heart valve, redo-sternotomy procedures, or combined valvular and coronary artery bypass graft procedures (aortic repair not excluded if meets other criteria). Exclusion Criteria: Left or right ventricular assist device implantation or explantation. Procedures not requiring cardiopulmonary bypass. Active infection or sepsis requiring antimicrobial therapy and/or vasopressor therapy (treated endocarditis is not excluded). Severe hepatic disease resulting in ascites. Pre-operative significant renal dysfunction including a baseline creatinine equal to or greater than 2 mg/dL or requiring dialysis. Immunosuppressive medication use (including current IV or oral steroids use, use of anti-rejection medications for transplant within 1 month, or chemotherapy within 6 months). Immunodeficiency syndrome including HIV/AIDS, leukemia, and multiple myeloma

Ages Eligible for Study
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Minimum Age: 70 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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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Anesthesia induction with Ketamine<br>Subjects will receive Ketamine to begin anesthesia for their cardiac surgery. | Drug: Ketamine<br>* 1-2 mg/kg induction with additional medication administered as needed to achieve intubating conditions<br>|
| Active Comparator: Anesthesia induction with Propofol<br>Subjects will receive Propofol to begin anesthesia for their cardiac surgery. | Drug: Propofol<br>* 0.5-1 mg/kg induction with additional medication administered as needed to achieve intubating conditions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute Kidney Injury | The incidence of acute kidney injury in patients following cardiac surgery | Immediately postop up to 10 days postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vasopressor use | Compare mean total vasopressor doses, in norepinephrine equivalents, between groups following induction as a surrogate for hemodynamic differences | Immediately post induction up to 30 minute following induction | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiopulmonary bypass