In Vivo Glycocalyx as Predictor of Complications After Cardiac Surgery

Study Overview
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Brief Summary
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Cardiac surgery has been described as altering endothelium structure and function, notably because of the use of cardiac-pulmonary bypass (CPB). Among the endothelial structure, glycocalyx, the thin layer recovering the endothelial surface, may be altered by the inflammatory process and probably the modification of flow during CPB. Endothelial and glycocalyx integrity are essential for vascular function and glycocalyx destruction is associated with organ failure and mortality. On the other hand, a chronic alteration of glycocalyx is observed in many diseases such as diabetes, hypertension or chronic kidney failure, all pathologies frequently observed in patients benefiting grom cardiac surgery. Thus the preoperative alteration of glycocalyx may be associated with postoperative organ failure.

Official Title
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Glycocalyx as Predictor of Complications After Cardiac Surgery

Conditions
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Endothelial Dysfunction, Cardiovascular Diseases, Surgery

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all patients benefiting from a cardiac surgery with cardio-pulmonary bypass Exclusion Criteria: impossibility to carry out the measurement by glycocheck device refusal to participate

Ages Eligible for Study
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Minimum Age: 18 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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and major postoperative complications | occurence within 48 postoperative hours of at least one item among: vasoplegic shock cardiogenic shock prolonged mechanical ventilation acute kidney failure Death | 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and death | death from any causes | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and cardiac arrythmia | atrial or ventricular arrythmia | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and Cerebral stroke | ischemic of hemorrhagic etiology | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and cognitive dysfunction | delirium or alteration of cognitive status | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and myocardial ischemia | occurence of ischemia: new Q wave, new occlusion of a coronary arteria, elevated troponinemia with a new dysfunction of at least one myocardial segment | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and acute respiratory failure | need for at least 5L/min of oxygen or non invasive ventilation of reintubation | 28 days | 
| association between preoperative sublingual glycocalyx thickness (glycocheck device) and sepsis | new sepsis condition as defined by SEPSIS-3 definition | 28 days |