A Trial of Intravenous Calcium and Myocardial Diastolic Dysfunction During Separation From Cardiopulmonary Bypass
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Purpose
Successful heart surgery requires the resumption of a strong beating heart prior to separation from the heart and lung machine. There are different ways to do this. At this hospital, the surgical team usually gives calcium to people when they come off of the heart and lung machine because some doctors believe that calcium can "jump start" the heart. Not every hospital does this.
Some people think that calcium may have a side effect of making the heart more stiff. Stiff hearts do not beat as well or receive as much blood to tissues as non-stiff hearts. If calcium makes the heart stiff, then doctors may have to use other medicines to support the heart in the operating room and the intensive care unit. This may ultimately lead to poorer outcomes including a longer stay in the intensive care unit and in the hospital.
This study is being performed to find out if calcium has the side effect of making the heart more stiff. This study compares calcium to placebo. The placebo looks exactly like the calcium, but it contains no calcium. During this study patients may receive placebo instead of calcium. Neither the doctor nor the study team will know which drug the subject will receive.
| Condition | Intervention | Phase |
|---|---|---|
|
Diastolic Dysfunction |
Drug: Calcium Chloride Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | A Randomized Double-Blind Placebo-Controlled Trial of Intravenous Calcium and Myocardial Diastolic Dysfunction During Separation From Cardiopulmonary Bypass |
- Diastolic dysfunction [ Time Frame: 64 enrolled patients or 9 months following start of protocol, whichever comes first ] [ Designated as safety issue: Yes ]
- Return to cardiopulmonary bypass secondary to hemodynamic instability [ Time Frame: 64 enrolled patients or 9 months following start of protocol, whichever comes first ] [ Designated as safety issue: Yes ]
- Need for inotropic or vasopressor support upon leaving the OR [ Time Frame: 64 enrolled patients or 9 months following start of protocol, whichever comes first ] [ Designated as safety issue: Yes ]
- Length of hospital stay (days) [ Time Frame: 64 enrolled patients or 9 months following start of protocol, whichever comes first ] [ Designated as safety issue: Yes ]
- Length of ICU stay (days) [ Time Frame: 64 enrolled patients or 9 months following start of protocol, whichever comes first ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 142 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | July 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Calcium Choloride
Calcium chloride, 10mg/kg
|
Drug: Calcium Chloride
Calcium chloride 10mg/kg in 50cc NS delivered over 5 minutes
|
|
Placebo Comparator: Placebo
Normal saline
|
Drug: Placebo
Normal saline, 50cc delivered over 5 minutes
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Men and women greater than 18 years of age
- Undergoing primary elective valve surgery at BWH
- Consented for TEE as part of routine intra-operative care and monitoring
Exclusion Criteria:
- Patients not consented for TEE as part of routine intra-operative care
- Any absolute contraindication to TEE
- Ionized calcium level < 0.80 mmol/L near separation from CPB
- Myocardial infarction (MI) or acute coronary syndromes < 3 months prior to surgery due to the presence of pre-operative diastolic dysfunction in infarcted or ischemic myocardium
- Ejection fraction (EF) < 35%
- Atrial fibrillation / flutter the absence of an A wave on mitral inflow Doppler
- Heart rate (HR) > 100 during 2 data point collections due to E / A wave superimposition
Contacts and Locations| United States, Massachusetts | |
| Brigham and Womens Hospital | |
| Boston, Massachusetts, United States, 02115 | |
| Principal Investigator: | Michael Nurok, MD, PhD | Brigham and Women's Hospital |
More Information
No publications provided
| Responsible Party: | Michael Nurok, MD PhD, Brigham and Womens Hospital |
| ClinicalTrials.gov Identifier: | NCT00955266 History of Changes |
| Other Study ID Numbers: | 2009-P-000052 |
| Study First Received: | July 30, 2009 |
| Last Updated: | February 22, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Brigham and Women's Hospital:
|
Separation Cardiopulmonary bypass Calcium chloride |
Additional relevant MeSH terms:
|
Calcium, Dietary Bone Density Conservation Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013