Starch or Saline After Cardiac Surgery (SSACS)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified December 2011 by London Health Sciences Centre.
Recruitment status was  Active, not recruiting
Sponsor:
Information provided by:
London Health Sciences Centre
ClinicalTrials.gov Identifier:
NCT00964015
First received: August 20, 2009
Last updated: January 3, 2012
Last verified: December 2011
  Purpose

When people undergo major surgery, they require intravenous supplementation of fluids for a number of reasons:

  • to compensate for no oral intake
  • to support blood pressure and organ function during and after surgery
  • to replace lost fluid or blood volume

There are a variety of fluid choices doctors have to provide to patients, and it is still not definitively known whether some fluids are better than others in specific situations. This is a particularly interesting question in patients undergoing heart surgery because of the significant volume of fluids used over the entire course of hospitalization, including before the operation, during the operation, and after the operation.

There has been some scientific evidence that the use of starch-based fluids (synthetic colloids) leads to better oxygen delivery to the organs with a smaller volume of fluid given, providing for better recovery from surgery. However, there has also been some scientific evidence that the use of these fluids can harm kidney function. Importantly, none of these large-scale studies were carried out specifically in patients undergoing heart surgery.

The purpose of this study is to answer the question of whether the use of starch-based fluid in the heart surgery patient makes for a safer and faster recovery, causes kidney dysfunction, or makes no discernable difference.


Condition Intervention
Coronary Artery Bypass Surgery
Drug: 6% Hydroxyethyl Starch 130/0.4
Drug: 0.9% Normal Saline

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: Treatment
Official Title: Short-term Outcomes of Fluid Replacement and Resuscitation Strategy in the Cardiac Surgery Patient: A Randomized, Controlled Trial

Resource links provided by NLM:


Further study details as provided by London Health Sciences Centre:

Primary Outcome Measures:
  • Incidence of acute kidney injury as defined by RIFLE criteria [ Time Frame: Short term (in hospital, up to 30 days) and mid-term (2 months) ] [ Designated as safety issue: Yes ]
  • Maximum postoperative weight gain [ Time Frame: Short-term (in hospital, up to 7 days) ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Operative mortality [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: Yes ]
  • Duration of ventilation support requirements [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: No ]
  • Total chest tube drainage (until removed) [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: No ]
  • ICU length of stay [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: No ]
  • Transfusion of blood products [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: Yes ]
  • Incidence of atrial fibrillation (necessitating a change in medical management) [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: No ]
  • Duration of oxygen supplementation [ Time Frame: In hospital (up to 30 days) ] [ Designated as safety issue: No ]
  • Creatinine, Urea, Cr Clearance as estimated by the MDRD formula [ Time Frame: In hospital at defined timepoints, and at 2 months post hospital discharge ] [ Designated as safety issue: No ]
  • Volume of fluid infused [ Time Frame: In hospital (up to 7 days) ] [ Designated as safety issue: No ]
  • Total hospital length of stay (when ready to leave tertiary hospital setting) [ Time Frame: In hospital ] [ Designated as safety issue: No ]

Estimated Enrollment: 300
Study Start Date: August 2009
Arms Assigned Interventions
Active Comparator: Starch group
Patients randomized to the Starch group will receive Voluven (6% Hydroxyethyl Starch 130/0.4) for their intravenous bolus and fluid resuscitation requirements.
Drug: 6% Hydroxyethyl Starch 130/0.4
Active Comparator: Saline group
Patients randomized to the Saline group will receive 0.9% Normal Saline for their intravenous fluid bolus and resuscitation requirements
Drug: 0.9% Normal Saline

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • patients undergoing elective primary isolated on-pump coronary artery bypass grafting

Exclusion Criteria:

  • pregnant patients
  • patients with an active intra-cranial bleed
  • patients with a history of hypersensitivity to starch solutions
  • patients with Stage 4 or 5 Kidney Disease (estimated glomerular filtration rate < 30 ml / min / 1.73 m2)
  • patients with a significant preoperative metabolic acidosis, defined by a preoperative capillary blood pH less than or equal to 7.2 and a serum bicarbonate less than 15
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00964015

Locations
Canada, Ontario
London Health Sciences Centre
London, Ontario, Canada, N6A 5A5
Sponsors and Collaborators
London Health Sciences Centre
Investigators
Study Director: Dave Nagpal, MD LHSC / UWO
Principal Investigator: Ray Guo, MD LHSC / UWO
Principal Investigator: Chris Harle, MD LHSC / UWO
  More Information

No publications provided

Responsible Party: Dave Nagpal, London Health Sciences Centre
ClinicalTrials.gov Identifier: NCT00964015     History of Changes
Other Study ID Numbers: LHSC
Study First Received: August 20, 2009
Last Updated: January 3, 2012
Health Authority: Canada: Ethics Review Committee

Keywords provided by London Health Sciences Centre:
colloid fluid
crystalloid fluid
surgery
coronary artery bypass grafting
renal function
Patients undergoing coronary artery bypass surgery

Additional relevant MeSH terms:
Hydroxyethyl Starch Derivatives
Blood Substitutes
Hematologic Agents
Pharmacologic Actions
Plasma Substitutes
Therapeutic Uses

ClinicalTrials.gov processed this record on October 20, 2014