Neuroprotection With Erythromycin in Cardiac Surgery

The recruitment status of this study is unknown because the information has not been verified recently.
Verified June 2009 by AHEPA University Hospital.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
University of Thessaly
Information provided by:
AHEPA University Hospital
ClinicalTrials.gov Identifier:
NCT01274754
First received: March 1, 2010
Last updated: January 11, 2011
Last verified: June 2009

March 1, 2010
January 11, 2011
November 2008
March 2011   (final data collection date for primary outcome measure)
biochemical markers of brain ischemia and intraoperative cerebral oxymetry data [ Time Frame: September 2010 ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT01274754 on ClinicalTrials.gov Archive Site
better neurocognitive outcome in Erythromycin group [ Time Frame: November 2010 ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Neuroprotection With Erythromycin in Cardiac Surgery
Perioperative Administration of Erythromycin and Brain Protection

Neurological complications occur in open heart surgery with a frequency of 40% and they range from major neurological deficits (due to a stroke) to neurocognitive and behavioral disorders. This study aims to determine if erythromycin, a worldwide known antibiotic, protects the brain from damage when given in high doses before and during open heart surgery.

The investigators consume that high dose of erythromycin will protect the brain with a pharmacological preconditioning against the global ischemia during the perioperative period of heart surgery.

First Version: Study Protocol Authors: Thomaidou E., Vretzakis G., Argiriadou E., Stamatiou G., et al.

Perioperative administration of erythromycin and brain protection

Study Setting: On-pump, planned cardiac surgery. Randomized, double blinded clinical trial of two parallel groups. Group A: control group. Group B: erythromycin group (dose 25mg/kg intravenously).

Purpose:

Neurological complications occur in open heart surgery with a frequency of 40% and they range from major neurological deficits (due to a stroke) to neurocognitive and behavioral disorders. This study aims to determine if erythromycin, a worldwide known antibiotic, protects the brain from damage when given in high doses before and during open heart surgery.

Hypothesis:

The investigators consume that high dose of erythromycin will protect the brain with a pharmacological preconditioning against the global ischemia during the perioperative period of heart surgery.

The aims of this study are:

  1. To determine the effect of high-dose perioperative erythromycin administration on neurological outcome in patients undergoing cardiac surgery
  2. To determine the relationship of neurological monitoring, specifically NIRS, to neurological outcomes and to determine if erythromycin affects this relationship.

Preoperative Period

Patient Exclusion Criteria: patients > 80 years old, cerebrovascular disease with residual deficits, stroke, alcoholism, psychiatric disease.

Preoperative patient neurocognitive status assessment from the same clinical psychologist in all patients:

at least one day before surgery, perform neurocognitive tests.

Patients of group A: 25mg/kg erythromycin intravenously 12 hours before surgery.

Intraoperative Period

Cerebral monitoring: continuous measurement and registration of cerebral oximetry data (NIRS - INVOS), record of frequency and duration of desaturation episodes (a fall >20% compared to baseline values) and record of interventions to correct desaturation.

Anaesthesia depth monitoring: continuous measurement of bispectral index (BIS).

Registration of: duration of CPB and cross clamp time, mean arterial pressure, heart rate, temperature and ETCO2.

Anesthesia Procedures: anesthesia induction with fentanyl 10-15μg/kg, propofol 2gm/kg and rocuronium 0,6mg/kg. Anesthesia maintenance with propofol.

Postoperative Period - ICU

Postoperative patient neurocognitive status assessment from the same clinical psychologist in all patients:

On discharge, and 3 months later perform neurocognitive tests.

Patients of group A: will receive high dose of erythromycin 12 hours after the end of surgery.

Registration of:

Post operative blood loss, duration of ICU stay, mechanical ventilation duration, duration of hospital stay, inotropic support, postoperative myocardial infarction, re-operation, dialysis, neurocognitive decline, other complications.

BIOCHEMICAL INDEX

Blood samples will be taken from all patients for the detection of tau protein, IL-1 and IL-6,

  1. preoperatively
  2. 12 hours after surgery
  3. the 6th day after surgery
Observational
Observational Model: Cohort
Time Perspective: Prospective
Not Provided
Retention:   Samples Without DNA
Description:

Blood samples will be taken from all patients for the detection of tau protein, IL-1 and IL-6,

  1. preoperatively
  2. 12 hours after surgery
  3. the 6th day after surgery
Non-Probability Sample

patients scheduled for elective cardiac surgey coronary artery bypass grafting

Functional Disturbances Following Cardiac Surgery
Not Provided
  • erythromycin group
    Patients of erythromycin group: 25mg/kg erythromycin intravenously 12 hours before surgery and 12 hours after the end of surgery.
  • control group
    no administration of erythromycin
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
40
June 2011
March 2011   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • patients < 80 years old scheduled for elective cardiac surgery coronary artery bypass grafting, good cooperation with the clinical psychologist

Exclusion Criteria:

  • patients > 80 years old
  • cerebrovascular disease with residual deficits
  • stroke
  • alcoholism
  • psychiatric disease
Both
18 Years to 80 Years
No
Contact: George Vretzakis, Prof. 00306946215721 gvretzakis@yahoo.com
Contact: Georgia Stamatiou, Prof. 00306978993102 gstamat@yahoo.com
Greece
 
NCT01274754
VRTE
No
Thomaidou Evanthia, AHEPA University Hospital
AHEPA University Hospital
University of Thessaly
Study Director: George Vretzakis, Prof. University of Thessaly
AHEPA University Hospital
June 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP