Neuro protection

  • Research type

    Research Study

  • Full title

    Brain vascular reactivity to hypothermic circulatory arrest with antegrade cerebral perfusion during aortic arch surgery in neonates and infants.

  • IRAS ID

    220447

  • Contact name

    Attilio Lotto

  • Contact email

    Attilio.Lotto@alderhey.nhs.uk

  • Sponsor organisation

    Liverpool John Moores University

  • Duration of Study in the UK

    1 years, 0 months, 0 days

  • Research summary

    This is a pilot study examining brain vascular reaction to hypothermic circulatory arrest with antegrade cerebral perfusion and neuro-protection techniques during aortic arch surgery in neonates and infants. A combination of duplex ultrasound and transcranial doppler will be used to record in-depth information on the cerebrovascular changes that occur during the entire length of the surgical procedure and during the early postoperative period. The proposed techniques and equipment are non-invasive and are in use clinically to evaluate brain perfusion in a similar age group.
    During aortic arch surgery, the patient’s body and brain temperature is reduced to values between 18 and 24 degrees centrigrade in order to decrease metabolic demand which provides a form of metabolic protection. However, there is no consensus within the clinical community regarding the optimal temperature at which to perform surgery. Moreover, in order to improve cerebral perfusion, the brain is perfused via the right internal carotid artery with cold blood. At Alder Hey Children Hospital, this surgery is undertaken by the three surgeons but, due to clinical preference, differs in relation to the temperature at which surgery is undertaken. This provides the opportunity to observe the impact of different temperatures on cerebral vascular reactivity in neonates and young infants
    The arguments for future comparisons and a larger randomised study will be made based on the information gained from this study.

  • REC name

    North West - Liverpool Central Research Ethics Committee

  • REC reference

    17/NW/0249

  • Date of REC Opinion

    6 Jun 2017

  • REC opinion

    Favourable Opinion