Novel blood markers and Micro-circulation after cardiac surgery 0.3

  • Research type

    Research Study

  • Full title

    The role of novel carbon-dioxide and oxygen based blood markers and incident dark field microcirculation imaging to identify children with high risk of adverse outcomes after cardiac surgery.

  • IRAS ID

    230085

  • Contact name

    Rohit Saxena

  • Contact email

    rohitlibran2002@doctors.org.uk

  • Sponsor organisation

    University Hospital Bristol NHS Foundation Trust

  • ISRCTN Number

    ISRCTN10476641

  • Duration of Study in the UK

    1 years, 8 months, 0 days

  • Research summary

    Children undergoing heart surgery are critically ill after the operation due to a variety of reasons. Two major contributing conditions could be (i) a reduced pumping action of the heart or (ii) a reduction in blood flow to the tissues due to changes in the calibre of blood carrying tubes (vessels) or both. This results in deprivation of oxygen and nutrients to essential organs such as brain, lungs, liver and kidney. Almost 25-30% of children undergoing heart surgery will experience such a complication to a varied severity. Currently, the diagnosis of this condition is based upon clinical examination, scan of the heart (echocardiography) and blood acid levels (lactate) or mixed venous blood oxygen level (saturations).
    Previous studies have shown that clinical estimation alone of this low blood flow condition is inaccurate in these children. Echocardiography is often technically difficult due to open chest wall and fluid in the chest wall. Lactate and venous oxygen saturations may have a lag time to pick up these changes. Hence, new markers and technologies are constantly being evaluated to detect these changes.
    Recently, a new blood based test (carbon dioxide and oxygen contents) has shown promising results in detecting these changes in adult patients with infection. In addition, we can now photograph and study the small blood carrying tubes (blood vessels) with the help of a special camera. This is a non-invasive procedure and is not painful.
    We are investigating the utility of this new blood based marker and the imaging device to detect such detrimental condition in children undergoing heart surgery. This may lead to early initiation of correct treatment hence, reducing the severity of illness and associated complications.

  • REC name

    London - Surrey Research Ethics Committee

  • REC reference

    18/LO/1587

  • Date of REC Opinion

    16 Oct 2018

  • REC opinion

    Favourable Opinion