Recovery from Cardiopulmonary Bypass in Children (the Recycle Study)
Research type
Research Study
Full title
Characterisation of glycocalyceal degradation following paediatric cardiopulmonary bypass: mechanisms and contribution to pathophysiology
IRAS ID
253801
Contact name
Jennifer Boston
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Congenital heart disease (CHD) is detected in 8/1000 live births in the UK and is a major cause of morbidity and mortality. Peri-operative care of infants and children requiring surgery accounts to 30% of paediatric intensive care admissions, and has a crude mortality rate of 2.5% in 2014, in the UK.\n\nCardiopulmonary bypass (a “heart-lung machine“) is mandatory for the surgical repair of most CHD. Following bypass surgery, recovery of infants may be compromised by leak of fluid from blood vessels into soft tissue, preventing perfusion of vital organs such as the kidneys and brain, particularly over the first hours and days following surgery. Previous data suggest that the fluid leak is associated with inflammatory damage to the glycocalyx, a fine layer of proteins and sugars lining the inner aspect of blood vessels. \n\nWe hypothesise that the breakdown of the glycocalyx from blood vessels is causally related to microvascular dysfunction (damage to small blood vessels, such as capillaries), fluid leak, and poor organ perfusion. We propose to measure key components of the glycocalyx and immune-related proteins in small volumes of plasma from the blood of children before, during and after cardiopulmonary bypass. We will also analyse the genes that are up – or down – regulated following cardiopulmonary bypass to comprehensively understand the biological pathways leading to glycocalyx breakdown.\n\nTo achieve these aims, we will recruit 40 infants scheduled to undergo elective repair of CHD at Evelina London Children’s Hospital, following informed consent from their parents. We will take additional samples of blood, and urine immediately before, during, and following surgery and analyse these samples for components of the glycocalyx, and gene transcription using recently developed techniques. The infants will have state-of-the-art clinical monitoring throughout as per standard routine care.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
19/SW/0180
Date of REC Opinion
3 Oct 2019
REC opinion
Further Information Favourable Opinion