X-LAB
Research type
Research Study
Full title
X-LAB: Vagus-local anaesthetic blockade of parasympathetic neural regulation of remote ischaemic preconditioning.
IRAS ID
165537
Contact name
Sanjiv Patel
Contact email
Sponsor organisation
University College London Hospitals
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Injury to the heart is commonplace during major surgery. This dramatically increases the risk of postoperative death and other complications, and delays recovery. A better understanding of the mechanisms contributing to heart injury after major surgery is necessary to develop new strategies to improve outcomes.
The heart and other organs in the body are protected by specialized nerves that constantly monitor our health. These nerves feedback signals to the brain that, in response to organ injury, help reduce inflammation. Laboratory models show that the vagus nerve is one such protective nerve that is particularly effective at protecting the heart. It remains unclear whether humans use the same nervous mechanism to help protect the heart.We will test the function of the vagus nerve by activating a special nervous reflex, which involves three five minute periods of inflating a blood pressure cuff and measuring heart rate. In patients undergoing surgery in the upper limb that requires regional anaesthetic, we will also test to see whether anaesthetizing the arm nerve prevents the vagus nerve being activated by inflation of the blood pressure cuff. In volunteers, we will assess the activation of the vagus nerve before and after receiving a safe drug that stops the vagus nerve from releasing a molecule acetylcholine [a neurotransmitter] that has been shown to protect the heart and other organs in laboratory models of disease.
Via an IV drip that patients will receive as part of their routine anaesthetic, we will take a tablespoon of blood before and after this blood pressure cuff test to see whether white blood cells and blood clotting is altered as evidence for protective effects exerted by the vagus nerve.
REC name
London - Stanmore Research Ethics Committee
REC reference
16/LO/0634
Date of REC Opinion
23 May 2016
REC opinion
Further Information Favourable Opinion