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Early identification of right ventricular dysfunction and failure in cardiothoracic and liver surgical patients

Recruiting

This is prospective, non-interventional, observational study. The main purpose of this study is to develop an algorithm for the early detection of RV dysfunction/failure. The algorithm will be based on the RV pressure waveform gradients (the difference between early right ventricular diastolic pressure and end right ventricular diastolic pressure), RV end-diastolic pressure, and RV contractility (dpdt) and validated through associated clinical measures including perioperative mean arterial blood pressure, advanced hemodynamic measures like cardiac output, stroke volume and systemic vascular resistance, perioperative cerebral oximetry (a measure of cerebral perfusion), intraoperative transesophageal echocardiography and clinical outcomes. These associations will be used to train multiple mathematical models to discriminate between patients with and without RV dysfunction/failure as a primary endpoint. Examining the association between the slope of the diastolic right ventricular waveform (RV end-diastolic pressure, and RV contractility) and perioperative hemodynamics, TEE, cerebral saturation and clinical outcomes will allow us to estimate the specificity and sensitivity of our model.

I'm interested

18 Years and over
This study is NOT accepting healthy volunteers
Inclusion Criteria:
All patients 18 years or older presenting to the University of Minnesota Medical Center for any cardiac surgery with cardiopulmonary bypass (CPB), single or double lung transplantation or liver transplantation.
Exclusion Criteria:
The following patients will be excluded; ? Patients with a history of internal jugular vein thrombosis or known reasons for not being able to thread a central venous catheter through either internal jugular vein ? Patients with a history of known esophageal strictures, esophageal or stomach cancer, esophageal varices, or any patient in whom a TEE is contraindicated ? Patients with permanent pacemakers whose right ventricle is being paced and not in normal sinus rhythm ? Patients unable to consent to participating in the study ? Patients who are pregnant will be excluded, as part of standard care, all female patients are screened for pregnancy prior to surgery. ? Patients under the age of 18 years old.

Heart & Vascular

Tjorvi Perry - perry655@umn.edu
Tjorvi Perry
NA
STUDY00010185
ANES-2020-29144

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