This study investigates the question of whether there are differences in the plasma concentration of hormones of the RAAS-axis between patients undergoing on-pump cardiac surgery and those receiving off-pump surgery
In patients undergoing cardiac surgery, the occurrence of vasoplegia or vasoplegic shock is a common and sometimes very severe complication. Although there are multiple factors that may affect the incidence and severity of vasoplegia, it remains unclear which role the use of cardiopulmonary bypass may play in the pathogenesis of this complication. The heart normally pumps blood through the lungs where the blood primarily gets oxygenated. However, it is also known that pulmonary blood flow is also essential for the activation of various hormones, some of which are central to the regulation of vascular tension and blood pressure. If the pulmonary circulation is bypassed, as is the case in on-pump cardiac surgery, it is likely that the resulting differential activity of hormones may cause or contribute to the incidence of vasoplegia. This study aims to show whether cardiopulmonary bypass leads to the differential regulation of hormones of the renin-angiotensin-aldosterone-system which could explain why some patients suffer from vasoplegia or vasoplegic shock following such procedures.
Study Type
OBSERVATIONAL
Enrollment
40
the surgery will be performed "on-pump"
the surgery will be performed "off-pump"
Deutsches Herzzentrum der Charité
Berlin, Germany
RECRUITINGUniversity Hospital Münster; Department of Anesthesiology, Intensive Care Medicine and Pain Medicine
Münster, Germany
RECRUITINGDifferences in plasma concentration of Angiotensinogen
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Renin
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Angiotensin I
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Angiotensin converting enzyme (ACE)
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Angiotensin II
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Aldosterone
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Angiotensin 1-9
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Angiotensin 2-7
Time frame: between induction of anesthesia and immediately after surgical intervention
Differences in plasma concentration of Dipeptidyl-peptidase 3 (DPP3)
Time frame: between induction of anesthesia and immediately after surgical intervention
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Incidence of vasoplegia
Time frame: within 12 hours post surgery
Cumulative dose of vasopressors
Time frame: within 12 hours post surgery