Evaluation of the Hypothalamic-pituitary-adrenal Axis in Patients With Vasoplegic Syndrome After Cardiac Surgery

Status: Recruiting
Location: See location...
Intervention Type: Other
Study Type: Observational
SUMMARY

Vasoplegic syndrome after cardiac surgery is common and is associated with increased morbidity and mortality. It is characterized by early and prolonged arterial hypotension, with preserved cardiac output and low systemic vascular resistance. Vasoplegic syndrome therefore shares pathophysiological features with septic shock. There are no data in the literature on the function of the hypothalamic-pituitary-adrenal (HPA) axis during vasoplegic syndrome after cardiac surgery. In situations of acute stress and systemic inflammation, relative adrenal insufficiency has been reported in the most severe patients, particularly those in septic shock. The term CIRCI (Critical Illness-Related Corticosteroid Insufficiency) is currently defined as an increase in total plasma cortisol of less than 9 µg/dl after stimulation with 250 µg tetracosactide (synthetic ACTH), or a basal total plasma cortisol level of less than 10 µg/dl. However, recent studies have called into question the usefulness of the cosyntropin stimulation test for exploring the HPA axis in intensive care patients. Tandem mass spectrometry (LC-MS/MS) assays can be used to measure steroid metabolites (steroidome), enabling more precise exploration of the corticotropic axis. The aim of this study is to evaluate, on an exploratory basis, the impact of the presence of a post-cardiac surgery vasoplegic syndrome on adrenal function by steroidome mapping (LC-MS/MS).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
View:

• Age ≥ 18 years

• Scheduled cardiac surgery with extracorporeal circulation

• Patient or trusted person or legal representative informed and having expressed non-opposition to participation in the study.

Locations
Other Locations
France
Pitié-Salpêtrière
RECRUITING
Paris
Contact Information
Primary
Adrien Bouglé, MD, PhD
adrien.bougle@aphp.fr
00 33 42 16 29 91
Backup
Jérémie Guillemin, MD
jeremie.guillemin@aphp.fr
00 33 84 82 82 58
Time Frame
Start Date: 2025-03-05
Estimated Completion Date: 2026-03-05
Participants
Target number of participants: 200
Treatments
Patients undergoing cardiac surgery
The patients included will be adult patients scheduled for cardiac surgery with extracorporeal circulation.
Sponsors
Leads: Assistance Publique - Hôpitaux de Paris

This content was sourced from clinicaltrials.gov

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