Diaphragmatic Inspiratory Amplitude Measured by Ultrasonography as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery: a Prospective Observational Cohort Study

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

Cardiac surgery is a critical intervention for a variety of cardiovascular conditions, yet it can frequently results in a spectrum of postoperative complications. Amongst various morbidities, Post-Operative Pulmonary Complications (POPCs) represent a significant clinical challenge leading to adverse outcomes like increased morbidity, mortality, and raised healthcare expenditures. The diaphragm, as the principal respiratory muscle, plays a pivotal role in maintaining pulmonary function. Diaphragmatic dysfunction (DD) in the perioperative period of Cardiac surgery has an incidence of up to 20%. Understanding the impact of DD on postoperative pulmonary function is imperative for optimizing patient care and clinical outcomes. Its occurrence has been linked to a spectrum of respiratory complications, ranging from pneumonia to difficulty in weaning from mechanical ventilation. In recent years, the advent of point-of-care ultrasonogram (POCUS) has emerged as a promising modality for real-time monitoring of DD. It offers a more accessible and feasible approach compared to traditional methods, providing immediate feedback on diaphragmatic movement, and facilitates timely intervention. Ultrasound has been used to assess Diaphragmatic Inspiratory Amplitude (DIA) (the expansion of the diaphragm when breathing). DIA has been shown to decrease in the post-operative period after cardiac surgery, which has been well-correlated with the occurrence of POPCs, however, its predictive value has not yet been studied in a cohort of cardiac surgical patients. Hence, we aim to address this gap by exploring the utility of DIA measured by ultrasonogram as a predictive tool in anticipating the occurrence of POPCs. We hypothesize that DIA can predict the occurrence of POPC in cardiac surgical patients. We will recruit 130 patients at University Hospital, London Health Science Centre, to this prospective, observational study.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 19
Maximum Age: 99
View:

• All patients aged\>18 years and undergoing elective cardiac surgery.

Locations
Other Locations
Canada
London Health Sciences Centre
RECRUITING
London
Contact Information
Primary
Raffael Zamper, MD
raffael.pereiracezarzamper@lhsc.on.ca
51966858500
Time Frame
Start Date: 2024-06-01
Estimated Completion Date: 2026-06-30
Participants
Target number of participants: 130
Treatments
DIA measured via Ultrasonography
Ultrasonographic measurements will be done preoperatively a day before surgery (T0) and on Postoperative day 1(T1) in Cardiac Surgery Recovery Unit (CSRU). Measurements will be done on both right and left sides during Quiet (Q) and Deep (D) breathing in semi- recumbent posture (30-450 recline of the bed).~Three measurements will be taken during both quiet and deep breathing and an average value will be derived (Qavg and Davg). this will be done for both right and left hemidiaphragms (both pre-surgery and post-surgery). So, for each patient a total of 8 diaphragmatic measurements will be obtained (4 in the pre-surgery period and another 4 in post-surgery period). Measurement technique and definition of Diaphragmatic Inspiratory Amplitude:~All examinations will be performed by Sonosite SII ultrasound machine (FUJIFILM Sonosite Inc, Bothell, WA, USA) using a 3.5- to5 MHz phased array probe or a 3-12 MHz linear probe.
Related Therapeutic Areas
Sponsors
Leads: London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

This content was sourced from clinicaltrials.gov