Assessing Diaphragmatic Function to Predict Postoperative Lung Issues After Heart Surgery

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

This study is testing if measuring diaphragm function before heart surgery can help identify patients who might have breathing problems after the surgery.

Quick facts

• Study type: Observational
• Enrollment: 130 (estimated)
• Ages: 19 Years to 99 Years
• Sex: All
• Sponsor: London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's (other)
• Locations: 1 site (London, Ontario)
• Trial ID: NCT06396767 on ClinicalTrials.gov

What this trial studies

This observational study aims to evaluate the diaphragmatic inspiratory amplitude using ultrasonography in patients undergoing elective cardiac surgery. It focuses on understanding how diaphragmatic dysfunction can impact the incidence of postoperative pulmonary complications (POPCs), which are significant contributors to morbidity and mortality following cardiac procedures. By measuring diaphragmatic function preoperatively, the study seeks to identify patients at higher risk for respiratory complications, thereby optimizing postoperative care and outcomes. The findings could lead to improved management strategies for patients undergoing cardiac surgery.

Who should consider this trial

Good fit: Ideal candidates for this study are adults over 18 years old who are scheduled for elective cardiac surgery.

Not a fit: Patients who may not benefit include those undergoing emergency cardiac surgery or those with pre-existing conditions affecting diaphragmatic function.

Why it matters

Potential benefit: If successful, this study could enhance postoperative care by identifying patients at risk for pulmonary complications, potentially reducing morbidity and healthcare costs.

How similar studies have performed: While the specific approach of using diaphragmatic amplitude as a prognostic tool is novel, similar studies have indicated that assessing respiratory muscle function can be beneficial in predicting postoperative outcomes.

Eligibility criteria

Inclusion Criteria:

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

Exclusion Criteria:

1. . Redo Cardiac surgery.
2. . Pre-existing CNS disease (like Parkinson's disease) or Brain injury or Psychiatric disorder
3. . Emergency cardiac surgery
4. . Surgeries done via Thoracotomy approach.
5. . Pre-surgery ICU stay/ on NIV/ on mechanical ventilation.
6. . Pre-surgery Hemodynamic instability requiring vasopressors/IABP institution.
7. . Age\<18
8. . Elevated hemidiaphragm before surgery on chest x ray
9. . Pre-existing neuromuscular disorders (like myasthenia gravis etc.)
10. . Patients planned for heart transplantation.
11. . Patients on mechanical circulatory support preoperatively (intra-aortic balloon pump, extracorporeal membrane oxygenation, or ventricular assist device).
12. . Inability to give consent.

Where this trial is running

London, Ontario

• London Health Sciences Centre — London, Ontario, Canada (RECRUITING)

Study contacts

• Principal investigator: Raffael Zamper, MD — Western University
• Study coordinator: Raffael Zamper, MD

Conditions: Postoperative Pulmonary Complications, Cardiac Surgery