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CompletedNCT03025659Updated Mar 23, 2020

Lactate Acidosis in Postoperative Hearts

An observational study in Post-cardiac Surgery and Hyperlactatemia, sponsored by University of Florida. Completed at 1 site in United States. Open to participants aged Up to 21 Years. Per ClinicalTrials.gov, last updated 2020-03-23.

Sponsored by University of Florida · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
43
Ages
Up to 21 Years
Sex
All
01

Study summary

This is a single-center, observational study. Investigators aim to characterize the metabolism of lactate in children over the first forty-eight hours following cardiac surgery. Blood samples will be obtained up to 12 timepoints. Samples will be analyzed for concentration of pyruvate. Results will be compared to standard of care laboratory results for lactate and other direct and indirect measures of cardiac output.

Read the detailed description

Investigators will characterize the etiologies of hyperlactatemia predominantly present at serial postoperative timepoints in children recovering from cardiac surgery by following lactate levels and the lactate-to-pyruvate ratio over the first 48 post-operative hours and correlating them with cardiac output as determined by conventional markers and physical exam. Investigators expect to validate the assumption that in children recovering from heart surgery whose cardiac output is apparently normal, hyperlactatemia (if seen) is predominantly due to impaired lactate clearance or metabolism, while in those whose cardiac output is low, it is predominantly due to inadequate oxygen delivery. Blood samples will be obtained up to 12 timepoints (arrival at the intensive care unit postoperatively, hour 1, hour 2, hour 3, hour 4, hour 6, hour 8, hour 10, hour 12, hour 24, hour 36 and hour 48 postoperative) or only at up to 6 time points (approximately Hour 0, 2, 4, 6, 8, and 12) for infants under 10 kg as described below. . Samples will be analyzed for concentration of pyruvate. Results will be compared to standard of care laboratory results for lactate and other direct and indirect measures of cardiac output.

02

Conditions studied

  • Post-cardiac Surgery
  • Hyperlactatemia

Keywords

  • pediatric
  • congenital heart disease
03

Who can participate

Ages eligible
Up to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Pediatric cardiac surgical patients at UF Health Shands Children's Hospital

Inclusion criteria

  • All immediately post-operative cardiac patients admitted to the pediatric cardiac intensive care unit (PCICU)

Exclusion criteria

Exclusion Criteria:

  • Lack of parental or patient consent, or patient assent when applicable, including non-English speakers and wards of the state
  • Dosing weight less than 4 kg*
  • Cardiac catheterization being the only operative procedure
  • Severe hepatic dysfunction at any time during the hospital course
  • Seizures during the study period
  • Sepsis during the study period
  • Need for extracorporeal membrane oxygenation or continuous renal replacement therapy
  • Known congenital myopathy, ataxia, polyneuropathies or inborn errors of metabolism including congenital lactic acidosis and other mitochondrial disorders
  • Primary hypoventilation
  • Malignancies
  • Fanconi syndrome
  • Wernicke encephalopathy
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
43 participants (actual)
Patient registry
No

Groups and cohorts

  • Pediatric post-cardiac surgery

    All immediately post-operative pediatric cardiac patients will be enrolled. Standard of care laboratory analysis will be performed based on current clinical protocols. Results for lactate, blood gases, liver enzymes, creatinine, glucose, hemoglobin, hematocrit and other direct and indirect measure of cardiac output will be collected. Investigators will also measure pyruvate levels at specific time points, which is not part of standard of care. To measure pyruvate, an additional 1 ml of arterial blood will be drawn at each routine postoperative blood draw. The lactate/pyruvate ratio will be calculated and compared to direct and indirect measure of cardiac output described above.

    Other: Pyruvate levels

Interventions

  • OtherPyruvate levels

    An additional 1 ml of arterial blood will be drawn at each routine postoperative blood draw (Hour 0, 1, 2, 3, 4, 6, 8, 10, 12, 24, 36, and 48 for participants 10kg and above or only at Hour 0, 2, 4, 6, 8, and 12 for infants under 10 kg) to measure the concentration of pyruvate in blood.

05

What researchers measure

Primary outcomes

  1. Lactate/pyruvate ratio

    Time frame: Hourly, assessed up to 48 hours

06

Study locations

1 site
  • University of Florida Shands Children's Hospital
    Gainesville, Florida 32610, United States
07

References and documents

Individual participant data

Plan to share: Yes — Data will be collected on REDCap (secure web application for building and managing online surveys and databases) and available to study staff via password protected access

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03025659
Lead sponsor
University of Florida
Responsible party
Sponsor
First posted
Jan 19, 2017
Start date
May 28, 2017
Primary completion
Jan 24, 2019
Completion
Jan 24, 2019
Last update
Mar 23, 2020

Study contacts

Michael D Tsifansky, MD
principal investigator · University of Florida

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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