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Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design

INTRODUCTION: Neurological complications after surgery for acute type A aortic dissection (ATAAD) increase patient morbidity and mortality. Carbon dioxide flooding is commonly used in open-heart surgery to reduce the risk of air embolism and neurological impairment, but it has not been evaluated in...

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Autores principales: Ede, Jacob, Teurneau-Hermansson, Karl, Moseby-Knappe, Marion, Ramgren, Birgitta, Bjursten, Henrik, Ederoth, Per, Larsson, Mårten, Mattsson-Carlgren, Niklas, Sjögren, Johan, Wierup, Per, Nozohoor, Shahab, Zindovic, Igor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10230889/
https://www.ncbi.nlm.nih.gov/pubmed/37230515
http://dx.doi.org/10.1136/bmjopen-2022-063837
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author Ede, Jacob
Teurneau-Hermansson, Karl
Moseby-Knappe, Marion
Ramgren, Birgitta
Bjursten, Henrik
Ederoth, Per
Larsson, Mårten
Mattsson-Carlgren, Niklas
Sjögren, Johan
Wierup, Per
Nozohoor, Shahab
Zindovic, Igor
author_facet Ede, Jacob
Teurneau-Hermansson, Karl
Moseby-Knappe, Marion
Ramgren, Birgitta
Bjursten, Henrik
Ederoth, Per
Larsson, Mårten
Mattsson-Carlgren, Niklas
Sjögren, Johan
Wierup, Per
Nozohoor, Shahab
Zindovic, Igor
author_sort Ede, Jacob
collection PubMed
description INTRODUCTION: Neurological complications after surgery for acute type A aortic dissection (ATAAD) increase patient morbidity and mortality. Carbon dioxide flooding is commonly used in open-heart surgery to reduce the risk of air embolism and neurological impairment, but it has not been evaluated in the setting of ATAAD surgery. This report describes the objectives and design of the CARTA trial, investigating whether carbon dioxide flooding reduces neurological injury following surgery for ATAAD. METHODS AND ANALYSIS: The CARTA trial is a single-centre, prospective, randomised, blinded, controlled clinical trial of ATAAD surgery with carbon dioxide flooding of the surgical field. Eighty consecutive patients undergoing repair of ATAAD, and who do not have previous neurological injuries or ongoing neurological symptoms, will be randomised (1:1) to either receive carbon dioxide flooding of the surgical field or not. Routine repair will be performed regardless of the intervention. The primary endpoints are size and number of ischaemic lesions on brain MRI performed after surgery. Secondary endpoints are clinical neurological deficit according to the National Institutes of Health Stroke Scale, level of consciousness using the Glasgow Coma Scale motor score, brain injury markers in blood after surgery, neurological function according to the modified Rankin Scale and postoperative recovery 3 months after surgery. ETHICS AND DISSEMINATION: Ethical approval has been granted by Swedish Ethical Review Agency for this study. Results will be disseminated through peer-reviewed media. TRIAL REGISTRATION NUMBER: NCT04962646.
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spelling pubmed-102308892023-06-01 Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design Ede, Jacob Teurneau-Hermansson, Karl Moseby-Knappe, Marion Ramgren, Birgitta Bjursten, Henrik Ederoth, Per Larsson, Mårten Mattsson-Carlgren, Niklas Sjögren, Johan Wierup, Per Nozohoor, Shahab Zindovic, Igor BMJ Open Cardiovascular Medicine INTRODUCTION: Neurological complications after surgery for acute type A aortic dissection (ATAAD) increase patient morbidity and mortality. Carbon dioxide flooding is commonly used in open-heart surgery to reduce the risk of air embolism and neurological impairment, but it has not been evaluated in the setting of ATAAD surgery. This report describes the objectives and design of the CARTA trial, investigating whether carbon dioxide flooding reduces neurological injury following surgery for ATAAD. METHODS AND ANALYSIS: The CARTA trial is a single-centre, prospective, randomised, blinded, controlled clinical trial of ATAAD surgery with carbon dioxide flooding of the surgical field. Eighty consecutive patients undergoing repair of ATAAD, and who do not have previous neurological injuries or ongoing neurological symptoms, will be randomised (1:1) to either receive carbon dioxide flooding of the surgical field or not. Routine repair will be performed regardless of the intervention. The primary endpoints are size and number of ischaemic lesions on brain MRI performed after surgery. Secondary endpoints are clinical neurological deficit according to the National Institutes of Health Stroke Scale, level of consciousness using the Glasgow Coma Scale motor score, brain injury markers in blood after surgery, neurological function according to the modified Rankin Scale and postoperative recovery 3 months after surgery. ETHICS AND DISSEMINATION: Ethical approval has been granted by Swedish Ethical Review Agency for this study. Results will be disseminated through peer-reviewed media. TRIAL REGISTRATION NUMBER: NCT04962646. BMJ Publishing Group 2023-05-25 /pmc/articles/PMC10230889/ /pubmed/37230515 http://dx.doi.org/10.1136/bmjopen-2022-063837 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Cardiovascular Medicine
Ede, Jacob
Teurneau-Hermansson, Karl
Moseby-Knappe, Marion
Ramgren, Birgitta
Bjursten, Henrik
Ederoth, Per
Larsson, Mårten
Mattsson-Carlgren, Niklas
Sjögren, Johan
Wierup, Per
Nozohoor, Shahab
Zindovic, Igor
Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title_full Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title_fullStr Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title_full_unstemmed Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title_short Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
title_sort carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type a aortic dissection: a prospective, randomised, blinded, controlled clinical trial, carta study protocol - objectives and design
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10230889/
https://www.ncbi.nlm.nih.gov/pubmed/37230515
http://dx.doi.org/10.1136/bmjopen-2022-063837
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