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
(2023) In BMJ Open 13(5). p.1-8- Abstract
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,... (More)
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.
(Less)
- author
- organization
-
- Neurological injury in acute type A aortic dissection (research group)
- Brain Injury After Cardiac Arrest (research group)
- Stroke Imaging Research group (research group)
- Neuroradiology (research group)
- Less invasive cardiac surgery (research group)
- Cardiothoracic anesthesia and intensive care (research group)
- Minimal invasive cardiac surgery in valvular heart disease (research group)
- Bleeding disorders and acute typ-A dissection (research group)
- LU Profile Area: Proactive Ageing
- WCMM-Wallenberg Centre for Molecular Medicine
- MultiPark: Multidisciplinary research focused on Parkinson´s disease
- Clinical Memory Research (research group)
- Department of Clinical Sciences, Lund
- Heparin bindning protein in cardiothoracic surgery (research group)
- publishing date
- 2023-05-25
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac surgery, Cardiothoracic surgery, Stroke
- in
- BMJ Open
- volume
- 13
- issue
- 5
- article number
- e063837
- pages
- 1 - 8
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:37230515
- scopus:85160456276
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2022-063837
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 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.
- id
- df32d397-424f-49f3-a5f6-14688eb202ce
- date added to LUP
- 2023-06-12 21:42:04
- date last changed
- 2024-04-19 22:48:52
@article{df32d397-424f-49f3-a5f6-14688eb202ce, abstract = {{<p>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.</p>}}, author = {{Ede, Jacob and Teurneau-Hermansson, Karl and Moseby-Knappe, Marion and Ramgren, Birgitta and Bjursten, Henrik and Ederoth, Per and Larsson, Mårten and Mattsson-Carlgren, Niklas and Sjögren, Johan and Wierup, Per and Nozohoor, Shahab and Zindovic, Igor}}, issn = {{2044-6055}}, keywords = {{Cardiac surgery; Cardiothoracic surgery; Stroke}}, language = {{eng}}, month = {{05}}, number = {{5}}, pages = {{1--8}}, publisher = {{BMJ Publishing Group}}, series = {{BMJ Open}}, 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}}, url = {{http://dx.doi.org/10.1136/bmjopen-2022-063837}}, doi = {{10.1136/bmjopen-2022-063837}}, volume = {{13}}, year = {{2023}}, }