Efficacy of propofol-supplemented cardioplegia on biomarkers of organ injury in patients having cardiac surgery using cardiopulmonary bypass: A protocol for a randomised controlled study (ProMPT2)

• Published in: Perfusion 2024-05, Vol.39 (4), p.722-732
• Main Authors: Heys, Rachael, Angelini, Gianni D, Joyce, Katherine, Smartt, Helena, Culliford, Lucy, Maishman, Rachel, de Jesus, Samantha E, Emanueli, Costanza, Suleiman, M-Saadeh, Punjabi, Prakash, Rogers, Chris A, Gibbison, Ben
• Format: Article
• Language: English
• Subjects: Adult; Aorta; Aortic valve; Biomarkers; Biomarkers - blood; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Cardiopulmonary Bypass - adverse effects; Cardiopulmonary Bypass - methods; Coronary artery; Coronary vessels; Creatinine; Ethics; Female; Heart; Heart Arrest, Induced - methods; Heart surgery; Heart valves; Humans; Injuries; Ischemia; Male; Patients; Propofol; Propofol - pharmacology; Propofol - therapeutic use; Randomized Controlled Trials as Topic; Renal function; Reperfusion; Research ethics; Surgery; Troponin; Troponin T
• ISSN: 0267-6591; 1477-111X; 1477-111X
• DOI: 10.1177/02676591231157269

Introduction Cardiac surgery with cardiopulmonary bypass and cardioplegic arrest is known to be responsible for ischaemia and reperfusion organ injury. In a previous study, ProMPT, in patients undergoing coronary artery bypass or aortic valve surgery we demonstrated improved cardiac protection when supplementing the cardioplegia solution with propofol (6 mcg/ml). The aim of the ProMPT2 study is to determine whether higher levels of propofol added to the cardioplegia could result in increased cardiac protection. Methods and Analysis The ProMPT2 study is a multi-centre, parallel, three-group, randomised controlled trial in adults undergoing non-emergency isolated coronary artery bypass graft surgery with cardiopulmonary bypass. A total of 240 patients will be randomised in a 1:1:1 ratio to receive either cardioplegia supplementation with high dose of propofol (12 mcg/ml), low dose of propofol (6 mcg/ml) or placebo (saline). The primary outcome is myocardial injury, assessed by serial measurements of myocardial troponin T up to 48 hours after surgery. Secondary outcomes include biomarkers of renal function (creatinine) and metabolism (lactate). Ethics and Dissemination The trial received research ethics approval from South Central – Berkshire B Research Ethics Committee and Medicines and Healthcare products Regulatory Agency in September 2018. Any findings will be shared though peer-reviewed publications and presented at international and national meetings. Participants will be informed of results through patient organisations and newsletters. Trial Registration ISRCTN15255199. Registered in March 2019.