Ketamine and Kidney Injury in Cardiac Surgery

NCT05268562 — Phase 4, Active not recruiting, 200 participants, Mayo Clinic

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  

Impact of Ketamine Versus Propofol for Anesthetic Induction on Acute Kidney Injury and Renal Biomarkers in Cardiac Surgery

RegistryNCT05268562
StatusActive not recruiting
PhasePhase 4
Study typeInterventional; randomized, parallel, masking: none, basic science
Enrollment200 (Actual)
SponsorMayo Clinic (Other)
ConditionsCardiac Surgery
InterventionsKetamine, Propofol (Drug)
Datesstart 2022-03-02, primary completion 2025-09-05, completion 2027-06-01 (estimated), first posted 2022-03-07, last updated 2026-10-20
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Cardiac Surgery All trials of Ketamine All trials of Propofol

-Summary

The purpose of this study is to investigate the affects of ketamine use for anesthesia at the beginning of heart surgery on kidneys compared to the use of propofol.

Expand all sections  ·  Collapse all

+Arms and interventions

ArmTypeInterventionsDescription
Anesthesia induction with KetamineActive comparatorDrug: KetamineSubjects will receive Ketamine to begin anesthesia for their cardiac surgery.
Anesthesia induction with PropofolActive comparatorDrug: PropofolSubjects will receive Propofol to begin anesthesia for their cardiac surgery.
  • Ketamine (Drug): 1-2 mg/kg induction with additional medication administered as needed to achieve intubating conditions
  • Propofol (Drug): 0.5-1 mg/kg induction with additional medication administered as needed to achieve intubating conditions

+Outcome measures

Primary outcomes

  • Number of Participants With Acute Kidney Injury [Immediately postop up to 10 days postoperatively]: The incidence of acute kidney injury in patients following cardiac surgery

Secondary outcomes

  • Number of Participants Receiving Vasopressors [Immediately post induction up to 30 minute following induction]: Compare vasopressor use between groups at and following induction as a surrogate for hemodynamic differences

+Eligibility

Sex: All, ages: 70 Years to any

Inclusion Criteria:

* Presenting for cardiac surgery at the Mayo Clinic in Rochester, Minnesota.
* Scheduled to undergo complex cardiac surgery with the use of cardiopulmonary bypass. Complex cardiac surgery will be defined as surgery involving more than one heart valve, redo-sternotomy procedures, or combined valvular and coronary artery bypass graft procedures (aortic repair not excluded if meets other criteria).

Exclusion Criteria:

* Left or right ventricular assist device implantation or explantation.
* Procedures not requiring cardiopulmonary bypass.
* Active infection or sepsis requiring antimicrobial therapy and/or vasopressor therapy (treated endocarditis is not excluded).
* Severe hepatic disease resulting in ascites.
* Pre-operative significant renal dysfunction including a baseline creatinine equal to or greater than 2 mg/dL or requiring dialysis.
* Immunosuppressive medication use (including current IV or oral steroids use, use of anti-rejection medications for transplant within 1 month, or chemotherapy within 6 months).
* Immunodeficiency syndrome including HIV/AIDS, leukemia, and multiple myeloma

+Posted results

Participant flow

MilestoneAnesthesia Induction With KetamineAnesthesia Induction With Propofol
Started100100
Completed8997
Not completed113

Outcome results

  • Number of Participants With Acute Kidney Injury (Primary), Count of participants, Participants: Anesthesia Induction With Ketamine 53; Anesthesia Induction With Propofol 47 (p 0.13)
  • Number of Participants Receiving Vasopressors (Secondary), Number, Participants: Anesthesia Induction With Ketamine 7; Anesthesia Induction With Propofol 22 (p 0.005)

Adverse events

Time frame: Up until one week from surgery

ArmDeathsSerious adverse eventsOther adverse events
Anesthesia Induction With Ketamine0/89 (0.0%)0/89 (0.0%)0/89 (0.0%)
Anesthesia Induction With Propofol3/97 (3.1%)0/97 (0.0%)0/97 (0.0%)

Limitations and caveats: Caveats: Initially intended to assess impact of renal biomarkers on ability to predict AKI however due to changes in cost over time as well as addition of some biomarkers as standard of care at a different time point, these were unable to be assessed. Limitations: The intervention, induction with one of two agents, could not be blinded from the anesthesiologists. This could allow for bias due to beliefs about impact of either medication to impact the amount given or additional therapies used.

+Locations (1)

FacilityCityCountryStatus
Mayo Clinic in RochesterRochester, MinnesotaUnited States

+Study documents

+Investigators