Joint AAGBI/ACTACC Research Grant
The successful applicant for the Joint AAGBI/ACTACC Research Grant was:
Dr Gudrun Kunst
King's College Hospital, London
Title
Comparison between Propofol and Isoflurane Anaesthesia (COPIA) on Cardiovascular Outcomes following Cardiac Surgery - a Randomised Controlled Feasibility Trial
Amount
£43,758
Scientific Abstract
The risk for patients undergoing cardiac surgery is continuously increasing, which is due to an ageing population and the presence of co-morbidities. This results in postoperative complications such as myocardial infarction, acute renal injury, stroke, and an increased one-year mortality.
Small clinical proof-of concept trials and meta-analyses support that volatile anaesthetics have an organ-protective effect in patients undergoing cardiac surgery, however with inconclusive and conflicting results. All of these studies compared volatile anaesthetics in addition to a propofol infusion versus propofol only. However, a propofol infusion can induce pro-inflammatory effects on the myocardium, and volatile anaesthetics only during cardiopulmonary bypass, induce less myocardial injury, when compared with propofol.
The proposed randomised controlled trial will, for the first time, compare the volatile anaesthetic isoflurane, including its administration during cardiopulmonary bypass without added propofol, with the administration of propofol only for the maintenance of anaesthesia. This feasibility trial is designed to assess recruitment targets and feasibility of the administration of volatile anaesthetics as the only maintenance of anaesthesia during surgery and cardiopulmonary bypass.
Eventually, the primary outcome of the subsequently planned multicentre study will be major adverse cardiac and cerebrovascular events (MACCE; stroke, non-fatal myocardial infarction, death from any cause) at one year.
