Conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery: protocol for a randomised controlled trial (COMICS)

Autor: Gianni D Angelini, Barnaby C Reeves, Jonathan Evans, Lucy A Culliford, Laura Collett, Chris A Rogers, Elizabeth Stokes, Kyriakos Anastasiadis, Polychronis Antonitsis, Thierry Carrel, Dorothée Keller, Andreas Liebold, Fatma Ashkanani, Aschraf El-Essawi, Ingo Breitenbach, Clinton Lloyd, Mark Bennett, Alex Cale, Lindsay Mclean, Serdar Gunaydin, Eren Gunertem, Farouk Oueida, Ibrahim Yassin, Cyril Serrick, Vivek Rao, Marco Moscarelli, Ignazio Condello, Prakash Punjabi, Cha Rajakaruna, Daniel Bone, William Lansdown, Narain Moorjani, Sarah Dennis
Přispěvatelé: Imperial College Healthcare NHS Trust
Jazyk: angličtina
Rok vydání: 2020
Předmět:
extracorporeal circulation
medicine.medical_specialty
Extracorporeal Circulation
Cardiac & Cardiovascular Systems
610 Medicine & health
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
medicine
Cardiopulmonary bypass
Humans
Minimally Invasive Surgical Procedures
Multicenter Studies as Topic
Radiology
Nuclear Medicine and imaging

In patient
Coronary Artery Bypass
1102 Cardiorespiratory Medicine and Haematology
METAANALYSIS
Randomized Controlled Trials as Topic
Advanced and Specialized Nursing
Science & Technology
Cardiopulmonary Bypass
business.industry
Extracorporeal circulation
General Medicine
Length of Stay
Original Papers
Surgery
Cardiac surgery
Treatment Outcome
Peripheral Vascular Disease
030228 respiratory system
Aortic Valve
Cardiovascular System & Cardiology
cardiopulmonary bypass
Cardiology and Cardiovascular Medicine
business
Life Sciences & Biomedicine
Safety Research
randomised controlled trial
COMICS investigators
The COMICS investigators

cardiac surgery
Zdroj: Perfusion
Angelini, G D, Reeves, B C, Evans, J, Culliford, L A, Rogers, C A, Stokes, E A, Collett, L, Anastasiadis, K, Antonitsis, P, Carrel, T, Keller, D, Liebold, A, Liebold, A, Ashkanani, F, El-Essawi, A, Breitenbach, I, Lloyd, C, Bennett, M D, cale, A, McLean, L, Gunaydin, S, Gunertem, E, Oueida, F, Yassin, I, Serrick, C, Rao, V, Moscarelli, M, Punjabi, P, Rajakaruna, C, Lansdowne, W, Bone, D, Moorjani, N & Dennis, S 2020, ' Conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery: protocol for a randomised controlled trial (COMICS) ', Perfusion . https://doi.org/10.1177/0267659120946731
The COMICS, investigators (2021). Conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery: protocol for a randomised controlled trial (COMICS). Perfusion, 36(4), pp. 388-394. Sage 10.1177/0267659120946731
DOI: 10.7892/boris.149609
Popis: Introduction: Despite low mortality, cardiac surgery patients may experience serious life-threatening post-operative complications, often due to extracorporeal circulation and reperfusion. Miniaturised cardiopulmonary bypass (minimally invasive extracorporeal circulation) has been developed aiming to reduce the risk of post-operative complications arising with conventional extracorporeal circulation. Methods: The COMICS trial is a multi-centre, international, two-group parallel randomised controlled trial testing whether type II, III or IV minimally invasive extracorporeal circulation is effective and cost-effective compared to conventional extracorporeal circulation in patients undergoing elective or urgent coronary artery bypass grafting, aortic valve replacement or coronary artery bypass grafting + aortic valve replacement. Randomisation (1:1 ratio) is concealed and stratified by centre and surgical procedure. The primary outcome is a composite of 12 serious complications, objectively defined or adjudicated, 30 days after surgery. Secondary outcomes (at 30 days) include other serious adverse events (primary safety outcome), use of blood products, length of intensive care and hospital stay and generic health status (also at 90 days). Status of the trial: Two centres started recruiting on 08 May 2018; 10 are currently recruiting and 603 patients have been randomised (11 May 2020). The recruitment rate from 01 April 2019 to 31 March 2020 was 40-50 patients/month. About 80% have had coronary artery bypass grafting only. Adherence to allocation is good. Conclusions: The trial is feasible but criteria for progressing to a full trial were not met on time. The Trial Steering and Data Monitoring Committees have recommended that the trial should currently continue.
Databáze: OpenAIRE