Overview
This interventional prospective randomized study is designed to compare hemodynamic management using postural mobilization (+/- noradrenaline) versus noradrenaline only in patients undergoing open-heart coronary artery bypass graft (CABG) surgery.
Description
OPTICAB is a single-site study in France that aims to compare two hemodynamic management techniques during off-pump coronary artery bypass graft (CABG) surgery: postural mobilization (+/- noradrenaline) versus noradrenaline only. Primary objective is to evaluate how often noradrenaline is needed when managing hemodynamics using postural mobilization (passive leg raising) during off-pump CABG surgery. The study will also compare revascularization rate and post-operative complications among both groups, and assess perioperative hemodynamic management during the 30-day follow up period.
Eligibility
Inclusion Criteria:
- Adult patient
- patient requiring isolated coronary bypass surgery
- Elective procedure or medical emergency
- First cardiac surgery
- Patient with an EF ≥30%
- Mandatory affiliation to a social security system
- Signed informed consent form
- Suspension of renin-angiotensin system inhibitors and angiontensn-neprilysin receptor blockers and sartans the day before surgical procedure
Exclusion Criteria:
- Contraindication to an inotropic substance (only NA will be used)
- Contraindication to passive leg raising
- Patient in a life-threatening emergency
- History of cardiac surgery
- Bilateral iliac or common femoral artery occlusion
- EF \< 30%
- Pregnancy and breastfeeding
- Renal failure (GFR \< 40 ml/min/1.73 m²)
- Patient with bilateral thigh amputation
- Class III obesity BMI \> 40 kg/m²