Grant: Operating Grant

Cardiac surgery is a common medical procedure, with more than 2,000,000 procedures performed worldwide including 30,000 in Canada. Despite its life-saving potential, it carries a high risk of complications and approximately 5% of patients (100,000 patients globally) will not survive their hospital stay after cardiac surgery. Cardio-pulmonary bypass -also known as heart-lung machine- is a technique where a pump takes over the function of the heart and lungs during surgery allowing surgeons to operate on hearts while keeping patients alive. The inflammatory reaction caused by cardio-pulmonary bypass is thought to be largely responsible for adverse outcomes following cardiac surgery. However, this inflammatory reaction is poorly understood and can't be predicted. There is thus an urgent need to develop novel blood tests to identify high-risk individuals, so to redirect them towards other options. Our objective is to improve outcomes in patients undergoing cardio-pulmonary bypass by developing a blood test that will indicate which patients are likely to have an adverse inflammatory reaction, and which patients are likely to respond to anti-inflammatory therapy. The ongoing publically funded Steroids In caRdiac Surgery trial (SIRS) is evaluating the benefits of an anti-inflammatory agent on major clinical outcomes in cardiac surgery. However, no blood sample is collected as part of the SIRS trial. We will collect blood samples in patients participating in the SIRS trial. We will then analyze these blood samples to measure the level of activity of genes of circulating inflammatory cells (white blood cells). Annually, 30,000 patients undergo cardio-pulmonary bypass in Canada for a variety of cardiac conditions, and 1,500 patients are expected not to survive their hospital stay. We believe this to be an unacceptable statistic and hope to improve it through better identification of patients not suited for this otherwise beneficial procedure.