Stress during surgery can result in damage to the microcirculation that impacts adversely on kidney, heart, liver, lungs, gut and brain function. This study aims to determine if giving albumin and dexamethasone immediately prior to and during surgery can reduce the stress/inflammatory response from surgery. The investigators will evaluate the effects of the dexamethasone and albumin in patients undergoing major liver, pancreatic and colorectal resections within 24 hours of surgery using one of the main biomarkers of endothelial damage, heparin sulfate.
Heparin sulfate is a measurable, validated surrogate biomarker shedding/breakdown of the endothelial glycocalyx. Supporting translational and mechanistic animal studies using electron microscopy to directly evaluate the impact of these interventions on endothelial glycocalyx of the major organs will also be undertaken, together with a health economic evaluation of dexamethasone and albumin.
The results of this pilot trial may lead to a larger multicentre, multinational NHMRC or MRFF funded trial. This in turn will inform anaesthetists, with a higher degree of precision, whether postoperative complications and long-term outcomes are improved after major abdominal surgery when dexamethasone and albumin are administered.
Professor Laurence Weinberg, Austin Hospital, Melbourne.
The project was awarded $A70,000 funding through the ANZCA research grants program for 2023.