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Congenital Heart DiseasePhase 4PLICSNCT07499154

Perioperative Lidocaine for Lung Protection in Infants Undergoing Cardiac Surgery

A Phase 4 study testing Lidocaine %2 ampoule and Normal Saline (0.9% NaCl) in people with Congenital Heart Disease and Postoperative Pulmonary Complications, run by The Children's Hospital of Zhejiang University School of Medicine at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Cardiopulmonary bypass-associated pulmonary injury is a common complication after infant cardiac surgery and may contribute to impaired oxygenation, prolonged mechanical ventilation, and longer intensive care stay. Read more about this study

Who is it for?
Ages Up to 12 months
What is being tested?
Lidocaine %2 ampoule and Normal Saline (0.9% NaCl)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
320 participants
Where
1 siteChina
Study dates
1 Apr 2026to 31 Dec 2027
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 12 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Infants aged 0 to 12 months.
  • Congenital heart disease requiring corrective, non-palliative cardiac surgery with cardiopulmonary bypass.
  • American Society of Anesthesiologists (ASA) physical status I to III.
  • Written informed consent provided by parent(s) or legal guardian(s).

Who cannot join

  • Multiple malformations, chromosomal abnormalities, or immunodeficiency.
  • Known or suspected allergy to lidocaine.
  • Concomitant continuous infusion of another local anesthetic.
  • Conditions associated with increased risk of lidocaine accumulation or toxicity, including severe conduction block or severe bradycardia.
  • ASA physical status IV or higher.
  • Severe malnutrition expected to substantially impair postoperative recovery.
Show all 11Show fewer
  • Severe hepatic or renal dysfunction.
  • Significant pre-existing pulmonary disease or markedly impaired preoperative pulmonary function.
  • Central nervous system disorders that may increase susceptibility to lidocaine neurotoxicity, including epilepsy or prior central nervous system infection.
  • Use of medications that may interact with lidocaine or constitute an exclusion, including class I or class III antiarrhythmic agents, cimetidine, or antiviral drugs, as determined by the clinical team.
  • Current or recent participation in another interventional clinical trial in its active intervention phase.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Xiangming Fan, MD, PhD contact

+86 13616532813

fanxiangming@zju.edu.cn

China1 site
  • Children's Hospital, Zhejiang University School of Medicine

    Hangzhou, Zhejiang, 310052

    Qian Chen, MD, PhD, +86 13883350798, qian.chen@zju.edu.cn

Other trials in China

About this study

Official title: Evaluation of the Effect of Perioperative Lidocaine Administration on Reducing Pulmonary Injury in Infants Following Cardiac Surgery: A Randomized, Placebo-Controlled, Double-Blind, Multi-center Superiority Trial.

Cardiopulmonary bypass-associated pulmonary injury is a common complication after infant cardiac surgery and may contribute to impaired oxygenation, prolonged mechanical ventilation, and longer intensive care stay. Lidocaine has anti-inflammatory and membrane-stabilizing properties and may attenuate perioperative lung injury. This investigator-initiated, randomized, placebo-controlled, double-blind trial will evaluate whether perioperative intravenous lidocaine reduces postoperative pulmonary injury in infants undergoing corrective non-palliative congenital cardiac surgery with cardiopulmonary bypass.

Read the detailed description

Infants undergoing cardiac surgery with cardiopulmonary bypass are at risk of postoperative pulmonary injury due to systemic inflammatory activation, ischemia-reperfusion injury, and disruption of the alveolar-capillary barrier. Intravenous lidocaine has been reported to exert anti-inflammatory, anti-arrhythmic, and potential organ-protective effects. However, evidence in infants undergoing cardiac surgery remains limited.

This randomized, double-blind, placebo-controlled superiority trial will enroll infants aged 0 to 12 months scheduled for corrective, non-palliative congenital cardiac surgery with cardiopulmonary bypass at a tertiary pediatric center. Participants will be randomized in a 1:1 ratio to receive either perioperative intravenous lidocaine or volume-matched normal saline placebo. The trial will assess postoperative pulmonary injury severity over the first 72 hours after surgery, together with respiratory, laboratory, echocardiographic, and safety outcomes until postoperative day 7 or at discharge.

Being tested
Lidocaine %2 ampoule, Normal Saline (0.9% NaCl)
Keywords
Lidocaine, Lung injury, Infant cardiac surgery, Cardiopulmonary bypass
Medical subject headings
Heart Defects, Congenital, Acute Lung Injury, Lung Injury

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lidocaine %2 ampouleDrug

    Intravenous lidocaine hydrochloride 2%: loading dose 1.0 mg/kg administered over 20 minutes starting at the surgery, followed by continuous infusion at 1.0 mg/kg/hour for 24 hours. Dosing is based on standard body weight or actual body weight according to protocol-defined rules.

  • Normal Saline (0.9% NaCl)Drug

    Volume-matched 0.9% normal saline placebo administered according to the same schedule as the lidocaine group.

Study groups in NCT07499154
Study groupRoleWhat they receive
Lidocaine GroupExperimentalParticipants receive intravenous lidocaine beginning at the surgery, with a loading infusion over 20 minutes followed by continuous infusion for 24 hours.
Receives: Drug: Lidocaine %2 ampoule
Placebo GroupPlacebo comparatorParticipants receive volume-matched intravenous normal saline placebo beginning at the surgery, with the same administration schedule as the active intervention.
Receives: Drug: Normal Saline (0.9% NaCl)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Acute Lung Injury Score within 72 hours after surgery

    Composite lung injury severity score ranging from 0 to 4, based on oxygenation index or oxygen saturation index, chest radiograph findings, positive en-expiratory pressure, and pulmonary compliance. Higher scores indicate more severe lung injury.

    Measured: Assessed at 0, 12, 24, 36, 48, 60, and 72 hours after surgery

Secondary outcomes (24)
  1. Arterial partial pressure of oxygen

    Measured by arterial blood gas analysis, reported in mmHg.

    Measured: 0, 12, 24, 36, 48, 60, and 72 hours after surgery

  2. Arterial partial pressure of carbon dioxide

    Measured by arterial blood gas analysis, reported in mmHg.

    Measured: 0, 12, 24, 36, 48, 60, and 72 hours after surgery

  3. Arterial oxygen saturation

    Measured by arterial blood gas analysis, reported as percentage (%).

    Measured: 0, 12, 24, 36, 48, 60, and 72 hours after surgery

  4. Arterial lactate concentration

    Measured by arterial blood gas analysis, reported in mmol/L.

    Measured: 0, 12, 24, 36, 48, 60, and 72 hours after surgery

  5. Duration of mechanical ventilation

    Total duration of invasive mechanical ventilation, measured in hours, from postoperative admission to the intensive care unit until first successful extubation without the need for reintubation.

    Measured: From postoperative ICU admission until successful discontinuation of invasive mechanical ventilation, assessed up to 72 hours after surgery.

  6. PICU length of stay

    Duration of stay in the pediatric intensive care unit, measured in days.

    Measured: From postoperative admission to the pediatric intensive care unit until discharge from the pediatric intensive care unit, assessed up to 7 days after surgery.

  7. Left ventricular ejection fraction (LVEF)

    Left ventricular fractional shortening assessed by transthoracic echocardiography, reported as percentage (%).

    Measured: Baseline, 24, 48, and 72 hours after surgery

  8. Plasma lidocaine concentration

    Plasma lidocaine concentration measured using the assay specified in the study laboratory manual, reported in ug/mL

    Measured: 6, 12, 18, 24 hours after surgery

  9. Incidence of postoperative pulmonary complications

    Incidence of at least one postoperative pulmonary complication within 72 hours after surgery, defined as the occurrence of any of the following: atelectasis, pulmonary edema, pleural effusion, pneumothorax, or infectious pneumonia. Reported as the percentage of participants with at least one postoperative pulmonary complication.

    Measured: Assessed within 72 hours after surgery

  10. Prothrombin time (PT)

    Measured in venous blood by routine clinical laboratory testing, reported in seconds.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  11. Activated partial thromboplastin time (aPTT)

    Measured in venous blood by routine clinical laboratory testing, reported in seconds.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  12. Alanine aminotransferase (ALT)

    Measured by routine clinical laboratory testing, reported in U/L.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  13. Aspartate aminotransferase (AST)

    Measured by routine clinical laboratory testing, reported in U/L.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  14. Serum creatinine

    Measured by routine clinical laboratory testing, reported in umol/L.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  15. Blood urea nitrogen

    Measured by routine clinical laboratory testing, reported in mmol/L.

    Measured: Baseline, 24, 48, and 72 hours after surgery

  16. Plasma soluble intercellular adhesion molecule-1 (sICAM-1) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  17. Plasma surfactant protein D (SP-D) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  18. Plasma soluble receptor for advanced glycation end products (sRAGE) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  19. Plasma interleukin-1 beta (IL-1β) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  20. Plasma angiopoietin-2 concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  21. Plasma double-stranded DNA (dsDNA) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  22. Plasma high-mobility group box 1 (HMGB1) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  23. Plasma neurofilament light chain (NFL) concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

  24. Plasma S100B concentration

    Measured using ELISA assay kit, reported in umol/L

    Measured: Baseline, 24, 48, and 72 hours after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Mar 2026
  2. Study start1 Apr 2026 (estimated)
  3. Primary completion1 Dec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized in a 1:1 ratio to receive either intravenous lidocaine or volume-matched normal saline placebo.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
320 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07499154
Sponsor's protocol ID
2026-IRB-0031-P-01
Acronym
PLICS
Status last verified
Mar 2026
First submitted
12 Mar 2026
Last updated
30 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Zhang C, Foo I. Is intravenous lidocaine protective against myocardial ischaemia and reperfusion injury after cardiac surgery? Ann Med Surg (Lond). 2020 Sep 11;59:72-75. doi: 10.1016/j.amsu.2020.09.008. eCollection 2020 Nov.

    PubMed 32994986
  • Gregory AJ, Arora RC, Chatterjee S, Crisafi C, Morton-Bailey V, Rea A, Salenger R, Engelman DT, Grant MC; ERAS Cardiac Working Group. Enhanced Recovery After Surgery (ERAS) cardiac turnkey order set for perioperative pain management in cardiac surgery: Proceedings from the American Association for Thoracic Surgery (AATS) ERAS Conclave 2023. JTCVS Open. 2024 Sep 6;22:14-24. doi: 10.1016/j.xjon.2024.08.018. eCollection 2024 Dec.

    PubMed 39780778
  • Wang L, Wang M, Li S, Wu H, Shen Q, Zhang S, Fang L, Liu R. Nebulized lidocaine ameliorates allergic airway inflammation via downregulation of TLR2. Mol Immunol. 2018 May;97:94-100. doi: 10.1016/j.molimm.2018.03.010. Epub 2018 Mar 30.

    PubMed 29609129
  • Lee JM, Suh JK, Jeong JS, Cho SY, Kim DW. Antioxidant effect of lidocaine and procaine on reactive oxygen species-induced endothelial dysfunction in the rabbit abdominal aorta. Korean J Anesthesiol. 2010 Aug;59(2):104-10. doi: 10.4097/kjae.2010.59.2.104. Epub 2010 Aug 20.

    PubMed 20740215
  • Kavcic H, Jug U, Mavri J, Umek N. Antioxidant activity of lidocaine, bupivacaine, and ropivacaine in aqueous and lipophilic environments: an experimental and computational study. Front Chem. 2023 Jun 20;11:1208843. doi: 10.3389/fchem.2023.1208843. eCollection 2023.

    PubMed 37408557
  • Weibel S, Jelting Y, Pace NL, Helf A, Eberhart LH, Hahnenkamp K, Hollmann MW, Poepping DM, Schnabel A, Kranke P. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database Syst Rev. 2018 Jun 4;6(6):CD009642. doi: 10.1002/14651858.CD009642.pub3.

    PubMed 29864216
  • Simonato M, Padalino M, Vedovelli L, Carollo C, Sartori A, Vida V, Gregori D, Carnielli V, Cogo P. Effect of preoperative pulmonary hemodynamic and cardiopulmonary bypass on lung function in children with congenital heart disease. Eur J Pediatr. 2023 Jun;182(6):2549-2557. doi: 10.1007/s00431-023-04926-0. Epub 2023 Mar 18.

    PubMed 36933017
  • Fischer MO, Brotons F, Briant AR, Suehiro K, Gozdzik W, Sponholz C, Kirkeby-Garstad I, Joosten A, Nigro Neto C, Kunstyr J, Parienti JJ, Abou-Arab O, Ouattara A; VENICE study group. Postoperative Pulmonary Complications After Cardiac Surgery: The VENICE International Cohort Study. J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt A):2344-2351. doi: 10.1053/j.jvca.2021.12.024. Epub 2021 Dec 25.

    PubMed 35094928
  • Jenke A, Yazdanyar M, Miyahara S, Chekhoeva A, Immohr MB, Kistner J, Boeken U, Lichtenberg A, Akhyari P. AdipoRon Attenuates Inflammation and Impairment of Cardiac Function Associated With Cardiopulmonary Bypass-Induced Systemic Inflammatory Response Syndrome. J Am Heart Assoc. 2021 Mar 16;10(6):e018097. doi: 10.1161/JAHA.120.018097. Epub 2021 Mar 5.

    PubMed 33666100
  • Sperotto F, Cogo P, Amigoni A, Pettenazzo A, Thiagarajan RR, Polito A. Extracorporeal Membrane Oxygenation Support for Failure to Wean From Cardiopulmonary Bypass After Pediatric Cardiac Surgery: Analysis of Extracorporeal Life Support Organization Registry Data. Crit Care Explor. 2020 Sep 15;2(9):e0183. doi: 10.1097/CCE.0000000000000183. eCollection 2020 Sep.

    PubMed 32984825
  • Cholette JM, Muszynski JA, Ibla JC, Emani S, Steiner ME, Vogel AM, Parker RI, Nellis ME, Bembea MM; Pediatric Critical Care Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB), in collaboration with the Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Plasma and Platelet Transfusions Strategies in Neonates and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass or Neonates and Children Supported by Extracorporeal Membrane Oxygenation: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med. 2022 Jan 1;23(13 Supple 1 1S):e25-e36. doi: 10.1097/PCC.0000000000002856.

    PubMed 34989703

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Lidocaine %2 ampoule and Normal Saline (0.9% NaCl) in people with Congenital Heart Disease and Postoperative Pulmonary Complications, run by The Children's Hospital of Zhejiang University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 30 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Xiangming Fan, MD, PhD (+86 13616532813, fanxiangming@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acute Lung Injury Score within 72 hours after surgery (time frame: Assessed at 0, 12, 24, 36, 48, 60, and 72 hours after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07499154, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Mar 2026.

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