Natriuretic peptides for perioperative management of cardiac surgery

Objective: Procalcitonin (PCT) has been associated with adverse outcomes after cardiac surgery. Nevertheless, there is no consensus on thresholds and timing of PCT measurement to predict adverse outcomes. Materials & methods: A total of 960 patients undergoing elective cardiac surgery were retrospectively evaluated. PCT levels were measured from the first to the seventh postoperative day (POD). The onset of complications was recorded. Results: Complications occurred in 421 (44%) patients. PCT on the third POD was associated with the occurrence of any kind of complications (odds ratio: 1.06; p: 0.037), and noninfectious complications (odds ratio: 1.05; p: 0.035), after adjusting. PCT above the median value at the third POD (>0.33 μg/l) predicted postoperative complications (incidence rate ratio: 1.13; p = 0.035). Conclusion: PCT seems to predict postoperative complications in cardiac surgery. The determination at the third POD yields the greatest sensitivity and specificity.

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Glucose-6-phosphate dehydrogenase deficiency and cardiac surgery

Perfusion ◽

10.1177/0267659110380770 ◽

2010 ◽

Vol 25 (6) ◽

pp. 417-421 ◽

Cited By ~ 7

Author(s):

N. Dogra ◽

GD Puri ◽

SS Rana

Keyword(s):

Cardiac Surgery ◽

Blood Cells ◽

Perioperative Management ◽

Dehydrogenase Deficiency ◽

Ischemia Reperfusion ◽

Anaesthetic Management ◽

Whole Body ◽

Free Radical Production ◽

Radical Production ◽

Glucose 6 Phosphate Dehydrogenase

Cardiac surgery involving cardiopulmonary bypass (CPB) in its conventional form involves many processes leading to free radical production, such as perioperative ischemia, reperfusion, circulation of whole body blood through the CPB circuit, hypothermia and acidosis. The red blood cells of a glucose-6-phosphate dehydrogenase (G6PD)-deficient person are unable to scavenge these free radicals, resulting in haemolysis. Here, we describe the successful anaesthetic management of two G6PD-deficient children who underwent cardiac surgery, on and off CPB, without any obvious haemolytic reaction, followed by a discussion of the disorder, with specific consideration of perioperative management of such cases.

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Risk reduction strategies: perioperative management in patients on antithrombotic therapy

ESC CardioMed ◽

10.1093/med/9780198784906.003.0638 ◽

2018 ◽

pp. 2657-2659

Author(s):

Steen D. Kristensen ◽

Kurt Huber ◽

Michael Maeng

Keyword(s):

Cardiac Surgery ◽

Risk Reduction ◽

Antithrombotic Therapy ◽

Perioperative Management ◽

Antithrombotic Drugs ◽

Reduction Strategies ◽

Thrombotic Complications ◽

Risk Reduction Strategies ◽

Cardiac Diagnosis ◽

Type Of Surgery

The choice of disruption or continuation of antithrombotic drugs prior to non-cardiac surgery is a challenging issue for surgeons and cardiologists. The type of surgery, cardiac diagnosis, and indication for antithrombotic therapy should be evaluated and discussed. This chapter provides some guidance for clinicians on how to balance bleeding and perioperative thrombotic complications.

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