Changes in serum iron and leukocyte count associated with open-heart surgery.

1983 ◽  
Vol 29 (11) ◽  
pp. 1984-1986 ◽  
Author(s):  
E J Fitzsimons ◽  
G H Ballantyne
Keyword(s):  
Serum Iron ◽  
Heart Surgery ◽  
Leukocyte Count ◽  
Iron Concentration ◽  
Open Heart Surgery ◽  
Stressful Events ◽  
Initial Increase ◽  
Open Heart ◽  
Ferritin Concentration ◽  
The Mean

Abstract Rapid and pronounced changes in serum iron concentration and leukocyte count in association with open-heart surgery were observed in each of 58 patients. We examined the temporal aspects of these alterations. An initial increase in Fe concentration from a mean of 0.94 mg/L before surgery to 1.20 mg/L was observed within 6 h of the start of surgery. Decreased Fe concentration, a phenomenon previously associated with physiologically stressful events, became apparent 12 h after surgery, by which time the mean Fe concentration had declined to 0.26 mg/L. An increase in the mean leukocyte count, from 7.1 to 15.2 X 1000/mm3 was observed within 6 h of the start of surgery. An increase in ferritin concentration in serum was concurrent with decreased iron concentration.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

S-100ao protein in blood and urine during open-heart surgery.

1989 ◽  
Vol 35 (9) ◽  
pp. 1942-1944 ◽  
Author(s):  
A Usui ◽  
K Kato ◽  
T Abe ◽  
M Murase ◽  
M Tanaka ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Open Heart ◽  
Arterial Blood ◽  
The Mean ◽  
Serial Samples ◽  
Mean Concentration ◽  
Coronary Sinus Blood

Abstract Concentrations of S100a0 protein and CK-MB were measured by enzyme immunoassay in serial samples of arterial and coronary-sinus blood and urine taken from 26 patients who were undergoing mitral valve surgery. The mean concentration of arterial S100a0 in plasma was 0.32 (SD 0.28) ng/mL at the beginning of anesthesia, increased sharply after reperfusion, peaking [14.4 (SD 6.63) ng/mL] after 45 min of reperfusion, then decreased rapidly. The concentration of creatine kinase (CK) isoenzyme MB in arterial blood plasma was greatest 3 h after reperfusion [107 (SD 54.5) ng/mL]. S100a0 concentrations in urine increased dramatically after reperfusion [16,300 (SD 12,000) ng/h vs 44 (SD 32) ng/h], while CK-MB increased slightly [135 (SD 75) ng/h vs 19 (SD 12) ng/h]. These results suggest that S100a0 in cardiac muscle is released into the bloodstream during open-heart surgery and is discharged into the urine more rapidly than is CK-MB. Determination of S100a0 in plasma or urine thus may be useful for estimating damage to heart muscle during open-heart surgery.

Homocysteine Levels in Patients Undergoing Open-Heart Surgery

2006 ◽  
Vol 8 (1) ◽  
pp. 66
Author(s):  
Necip Becit ◽  
Sait Kele? ◽  
Yahya �nl� ◽  
M�nacettin Ceviz ◽  
Ahmet Yavuz Balci ◽  
...  
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
High Performance ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Post Surgery ◽  
Normal Plasma ◽  
The Mean ◽  
Artery Disease

Background: The aim of this prospective study was to determine the levels of plasma homocysteine (HCY) in patients who have undergone open-heart surgery for ischemic heart disease (IHD) or nonischemic heart disease (NIHD) and to evaluate whether an association is present between hyperhomocysteinemia and coronary artery disease.Material and Methods: We investigated prospectively 30 patients who underwent open-heart surgery. Of these patients, 15 had IHD, and 15 had NIHD such as mitral and/or aortic valve disease. The 2 groups were well matched for age, sex, body mass index, and blood pressure. In all patients HCY was assayed by high performance liquid chromatography preoperatively and on the first, second, and third day postoperatively.Results: The mean age of the patients was 57.2 years in group IHD and 52.6 years in group NIHD. The male:female ratio was 8:7 in group IHD and 7:8 in group NIHD. Of 15 patients in group IHD, 13 had hyperhomocysteinemia and 2 had normal plasma HCY levels. Of 15 patients in NIHD group, 1 had hyperhomocysteinemia and the others had normal plasma HCY levels. Preoperative plasma HCY levels of all patients in the IHD group were significantly lower during all subsequent time periods, whereas preoperative plasma HCY levels in the NIHD group were lower only on the first day post-surgery (P < .05).Conclusions: Our data suggest that plasma HCY levels in patients with IHD are associated with the development of atherogenesis and coronary artery disease. For this reason, HCY levels should be measured routinely and treated appropriately in patients with risk factors for atherosclerosis.

Utility of Omentoplasty in Mediastinitis Treatment following Sternotomy

2016 ◽  
Vol 19 (6) ◽  
pp. 265
Author(s):  
Abdurrahim Colak ◽  
Ugur Kaya ◽  
Münacettin Ceviz ◽  
Necip Becit ◽  
Fehimcan Sevil ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Subcutaneous Tissue ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Coagulase Negative Staphylococci ◽  
Female Ratio ◽  
Mediastinal Infection ◽  
The Mean ◽  
Age Range ◽  
Male To Female

Background: Mediastinal infection is one of the most serious complications that occurs following open-heart surgery by sternotomy. In the present study, omentoplasty was initially and aggressively used to treat the infection and prevent the recurrence caused by bones in cases of mediastinitis following open-heart surgery at our clinic.Methods: Among the 3656 patients who underwent surgery at our department of cardiovascular surgery between January 1996 and December 2012, omentoplasty as a treatment for mediastinitis was applied to 19 (0.51%) patients (of which 13 were males) following sternotomy. The cases were revised on the 15th day following the first surgery and/or when there was a suspicion of mediastinal infection. The necrotic skin, subcutaneous tissue, and bone tissue were resected, and all the affected sternal tissues were removed until healthy hemorrhagic areas were reached. Results: The average age of the patients was between 49 and 81 years (mean: 65.7 ± 10.5 years). The mean age of the men was 66.08 ± 12.7 years (age range: 49-81 years) and that of the women was 63.2 ± 6.8 years (age range: 55-71 years). The male to female ratio was 2:1, and in both the male and female groups, the approximate age ranged from 55 and 70 years. In the intraoperative cultures received from wound cases, the most common agent of infection was methicillin-resistant coagulase-negative staphylococci. Purulent leaks from eight patients stopped in approximately 4 days. Purulent leaks from the other 11 patients continued until the 6th day, and thus, medical dressing also continued, after which the leaks stopped on the 15th day. The approximate postoperative hospital stay was 32 days (range: 13-63 days). Conclusion: Omentoplasty in heart surgery can be considered an effective method when used to control infection and treat secondary poststernotomy mediastinitis.

scholarly journals Avoidance of Allogeneic Blood Transfusions by Treatment With Epoetin Beta (Recombinant Human Erythropoietin) in Patients Undergoing Open-Heart Surgery

Blood ◽  
1997 ◽  
Vol 89 (2) ◽  
pp. 411-418 ◽  
Author(s):  
Olaf Sowade ◽  
Harry Warnke ◽  
Paul Scigalla ◽  
Birgit Sowade ◽  
Werner Franke ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Heart Surgery ◽  
Cell Mass ◽  
Open Heart Surgery ◽  
Allogeneic Blood ◽  
Blood Transfusions ◽  
Open Heart ◽  
Epoetin Beta ◽  
Human Erythropoietin ◽  
The Mean

Abstract In a double-blind, randomized, placebo-controlled trial, we evaluated the ability of epoetin beta (recombinant human erythropoietin) to avoid allogeneic blood transfusions (ABT) and the associated risks in patients undergoing primary elective open-heart surgery and in whom autologous blood donation (ABD) was contraindicated. Seventy-six patients overall were enrolled onto the trial and were randomly assigned to the two treatment groups, 5 × 500 U/kg body weight (BW) epoetin beta or placebo intravenously over 14 days preoperatively. All patients received 300 mg Fe2+ orally per day during the treatment period. Preoperatively, the mean hemoglobin increase was 1.50 g/dL greater in epoetin beta patients than in placebo patients (95% confidence interval, 1.10 to 1.90 g/dL), allowing a rapid return to the baseline value by the seventh postoperative day in most epoetin beta patients. The mean volume of blood collected by intraoperative isovolemic hemodilution was 562 mL (red blood cell mass, 274 mL) in the epoetin beta group and 218 mL (red blood cell mass, 94 mL) in the placebo group, respectively. Only four patients (11%) in the epoetin beta group received an ABT, compared with 19 (53%) in the placebo group (P = .0003). Epoetin beta was most useful in patients with a perioperative blood loss greater than 750 mL, in those with a baseline hematocrit value less than 0.42, and in those aged ≥60 years. The iron supplementation proved adequate despite the fact that a significant decrease in ferritin (median, 48.1%) and transferrin saturation (median, 40.5%) was observed in epoetin beta patients preoperatively. No influence of epoetin beta therapy on blood pressure, laboratory safety variables, or the frequency of specific adverse events was observed. Intravenous epoetin beta treatment of 5 × 500 U/kg BW in combination with 300 mg Fe2+ orally per day administered over 14 days preoperatively is an adequate therapy for increasing mean hemoglobin levels by approximately 1.50 g/dL and reducing the allogeneic blood requirement in patients undergoing elective open-heart surgery and in whom ABD is contraindicated.

scholarly journals Comparison of analgesic efficacy between erector spine plane block and intravenous patient-controlled analgesia with morphin after open heart surgery

2021 ◽  
Vol 35 ◽  
pp. 84-92
Author(s):  
Vu Thi Thuc Phuong ◽  
Bui Duc Tam ◽  
Tran Cong Thanh
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Circulation ◽  
Analgesic Effect ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Patient Controlled Analgesia ◽  
Vas Score ◽  
The Mean ◽  
Mean Time

Pain after cardiac surgery is always an obsession of patients and a top concern of anesthesiologists. Experimental subjects challenged by acute pain and patients in chronic pain experience impairments in attention control, working memory, mental flexibility, problem solving, and information processing speed. The two most commonly used analgesia methods are patient-controlled analgesia (PCA) and erector spinea plane block (ESP). Our study aimed to compare the analgesic effect of ESP with PCA in patients after cardiac surgery using extracorporeal circulation and evaluate the disavantages of these two pain relief techniques. Subject and methods: This study was a randomized controlled intervention study of adult patients who underwent open-heart surgery patients with extracorporeal circulation from May 2020 to September 2021 in the Department of Anesthesiology and Intensive Care Unit - Hanoi Heart Hospital. Results: Two hundred and four (204) consecutive patients were collected, included 108 patients in the ESP group and 96 patients in the PCA group. The mean intraoperative fentanyl amount in the ESP group (0.57±0.50 mg) was lower than in the PCA group (1.00±0.00 mg) (p<0.05). The average VAS score when the patient was lying still and taking deep breaths at the time of assessment in both groups was below 3 (corresponding to low pain level) (p>0.05). The mean morphin consumption 24 hours after surgery was significantly lower in the ESP group (0,23±0,12 mg) than in the PCA group (17,92±3,32 mg) (p<0.05). The mean time after surgery in the ESP group (3.80±1.02 hours) and the PCA group (5.21±1.10 hours) had a clear difference between p<0.05. The mean time of extubation in the ESP group (8.06±1.60 hours) was statistically significantly lower than in the PCA group (8.83±1.43 hours) (p<0.05). The rate of nausea in the ESP group (20.98%) was lower than in the PCA group (58.33%) (p<0.05). Conclusion: Both methods had good analgesic effect with an average VAS score ≤ 3. The ESP group had a lower mean postoperative morphine consumption, a higher patient satisfaction level, and a lower rate of nausea, vomiting, and slow breathing statistically significant less than the PCA group.

scholarly journals The Effect of Multi-Component Interventions on the Incidence Rate, Severity, and Duration of Post Open Heart Surgery Delirium among Hospitalized Patients

2020 ◽  
Author(s):  
Banafsheh Tehranineshat ◽  
Nima Hosseinpour ◽  
Arash Mani ◽  
Mahnaz Rakhshan
Keyword(s):  
Incidence Rate ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Intervention Group ◽  
Hospitalized Patients ◽  
Control Group ◽  
Open Heart ◽  
Environmental Interventions ◽  
Post Operation ◽  
The Mean

Abstract Background: Delirium is one of the prevalent complications of post open heart surgery. The present research aimed to assess the effect of multi-component interventions on the incidence rate, severity, and duration of post open heart surgery delirium among hospitalized patients.Methods: In this quasi-experimental study, 96 patients under open heart surgery were selected using convenience sampling and were divided into a control and an intervention group. The interventions included patients’ preoperative education, nurses’ education, and intra-ward environmental interventions. The demographic information and Mini-Mental State Examination (MMSE) questionnaires were completed a day before surgery. The patients in both groups were also surveyed after extubation until the fourth day post operation using Delirium Observation Screening (DOS) scale considering the incidence, severity, and duration of delirium. The data were analyzed using the SPSS statistical software, version 20.Results: The incidence rate of delirium was 14.6% and 6.2% in the control and intervention groups, respectively (p>0.05). Besides, the mean severity of delirium was 0.53 in the control group and 0.40 in the intervention group (p>0.05). Finally, the mean duration of delirium was 4.5 and 3.25 hours in the two groups, respectively (p>0.05).Conclusions: Since prevention of delirium can play a considerable role in patients’ recovery after heart surgery, it is necessary to carry out some measures to prevent such complications. Even though the interventions performed in this study did not cause significant changes in this regard, the results suggested that prevention interventions should be performed with stronger and more integrated planning for achieving better outcomes.

scholarly journals Diagnosis and Treatment of Lambl’s Excrescence on the Aortic Valve

2018 ◽  
Vol 21 (3) ◽  
pp. 148 ◽  
Author(s):  
Ren Chong-lei ◽  
Jiang Sheng-li ◽  
Wang Rong ◽  
Xiao Cang-song ◽  
Wang Yao ◽  
...  
Keyword(s):  
Heart Disease ◽  
Surgical Treatment ◽  
Aortic Valve ◽  
Cerebrovascular Accident ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Surgical Excision ◽  
Diagnosis And Treatment ◽  
Open Heart ◽  
The Mean

Objective: Our objective is to summarize our experience in the diagnosis and treatment of Lambl’s excrescence (LE) on the aortic valve. Methods: The clinical data of 25 patients with LE admitted to our hospital from January 2010 to December 2014 were analyzed retrospectively. There were 17 males and 8 females, with the mean age of 55.7 ± 11.43 years (range: 30 to 70 years). Among the patients analyzed, eight also had cerebral embolism. All of the patients were diagnosed by transesophageal echocardiography (TEE). In seven cases, surgical treatment to remove the excrescence was successfully performed. Results: All 25 patients were cured and discharged. There were no complications or operative mortalities in the seven patients that underwent surgical treatment. Follow-ups were performed for all patients for an average of 2.9 ± 1.5 years. During this time, none had a new cerebrovascular accident (CVA). Conclusions: Most patients with LE are asymptomatic, though some patients showed repeated episodes of stroke. We recommend TEE as the main diagnostic means of the disease. Patients with LE that have experienced two or more CVAs or combined other heart disease and need open heart surgery should be offered surgical excision of the excrescences. Other patients should be treated conservatively with anticoagulation, or monitored closely.

Bloodless open-heart surgery in infants and children

Perfusion ◽  
1994 ◽  
Vol 9 (4) ◽  
pp. 257-263 ◽  
Author(s):  
Victor T Tsang ◽  
Richard J Mullaly ◽  
Philip G Ragg ◽  
Tom R Karl ◽  
Roger BB Mee
Keyword(s):  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Postoperative Management ◽  
Double Outlet Right Ventricle ◽  
Subaortic Stenosis ◽  
Congenital Defects ◽  
Open Heart ◽  
The Mean ◽  
Congenital Mitral Regurgitation

Between October 1984 and January 1993, seven children of Jehovah's Witnesses underwent corrective open-heart surgery for congenital defects, on cardiopulmonary bypass (CPB). Age at surgery ranged from three months to 6.5 years, and weight ranged from 4.2 kg to 23.2 kg, with two children weighing less than 10 kg. The principal cardiac anomalies were tetralogy of Fallot (two), double outlet right ventricle (one), subaortic stenosis (one), transposition of the great arteries and ventricular septal defect (one), atrial septal defect and congenital heart block (one), and congenital mitral regurgitation (one). Hypothermic CPB was used in all seven operations with crystalloid priming of the extracorporeal circuit. CPB was based on our standard perfusion protocols. All surgical procedures were done without the use of blood or blood products. The mean preoperative haematocrit (Hct) was 40.9% (range 31.0-47.8%). The mean lowest intraoperative Hct was 17.3% (range 15.0-24.3%), whereas the immediate post-CPB Hct was 19.6% (range 15.3-24.0%). The Hct progressively increased to 29.2% (range 21.0-34.2%) on the first postoperative day, and 32.3% (range 24.2-38.3%) at the time of discharge. There was no hospital mortality, and the mean hospital stay was 10 days (8-13 days). We report the safe repair of complex open-heart surgery in children, without blood transfusion, even in small infants. The successful management of these patients requires meticulous attention to surgical and perfusion technique, and sound postoperative management.

scholarly journals Evaluation of Aminoglycosides Consumption in Open Heart Surgery Based on the Defined Daily Dose Index

2020 ◽  
Author(s):  
Golpar Gholizadeh Shirdarreh ◽  
Gohar Eslami ◽  
Aria Soleimani ◽  
Ebrahim Salehifa
Keyword(s):  
Side Effects ◽  
Creatinine Clearance ◽  
Heart Surgery ◽  
Laboratory Data ◽  
Open Heart Surgery ◽  
Defined Daily Dose ◽  
Open Heart ◽  
Number Of Patients ◽  
Daily Dose ◽  
The Mean

Background: Resistance to antibiotics, including aminoglycosides  (AMG) is one of the problems associated with inappropriate administration of broad-spectrum antibiotics. Objectives: This study aimed to assess the clinical features of aminoglycosides consumption based on the Defined Daily Dose (DDD) index in open heart surgery. Methods: This study was done on 268 patients who underwent heart surgery during 2015 and 2016. Clinical and demographic characteristics, laboratory data, and aminoglycoside-related data such as dose and the total duration of administration were collected through a questionnaire designed by the authors. The patients’ DDD/100 bed-days were calculated, too. Results: Out of 268 patients, 170 patients (63.4%) were male. The Mean±SD age of the patients was 60.65±10.71 years and the Mean±SD duration of hospitalization was 12.19±7.02 days. Ischemic heart disease was the most prevalent cause of hospitalization. The Mean duration of receiving aminoglycosides was 3.61 days. In 134 patients (50%), creatinine clearance was less than 60 mL/min during aminoglycosides administration. In 25 patients (9.32%), a 50% increase in serum creatinine during receiving aminoglycosides was observed. Creatinine clearance had not been calculated for any patient. Conclusion: In this study, monitoring the side effects of aminoglycosides and the serum concentration was not routinely performed. Dose adjustment of aminoglycosides based on renal function test was not considered in a large number of patients and as a result, the dose was inappropriate in many patients. Therefore, it is recommended that the guidelines of drug usage were followed and the patients were monitored more closely for side effects.

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