Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part I - the effects of heparin, protamine and propofol

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 163-165 ◽  
Author(s):  
F Gao ◽  
D NF Harris ◽  
S Sapsed-Byrne ◽  
S Sharp
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Normal Saline ◽  
Lipid Emulsion ◽  
Cerebral Damage ◽  
Blood Samples ◽  
S 100 ◽  
Group A ◽  
Group B ◽  
Group D

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) (Sangtec Medical, Sweden) assays are designed for clotted samples, but when studying cerebral damage following cardiac surgery, perioperative samples will contain heparin and/or protamine. The lipid emulsion propofol is also frequently used during cardiac surgery and could affect the assays. We, therefore, studied the effects of heparin, protamine and propofol on the accuracy of NSE and S-100 assays in five healthy patients. Blood samples were taken and divided into four groups: normal saline was added to group A; heparin to group B; heparin followed by protamine to group C; and propofol to group D. NSE and S-100 concentrations were measured for all samples. Neither heparin, protamine nor propofol affected the accuracy of S-100 and NSE assays; therefore, samples can be taken throughout operations involving cardiopulmonary bypass without influencing the results.

Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part II - must samples be spun within 30 min?

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 167-169 ◽  
Author(s):  
S Sapsed-Byrne ◽  
F Gao ◽  
D N F Harris
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Plasma Levels ◽  
Room Temperature ◽  
Cerebral Damage ◽  
Blood Samples ◽  
Before And After ◽  
S 100

Sangtec 100 (S-100) (Sangtec Medical, Sweden) and neurone-specific enolase (NSE) assays are showing promise in the assessment of cerebral damage following cardiopulmonary bypass (CBP). The manufacturer’s instructions state, however, that samples must be spun and frozen within 30 min, which is inconvenient for serial studies. We, therefore, investigated whether storing blood samples at room temperature (RT) or 4°C for up to 48 h affected the measured levels. Blood samples were taken before and after CBP in six patients and stored for 15 min, 4, 8, 24 or 48 h at RT or 4°C. S-100 and NSE levels did not alter in either ‘before surgery’ or CPB samples when stored for up to 48 h at 4°C. There was a small, nonsignificant rise when stored at RT. Samples may, therefore, be collected throughout long operations or stored overnight without affecting NSE or S-100 plasma levels.

Abstract 1667: Early Childhood Mental Development After Transfusion-free Cardiac Surgery On Cardiopulmonary Bypass: A Multi-institutional Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Tomohiko Ukai ◽  
Takenori Adachi ◽  
Atsusi Numaguchi ◽  
Daichi Fukumi ◽  
Toshiaki Yasuda ◽  
...  
Keyword(s):  
Early Childhood ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Brain Dysfunction ◽  
Hemoglobin Level ◽  
Mental Development ◽  
Blood Products ◽  
Surgical Closure ◽  
Group A ◽  
Group B

Background: The use of blood products is often necessary to prime the extracorporeal circuits for pediatric cardiac surgical patients. The use of blood products carries serious risks both in the acute and long-term aspects of patient care. However, excessive hemodilution during cardiopulmonary bypass (CPB) is associated with decreased oxygen carrying capacity, edema, and organ dysfunction. Especially, whether brain dysfunction after transfusion-free cardiac surgery on CPB occurred is unknown. Objective: This study aims to investigate whether excessive hemodilution affects child’s mental development. Methods: We studied 143 infants (24.2 +/− 15.8 months, 5 months ~ 3 years of age) had performed surgical closure of ventricular septal defect (VSD) in less than 12 months (4.8 +/− 2.6 months) of age in 7 children’s hospitals. Questionnaires mailed to the parents included the Tsumori-Inage Infant Developmental Scale estimating subjects’ behavioral developmental level as Developmental Quotients (DQ). The infants were divided into 3 groups; transfusion-free (Group A, n=52), transfusion during CPB (Group B, n=24) and transfusion after CPB (Group C, n=66). Results: Lower DQ was found for Group A (94.7 +/− 11.6) than Group B (103.5 +/− 16.0, p=0.008) and Group C (101.7 +/− 17.9, p=0.016). No correlation was found between DQ and minimum hemoglobin level during CPB (min-Hb) in Group A. The DQ was likely to be lower in the infants with below 6 g/dl (93.0 +/− 13.0) than with over 6 g/dl (98.7 +/− 8.3. p=0.10) of min-Hb. Conclusions: The results suggest that the infants after transfusion-free surgery of VSD on CPB delay in the mental development in their early childhood. Maintaining minimum hemoglobin level over 6 g/dl during CPB seems to prevent the mental development from delay.

scholarly journals Comparison of effects of propofol versus sevoflurane for patients undergoing cardiopulmonary bypass cardiac surgery

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Shaoqun Tang ◽  
Wei Huang ◽  
Kun Zhang ◽  
Wei Chen ◽  
Tao Xie
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Mmse Score ◽  
Postoperative Cognitive Dysfunction ◽  
Neuron Specific Enolase ◽  
Serum Levels ◽  
Creative Commons ◽  
Group A ◽  
Group B ◽  
Laboratory Index

Objective: To compare the effects of propofol versus sevoflurane on the outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: A total of 110 patients undergoing cardiac surgery with CPB in our hospital from January 2015 to June 2017 were randomly divided into 2 groups (n=55): Group A, in which anesthesia was maintained with sevoflurane, and Group B, in which anesthesia was maintained with propofol. The MMSE score before and after operation, perioperative laboratory index, incidence of postoperative cognitive dysfunction (POCD) and incidence of adverse events between the two groups were compared. Results: The MMSE score was significantly higher in Group B than in Group A after anesthesia (p<0.05). Serum levels of the brain injury markers neuron-specific enolase, S100β and matrix metalloproteinase 9 were significantly lower in Group B than in Group A (p<0.05). POCD incidence at 12 hour and 24 hour after operation was significantly lower in Group B than in Group A (p<0.05). There were no significant differences in the incidence of low cardiac output and thoracotomy bleeding between two groups. Conclusion: Compared with sevoflurane, the use of propofol during cardiac surgery with CPB can efficiently improve postoperative cognitive function without increasing the risk of adverse reactions. doi: https://doi.org/10.12669/pjms.35.4.1279 How to cite this:Tang S, Huang W, Zhang K, Chen W, Xie T. Comparison of effects of propofol versus sevoflurane for patients undergoing cardiopulmonary bypass cardiac surgery. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1279 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Neurone-specific enolase and Sangtec 100 assays during cardiac surgery: part III - does haemolysis affect their accuracy?

Perfusion ◽  
1997 ◽  
Vol 12 (3) ◽  
pp. 171-177 ◽  
Author(s):  
F Gao ◽  
D N F Harris ◽  
S Sapsed-Byrne ◽  
S Sharp
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Neuronal Damage ◽  
Red Cells ◽  
Cerebral Damage ◽  
Correction Formula ◽  
S 100 ◽  
Serial Dilutions

Neurone-specific enolase (NSE) and Sangtec 100 (S-100) are useful for detecting cerebral damage during cardiopulmonary bypass (CPB). However, red cells contain NSE, and the haemolysis frequently caused by CPB could produce a false rise in NSE; S-100 is not found in red cells and should not be affected. We, therefore, compared the effects of haemolysis on NSE and S-100 to see if correction was necessary and possible. From seven patients, serial dilutions of haemolysed red cells were added to plasma (1/64-1/2048), measured for absorption at 540 nm and assayed for NSE and S-100. S-100 concentrations showed no change with haemolysis. Measured NSE increased significantly with haemolysis >1/512 (an increase of 6.6 μg/ml): a correction formula is presented. In 39/48 patients after CPB, mean haemolysis was <1/256 and would not need any correction. NSE and S-100 assay can, therefore, be used throughout CPB, which allows both glial and neuronal damage to be studied.

scholarly journals Effect of cardiopulmonary bypass on hemostasis in patients undergoing cardiac surgery

2018 ◽  
Vol 11 (2) ◽  
pp. 134
Author(s):  
Jubayer Ahmad ◽  
Redoy Ranjan ◽  
Heemel Saha ◽  
S. M. G. Saklayen ◽  
Masuda Begum ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Fibrinogen Level ◽  
Cardiopulmonary Bypass Time ◽  
Elective Cardiac Surgery ◽  
Bypass Group ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

<p class="Abstract">This study aimed to evaluate the hemostatic derangement in patients undergoing elective cardiac surgery using cardiopulmonary bypass. Total 55 patients of either sex, were divided into three groups: Group A (n=20): Patients selected for elective cardiac surgery without cardiopulmonary bypass; Group B (n=20): Patients who undergone cardiac surgery with cardiopulmonary bypass time &lt;90 min; and Group C (n=15): Patients who undergone cardiac surgery with cardiopulmonary bypass time either 90 min or more. The difference of mean hemoglobin, total count of WBC, and platelet count on immediate post-operative period and at 7 days after surgery were statistically significant among the groups. The mean hematocrit value, fibrinogen level and coagulation profile were statistically significant between the two groups in comparison to pre-operative value. The mean cross-clamp time and bypass time were statistically significant between the two sub-groups of cardiopulmonary bypass population. The mean blood loss was more (1513.3 ± 307.9 mL) where the cardiopulmonary bypass was used for &gt;90 min in comparison to other population. Prolong cardiopulmonary bypass time associated with more hemostatic abnormalities and complications can be minimized by shortening the bypass time.</p>

scholarly journals Effects of Propofol and Ketamine as Induction Agent to Isoflurane and as Continuous Rate Infusion on Haematobiochemical Parameters in Dogs Premedicated with Glycopyrrolate, Dexmedetomidine and Butorphanol

2021 ◽  
Author(s):  
Hitesh Bayan ◽  
Kushal Konwar Sarma ◽  
Gutti Dhananjaya Rao ◽  
Dwijen Kalita ◽  
Devojyoti Dutta ◽  
...  
Keyword(s):  
Serum Glucose ◽  
Induction Agent ◽  
Neutrophil Granulocyte ◽  
Monocyte Count ◽  
Blood Samples ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Rate Infusion ◽  
Observation Period

Background: The study was conducted to evaluate the effect of propofol and ketamine as induction agent to isoflurane and as continuous rate infusion on haematobiochemical parameters in dogs premedicated with glycopyrrolate, dexmedetomidine and butorphenol. Methods: Twenty four animals were randomly divided into four Groups (A, B, C and D) comprising six animals in each. All the animals were premedicated with glycopyrrolate, dexmedetomidine and Butorphanol. Induction was done with propofol in group A and B and with ketamine in group C and D. Anaesthesia was maintained with isoflurane in group A and C and with propofol and ketamine continuous rate infusion in group B and D, respectively. Blood samples were collected at 0(before premedication), 20, 40 and 60 min (during maintenance) to evaluate different haematobiochmical parameters. Result: The haemoglobin levels decreased in all the groups but significantly in Group C and Group D. The total erythrocyte count decreased in all the groups with significant change in Group D. The TLC, PCV, platelet, lymphocyte and monocyte count decreased non-significantly. The neutrophil, granulocyte count in all the groups increased non-significantly over the different observation period. The serum glucose and LDH increased significantly in all the groups. The GGT, alkaline phosphatise, BUN and serum creatinine increased non-significantly in all the groups.

scholarly journals Effect of Vitamin E on Serum Urea Level on Gentamicin Induced Nephrotoxicity in Long Evans Rats

2019 ◽  
Vol 7 (1) ◽  
pp. 11-15
Author(s):  
Md Shameem Ahmed ◽  
Mohammad Ashraf Ahmed ◽  
Md Rezwanur Rahman ◽  
Ashrafuzzaman ◽  
Mushtari Jahan ◽  
...  
Keyword(s):  
Vitamin E ◽  
Normal Saline ◽  
Saline Control ◽  
Serum Urea ◽  
Urea Level ◽  
Significant Difference ◽  
Group A ◽  
Long Evans ◽  
Group B ◽  
Group D

Background: The kidneys have an important role in eliminating the final products of metabolic activities, excreting the drugs and chemicals. A variety of frequently used drugs have been demonstrated to produce nephrotoxic effects. Objective: This study was carried out to observe the effect of vitamin E on gentamicin-induced nephrotoxicity by assessing serum urea level in Long Evans rats. Materials and method: The experimental study was carried out on 40 healthy Long Evans rats of both sex with the weight ranges from 172-255 gm and the age ranges from 7 to 10 weeks. The rats were divided into four groups - Group A (normal control) received normal saline, group B, C and D received gentamicin for 6 days, rats of group C received vitamin E capsule for total 9 days with gentamicin whereas group D received vitamin E capsule for total 10 days with gentamicin. Serum urea level was measured at the end of the experiment. Results: The (mean±SD) serum urea levels in group A, B, C and D were 4.79±0.32, 12.41±1.22, 7.56±1.11 and 7.15±1.09 mmol/L respectively. The differences between groups were highly significant (p<0.001) for group A & B, A & C, A & D, B & C, B & D whereas the difference between C & D (p>0.01) was not significant. Serum urea level of the normal saline control group (group A) was within the normal limit (4.79 mmol/L). Serum urea level in gentamicin treated rats (group B) was more in comparison to gentamicin and vitamin E treated rats (group C & D) and pretreatment with longer duration group (group D) showed lower serum urea value than shorter one (group C) though the groups showed no significant difference. Conclusion: Vitamin E treatment showed some protective effect against gentamicin-induced nephrotoxicity. The results also indicated that effectiveness of vitamin E depends on duration of pretreatment that means the pretreatment duration must be increased to a suitable period for better protection against gentamicin-induced nephrotoxicity. Delta Med Col J. Jan 2019 7(1): 11-15

scholarly journals Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Hamid Raza ◽  
Maqsood Ahmed Siddiqui ◽  
Ahmed Uddin Soomro ◽  
Kamlaish
Keyword(s):  
Adverse Events ◽  
Incidence Rate ◽  
Normal Saline ◽  
Pediatric Population ◽  
Injection Pain ◽  
P Value ◽  
Care Hospital ◽  
Group A ◽  
Group B ◽  
Group D

Objectives: The aim of our study is to observe the pain difference as experienced by the pediatric patient when administered different preparations of propofol utilizing the verbal rating scale. Study Design: Prospective double-blind randomized control trial. Setting: A large tertiary care hospital in Karachi, Pakistan. Period: 6 months from June 2016 to November 2016. Material & Methods: The final patient population included in the study was n= 180 and were divided into six groups. These patients received general anesthesia and underwent surgery. Patients in Group A received 2ml of normal saline and a mixture of propofol and normal saline after waiting for half a minute. Group B patients received 0.5mg/kg Lidocaine followed by normal saline after waiting for half a minute. Group C received 2ml of normal saline followed by a mixture of propofol and Lidocaine after half a minute. Group D received 0.2mg/kg of Ketamine followed by a mixture of normal saline and propofol. Group E patients received 2ml of normal saline followed by a mixture of propofol and Ketamine half a minute later. And finally, patients belonging to group F received 2ml of normal saline followed by a mixture of propofol M/LCT and normal saline half a minute later respectively. Results: The gender, age, body weight and ASA grade of all the pediatric patients were similar having a P value of >0.05. The incidence rate of propofol injection pain in the groups were found to be Group A= 76.66%, Group B= 66.66%, Group C= 50%, Group D= 60%, Group E= 63.33%, Group F= 60% respectively. The incidence rate for adverse events was significantly lower in all the groups as compared to Group A that is the normal saline and propofol group having a p-value of less than 0.01. And the incidence rate of adverse events was lower in Groups C, D, E, and F were significantly lower than Group B having a p-value of less than 0.05. All the experimental groups had significantly lower scores of the VRS scale as compared to the control group (Group A) and the intergroup differences were found to be statistically significant having a p-value of less than 0.01. Conclusion: In our study, we found that the injection pain of propofol administration in the pediatric population was significantly reduced when using M/LCT pre-injection, 0.5mg/kg lidocaine or 0.2mg/kg of Ketamine. Another good combination is mixing 180mg propofol with 40mg of lidocaine or mixing propofol with 16mg of Ketamine.

scholarly journals Gastroprotective Effect of Azadirachta indica Leaves (Neem) Extract on Aspirin Induced Gastric Ulcer in Rats

2020 ◽  
Vol 7 (2) ◽  
pp. 61-65
Author(s):  
Sultana Farzana ◽  
Supti Prava Saha ◽  
Nashid Sultana ◽  
Md Ismail Khan
Keyword(s):  
Gastric Ulcer ◽  
Azadirachta Indica ◽  
Normal Saline ◽  
Aqueous Suspension ◽  
Gastric Mucosal Damage ◽  
Alcoholic Extract ◽  
Neem Extract ◽  
Group A ◽  
Group B ◽  
Group D

Background: Gastric ulcer is one of the common diseases worldwide. Different parts of Azadirachta indica (Neem) tree has different uses in medicine for its beneficial properties and its leaves are also known to have anti ulcerant effect. Objective: This study was conducted to find out the protective role of Azadirachta indica (Neem) extract in the development of gastric ulcer. Materials and method: The study comprised of 30 Albino rats: Group-A, Group-B, Group-C, Group-D and Group-E having 6 rats in each group. The experiment was divided into 2 parts: Experiment-1 and Experiment-2. Experiment-1 comprised of Group-A and Group-B where Group-A served as control and was provided with normal saline (2 ml/kg body wt). In group-B rats ulcer was produced by administration of aqueous suspension of Aspirin (200 mg/kg body wt). All the rats were sacrificed after 4 hours to confirm gastric ulcer by histopathology. In Experiment-2, rats of Group-C served as disease control group and provided with normal saline (2ml/kg body wt). Group-D was provided with alcoholic extract of Azadirachtaindica leaves (150mg/kg body wt) and Group-E was provided with Ranitidine suspension (20mg/kg). After 8 days of treatment, animals were fasted for 24 hours. Then aqueous suspension of Aspirin (200 mg/kg body wt) was administered and after 4 hours all rats were sacrificed. Gross and microscopic examinations were performed to evaluate the results. Results: Histologically Aspirin treated rats showed ulcerated mucosa. Pretreatment with Neem extract showed protection against Aspirin induced gastric mucosal damage which was statistically highly significant (p<0.001). Conclusion: The study suggests that pretreatment with Azadirachta indica (Neem) leaves extract may be useful in prevention of Aspirin induced gastric ulcer. Delta Med Col J. Jul 2019 7(2): 61-65

scholarly journals Effects of Diabetogenic Agent Streptozotocin on Hematological Parameters of Wistar Albino Rats “An Experimental Study”

2019 ◽  
pp. 1-8
Author(s):  
Akhtar Ali ◽  
Shehla Shaheen ◽  
Zahida Memon ◽  
Faiza Agha ◽  
Moazzam Ali Shahid ◽  
...  
Keyword(s):  
Experimental Study ◽  
Animal Models ◽  
Normal Saline ◽  
Hematological Parameters ◽  
Diabetic Animal ◽  
Blood Samples ◽  
Study Results ◽  
Group A ◽  
Group B ◽  
Animal House

Background: Diabetes mellitus has remained the major concern for medical sciences               researches due to its deleterious effects on general, physical and mental health of patients. To understand the pathophysiology and to explore better treatment options for such kind of metabolic disorders it is necessary to generate the experimental animal models. To create diabetic animal models, streptozotocin has shown predominance in selectivity as a diabetogenic agent. While studying effects of any intervention in the diabetic animal models, being a cytotoxic drug streptozotocin may affect the study results by inhibiting highly replicating cells especially hematopoietic cells. Aims: The aim of study was to analyze the effects of streptozotocin on various cellular components of blood such as RBCs, WBCs (Lymphocytes, Neutrophils, Eosinophils), Hb%, HCT and Platelets, at baseline, 5th day and 15th day without any intervention. Study Design: Animal based Experimental study. Place and duration of Study: The study was conducted at animal house of faculty of Pharmacy Ziauddin University Karachi, while laboratory work was performed at MDRL-1 Ziauddin University. Methodology: In Group A normal saline and in group B and C 60 mg / kg streptozotocin diluted in normal saline was administered intraperitoneally. After the confirmation of induction of Diabetes in rats, on fifth day blood samples were drawn from Group A and B and were analyzed. While blood samples from group C were drawn on fifteenth day. Results: Analysis of various hematological parameters on 5th day revealed that there was a decrease in the levels of Hb, HCT, RBCs and WBCs with an increase in platelet count in group B in comparison to group A (control). On the other hand, in Group C (15th day), blood cell counts (Hb, HCT, RBCs, WBCs, Lymphocytes, Neutrophils and platelets) seemed to recover from streptozotocin induced decline that was observed in group B, however did not reach the baselines as in group A(control). Conclusion: It is concluded that change in hematological parameters of rats after administration of streptozotocin is reversible. The blood parameters may recover near to base line values without any intervention within two weeks.

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