Does heparin coating improve biocompatibility? A study on complement, blood cells and postoperative morbidity during cardiac surgery

Perfusion ◽  
1997 ◽  
Vol 12 (6) ◽  
pp. 385-391 ◽  
Author(s):  
Ali Belboul ◽  
Najib Al-Khaja
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Morbidity ◽  
Artery Bypass ◽  
Classical Pathway ◽  
Serum Pool ◽  
Heparin Coating ◽  
Cell Counts ◽  
Significant Difference ◽  
White Blood Cell Counts ◽  
Coated Surfaces

To evaluate whether the effect of heparin coating the extracorporeal circuit resulted in differences in patient outcome and haemostatic alteration, 24 patients undergoing elective, isolated coronary artery bypass were randomized prospectively to cardiopulmonary bypass (CPB) with heparin-coated circuits (group H, n = 12) or uncoated circuits (group C, n = 12). The technique of CPB, heparinization and its reversal were the same in both groups. We studied complement status (C3d, C3, C3d/C3, C4 and C-function), white blood cell counts with differentiation and the postoperative morbidity. The results confirmed that CPB activates complement and increases neutrophils in both the H and C groups. A significantly lower level of Ieucocytosis was seen in group H compared to the C group ( p < 0.05). The complement function via the classical pathway (C-function), expressed as a percentage of the function of a reference serum pool (the values of normal sera were 75-125%), was significantly reduced in both heparin-coated and uncoated circuits ( p < 0.05). There was no significant intergroup difference regarding C3, C3d/C3, C4 and C-function during the study period. A lower frequency of postoperative morbidity was present in the H group. We conclude that heparin-coated surfaces elicit less leucocytosis and decrease postoperative morbidity in patients undergoing cardiac surgery but do not cause a significant difference regarding activation of the complement system as reported by many other investigators.

scholarly journals Stability across time of the neutrophil-lymphocyte and lymphocyte-neutrophil ratios and associations with outcomes in cardiac surgery patients

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jeremy Green ◽  
Syed Usman Bin Mahmood ◽  
Makoto Mori ◽  
Sameh Yousef ◽  
Abeel A. Mangi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pearson Correlation ◽  
Artery Bypass ◽  
Temporal Stability ◽  
Correlation Coefficients ◽  
Coronary Artery Bypass Grafts ◽  
Elective Cardiac Surgery ◽  
Cell Counts ◽  
White Blood Cell Counts ◽  
Over Time

Abstract Background Elevated white blood cell counts and leukocyte ratios are recognized markers of systemic inflammation associated with poor surgical outcomes. We analyzed the temporal stability and prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) and Lymphocyte-to-Neutrophil ratio (LNR) in patients undergoing coronary artery bypass grafts and/or valve surgery. Methods We retrospectively reviewed 558 patients who underwent elective cardiac surgery between July 2014 and December 2016, excluding patients with immunosuppressed status. The stability of NLR and LNR was evaluated using interclass correlation coefficients. The patients were dichotomized into two groups, high NLR and low NLR, based on the median value of preoperative NLR in our cohort. A logistic regression model compared preoperative NLR and LNR values to clinical outcomes, including a composite of perioperative events and mid-term mortality. Results We identified that NLR reliability over time was good (ICC = .592; R-squared = .351), and LNR reliability over time was excellent (ICC = .761; R-squared = .601). Furthermore, an increased duration between collection dates was not significantly correlated with increased variability in NLR (Pearson Correlation Coefficient: −.111, p = .117). On multivariate model, neither high NLR (OR = .879, p = .168) nor low LNR (OR = 3.30, p = .214) was significantly associated with a composite of perioperative events, but increased LNR was associated with lower mid-term mortality (HR .001, p = .026). Conclusions Both NLR and LNR were stable over time, up to 100 days, but LNR values were more consistent compared to NLR. High LNR was significantly associated with decreased risk of mid-term mortality, and LNR showed a stronger relationship with mid-term mortality than its NLR counterpart. Both of these findings indicate that LNR may be a more useful and valuable clinical marker.

scholarly journals EPICARDIAL PACING

2010 ◽  
Vol 17 (01) ◽  
pp. 55-58
Author(s):  
ZAHID PARVEZ ◽  
FARID AHMAD CHAUDHARY ◽  
AJMAL HASAN NAZQVI ◽  
Muniza Saeed
Keyword(s):  
Cardiac Surgery ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Right Atrial ◽  
Routine Practice ◽  
Optimum Time ◽  
Pacing Threshold ◽  
Significant Difference ◽  
Group 2 ◽  
The Right

Placement of epicardial wires on the right atrial and right ventricle surfaces is a routine practice in cardiac surgery. These pacingelectrodes are used for invasive pacing of the myocardium for a variety of emergent and elective conditions postoperatively. There is uncertaintyin actual practice about the optimum time for their removal, and practice varies widely between different institutions. Objectives: To determine thetime related efficacy of these pacing electrodes after cardiac surgery, to find out the optimum time of their removal. Period: July 2008 toOctober 2008. Patients & Methods: 47 patients those underwent coronary artery bypass surgery were prospectively enrolled and evaluatedwith standard 12 lead ECG and ventricle pacing threshold immediately after surgery and on the 5t h postoperative day. The patients were dividedinto two subgroups according to their left ventricle ejection fraction ( > 40% verses < 40%). Results: There was significant difference in theeffective pacing threshold in groupl and 2 on immediate post operative period and on day 5. (P = 0.002 and P = 0.02 respectively) The sensingthreshold immediately after operation and on 5t h post operative day also differed significantly (P = 0.009 in group 1 and 0.02 in group 2) Theeffective VVI* pacing was lost in 17 patients (40.5%) on the 5t h post operative day and comparison of effective pacing threshold in the twogroups showed no significant difference during the same period of time (P = NS). "Ventrculo-ventrical inhibition. Conclusions: The epicardialpacing wires have little usefulness after the fifth postoperative day and should be removed by this time. In addition postoperative pacingthreshold was not affected by the decreased left ventricular function.

scholarly journals Physiotherapy following cardiac surgery: Program comparison

2018 ◽  
Vol 40 ◽  
pp. 02012
Author(s):  
D. Pulmane ◽  
A. Vetra ◽  
R. Lacis ◽  
D. Driba
Keyword(s):  
Cardiac Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Forced Expiratory Volume ◽  
Replacement Surgery ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Group 2

The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second group - modified physiotherapy – the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirography - dynamic indicators - forced vital capacity (FVC), forced expiratory volume in the 2nd second (FEV1), Tiffeneau index (FEV1 / VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: −8.25 to 4.8] and it is not statistically significant (t (155) = −0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p=0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective.

scholarly journals A possible correlation between the type of bcr-abl hybrid messenger RNA and platelet count in Philadelphia-positive chronic myelogenous leukemia [see comments]

Blood ◽  
1991 ◽  
Vol 78 (12) ◽  
pp. 3125-3127 ◽  
Author(s):  
K Inokuchi ◽  
T Inoue ◽  
A Tojo ◽  
M Futaki ◽  
K Miyake ◽  
...  
Keyword(s):  
Chronic Myelogenous Leukemia ◽  
Messenger Rna ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
Exon 2 ◽  
Initial Event ◽  
Cell Counts ◽  
Splicing Pattern ◽  
Significant Difference ◽  
White Blood Cell Counts

The Philadelphia (Ph1) chromosome, in which the hybrid bcr-abl gene is formed, is thought to be the initial event in chronic myelogenous leukemia (CML). The position of the breakpoint within the breakpoint cluster region (bcr) on Ph1 chromosome and the splicing pattern determine the species of the fused bcr-abl messenger RNA (mRNA). We tried to detect the two types of fused mRNAs in 57 chronic-phase cases of Ph1-positive CML using the polymerase chain reaction procedure (RT- PCR). The bcr exon 2/abl exon 2 fused mRNA (b2-a2) was detected in 17 patients, the bcr exon 3/abl exon 2 fused mRNA (b3-a2) was detected in 34 patients, and both types of mRNA were detected in six patients. The platelet counts of patients who expressed b3-a2 mRNA or both types were significantly higher than those of patients who expressed only b2-a2 (841.5 v 373.5 x 10(9)/L; P less than .015), although there was no significant difference in the white blood cell counts or hemoglobin. This finding suggests a possibility that the type of bcr-abl mRNA may affect the thrombopoietic activity in CML.

scholarly journals Systemic Immune Profile in Patients With CRSwNP

2019 ◽  
pp. 014556131989316
Author(s):  
Rafaela Veloso-Teles ◽  
Rui Cerejeira ◽  
Rosa Roque-Farinha ◽  
Christian von Buchwald
Keyword(s):  
Serum Levels ◽  
Atopic Disease ◽  
Differential Count ◽  
Immunological Parameters ◽  
Immune Profile ◽  
Prick Test ◽  
Cell Counts ◽  
Significant Difference ◽  
White Blood Cell Counts ◽  
Igg1 Subclass

The immune pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains obscure. Our aim was to compare humoral immunity and white blood cell counts in patients with CRSwNP and controls. A prospective case–control study was carried out in 37 patients with CRSwNP and 34 controls without CRS. Clinical data were gathered through a systematic interview. Computed tomography scan, skin prick test, spirometry, and immunological parameters (leukocyte differential count, immunoglobulin classes, and immunoglobulin [Ig] G subclasses) in serum specimens were obtained. Statistical analysis was performed using SPSS v.23. The prevalence of chronic lower respiratory diseases was greater in the CRSwNP group ( P < .001), but atopic disease had no significant difference. A significantly higher eosinophil ( P < .001) and basophil relative count ( P = .022) and a lower relative neutrophil count ( P = .013) were found among CRSwNP group. Patients with CRSwNP had higher IgG1 ( P = .022), but lower IgG2 ( P = .014) and IgG3 ( P = .018) serum levels compared to controls; IgG4, total IgG, IgA, IgM, and IgE serum levels did not differ between groups, as well as the prevalence of immunoglobulin classes or IgG subclasses deficiency. The variation observed in peripheral relative leukocyte count and the systemic IgG1 subclass shift are similar to what is known to happen in nasal polyp tissue. A unique systemic immune profile seems to be present in patients with CRSwNP.

Post-Operative Outcomes of Off-Pump Coronary Artery Bypass Surgery Patients after Topical Use of Tranexamic Acid

2017 ◽  
Vol 2 (2) ◽  
pp. 79-83
Author(s):  
Asraful Hoque ◽  
Asit Baran Adhikary ◽  
KAM Mahbub Hasan ◽  
Romena Rahman ◽  
Mauin Uddin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Tranexamic Acid ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Pericardial Cavity ◽  
Significant Difference ◽  
Opcab Surgery ◽  
Group 2 ◽  
Topical Tranexamic Acid ◽  
Group 1

Background: Postoperative mediastinal bleeding in patients undergoing cardiac surgery is still one of the most common complications. Objective: This study was intended to investigate the efficacy of topical tranexamic acid in reducing postoperative bleeding after OPCAB surgery. Methodology: This non-randomized, double blinded, clinical trial was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh during January 2014 to December 2015 for a period of two (2) years. Patients’ undergone CABG after fulfilling the inclusion and exclusion criteria was recruited for this study. They were assigned in two groups 30 patients in tranexamic acid group (Group 1) and 30 patients in placebo group (Group 2). On completion of the grafting, before closure of the sternum tranexamic acid (2.5 g/25 mL) or placebo (25 mL of saline) diluted in 100 mL of warm saline (37° C) was instilled into the pericardial cavity including the mediastinal tissues and left for 5 minutes. Then it was cleared out by wall sucker and sternum was closed. Result: There was no significant difference in baseline demographic data, basic clinical characteristics and preoperative coagulation profile between the 2 groups (P>0.05). Total mediastinal bleeding in group 1 and group 2 patients were 421.67±70.32 vs 593.33±77.38 ml (p<0.001). In case of, whole blood transfusion in group 1 and group 2 patients were 0.87±0.0.73 units and 1.77±0.57 units respectively (p<0.001). No patient required reoperation for bleeding and there was no incidence of prolonged ventilation, MI, thromboembolism, DVT or CVA in any of the patients in either group. Conclusion: In conclusion the efficacy of topical tranexamic acid is helpful for reducing postoperative bleeding after OPCAB surgery. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 79-83

scholarly journals Impact of Split Dosing the First Rituximab Infusion in Patients with High Lymphocyte Count

2021 ◽  
Vol 28 (5) ◽  
pp. 4118-4128
Author(s):  
Maude Plante ◽  
Laurence Garneau ◽  
Magali Laprise-Lachance ◽  
Pierre Lemieux ◽  
Michel Dorval
Keyword(s):  
Relative Risk ◽  
Lymphocyte Count ◽  
Adverse Reactions ◽  
Adjusted Relative Risk ◽  
Hematological Cancer ◽  
Cell Counts ◽  
Healthcare Center ◽  
Significant Difference ◽  
White Blood Cell Counts ◽  
Split Dosing

The most common adverse reactions to rituximab are infusion-related reactions (IRR). We evaluated the efficacy of split dosing the first rituximab infusion over two days to reduce IRR incidence in patients with hematological cancer and a high lymphocyte count. This is a retrospective observational study conducted in two healthcare centers in Quebec, Canada. The study enrolled patients with white blood cell counts ≥25.0 × 109/L who received their first rituximab dose for hematological cancer between December 2007 and May 2020. One healthcare center used asymmetrical split dosing, while the other used symmetrical split dosing. A total of 183 treatment episodes were collected from 143 patients. Among patients who received a fractionated dosing schedule, 42% developed an IRR from the first rituximab infusion compared with 50% for the standard protocol (adjusted relative risk, 0.89; p = 0.540). No significant difference was observed in IRR severity between either groups. However, 24% of patients who received the asymmetrical protocol developed an IRR compared to 68% for the symmetrical protocol (adjusted relative risk, 0.32; p = 0.003). These results suggest that an asymmetrical split dosing could be effective in reducing the incidence of IRR and is preferable to a symmetrical one.

The Effect of Heart Rate Variability on Exercise Training Post-Cardiac Surgery

2013 ◽  
Vol 440 ◽  
pp. 140-144
Author(s):  
Shu Cheng Lin ◽  
Ho Cheng Chen ◽  
Shu Wang Lin ◽  
Wei Chin Hong ◽  
Wei Lun Huang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiac Surgery ◽  
Exercise Training ◽  
Artery Bypass ◽  
Analysis Of Covariance ◽  
Surgery Patient ◽  
Significant Difference ◽  
Training Post ◽  
Post Cardiac Surgery

Purpose: the purpose of this study was to investigate heart rate variability on exercise training post-cardiac surgery. Method: the data collection was from the Chia-yi Christian Hospital Cardiac Surgery implementation of beating heart coronary artery bypass surgery and valve replacement patients. There were a total of 10 patients included in this study. Cardiac patients after discharge from hospital were the participation of exercise training groups (n=5), and no receiving cardiopulmonary physical therapy of patients was the home-based group (n=5). Statistics: Data analysis was conducted using the SPSS statistical software for Windows 20.0. Analysis of covariance (ANCOVA) was used as the statistical method at a significance level (α) of .05. Through statistical analysis and comparison, the results were obtained as below: In HRV time domain portion, SDNN, CV%, results were significant difference. In frequency domain portion, indices such as LF and VHF, results were significant difference. Conclusion: According to the experimental results, the heart rate variability on exercise training better than patients did not participate in sports training after cardiac surgery patient.

scholarly journals Effect of Cardiopulmonary Bypass Machine on the Platelet Function Testing.

2020 ◽  
Author(s):  
Khalid A. AlSaleh ◽  
Rashed B. AlBakr ◽  
Turki B. AlBacker ◽  
Rakan AlNazer ◽  
Abdulkareem Almomen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Platelet Function ◽  
Clinical Decision Making ◽  
Complete Blood Count ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Inverse Correlation ◽  
Platelet Dysfunction ◽  
Significant Difference

Abstract Background: Bleeding during coronary artery bypass surgery is a leading cause of mortality. Several factors have been associated with bleeding, platelet dysfunction being the most significant.Objective: to assess the effect of cardiopulmonary bypass machine (CPB) during cardiac surgery on platelet function using Platelet Function Analyzers (PFA-100), and Multiplate Electrode Aggregometry (MEA), and correlating that with a drop in Hemoglobin (Hb).Methods: Whole blood samples were collected preoperative and sixty minutes intraoperatively of different cardiac procedures utilizing (CPB) and tested for platelet function by PFA-100 and MEA. Complete blood count was measured using an automated hematology analyzer.Results: A significant difference was found between pre- and intraoperative ADP and EPI measurement in PFA-100, where preoperative PFA-ADP values displayed the ability to predict the intra-op drop in Hb (P–value 0.01, correlation coefficient 0.4699). At the same time, pre-op MEA- Ristocetin and TRAP showed an inverse correlation with an intra-op drop in Hb (-0.31 and -0.36). Conclusion: The current study reported significant changes in platelet dysfunction in cardiac surgeries with CPB, measured by two modalities PFA-100, and MEA. While PFA-100 and MEA both detected the changes in platelet dysfunction due to CPB, PFA-100 results were sensitive and positively predicted intra-op Hb drop as compared to MEA. There was a significant change in Hb one hour into the CPB, indicating that platelet transfusion might help decrease Intra- and postoperative bleeding independent of the platelet count as they are dysfunctional. PFA-100 results can be relied upon for distinction of high-risk cardiac surgery patients for bleeding and can be used for clinical decision making to improve patient outcome.

Some immunological parameters in workers occupationally exposed to n-hexane

1996 ◽  
Vol 15 (1) ◽  
pp. 56-58 ◽  
Author(s):  
A. Karakaya ◽  
B. Yücesoy ◽  
S. Burgaz ◽  
HU Sabir ◽  
AE Karakaya
Keyword(s):  
Exposed Group ◽  
Quantitative Relation ◽  
Significant Suppression ◽  
Immunological Parameters ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Significant Difference ◽  
Occupationally Exposed ◽  
White Blood Cell Counts ◽  
Two Populations

1 To estimate the quantitative relation between exposure to airborne n-hexane and various markers of immune function, 35 male workers were examined and compared with unexposed controls. 2 Urinary 2,5-hexanedione concentrations were signifi cantly higher in the exposed group than in the unexposed. 3 A significant suppression was observed in the serum immunoglobulin (IgG, IgM and IgA) levels between two populations. Also, a significant correlation was found between urinary 2,5-hexanedione concentrations and serum Ig level of the exposed group. 4 No significant difference between white blood cell counts was found in the two groups.

Sign in / Sign up

Export Citation Format

Share Document