scholarly journals Changes of the Serum Antibiotic Levels During Open Heart Surgery (ceftazidim, ciprofloxacin, clindamycin)

2000 ◽  
Vol 43 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Vladimír Lonský ◽  
Jan Dominik ◽  
Jiří Manďák ◽  
Eugenie Pozlerová ◽  
Miroslav Hejzlar ◽  
...  
Keyword(s):  
Time Course ◽  
Heart Surgery ◽  
Left Internal Mammary Artery ◽  
Open Heart Surgery ◽  
Sharp Decrease ◽  
Serum Levels ◽  
Skin Incision ◽  
Anesthesia Induction ◽  
Open Heart ◽  
Serum Concentrations

Background: Wound, mediastinal and intracardiac infections are still very serious complications of open-heart surgey. The incidence of it is still in the range of 0.4%-5%. The aims of our study were to assess the adequacy of regimen using ceftazidim (CTZ), ciprofloxacin (CPF) and clindamycin (CLIN) as prophylactic antibiotics and to verify whether cardiopulmonary bypass (CPB) can modify the time of antibiotic serum concentrations. That is why the serum levels of them were measured during open heart procedures. Methods: The prospective study comprised 75 consequent coronary patients randomized in to three groups receiving 1 g of CTZ or 400 mg of CPF or 900 mg of CLIN i.v. with anesthesia induction. Routine coronary surgery with left internal mammary artery harvesting, moderate body hypothermic (30 °C) CPB with crystaloid cardioplegia was performed. Serum antibiotic levels were determined before application, with skin incision, prior CPB induction, after cardioplegia infusion, every 20 minutes of CPB, prior end of CPB, in time of chest closure. Conventional cylinder – plate microbiological assay was used for antibiotic levelmeasurement. Results: All serum antibiotic concentrations showed a sharp decrease immediately after starting CPB and lasted until CPB ended. After initiating of CPB after cardioplegia administration serum concentrations of CTZ (105 min after initial dose) decreased by, on average 55%, CPF (97 min) by 42% and CLIN (116 min) by 78%. Conclusion: CPB can modify the time course of antibiotic serum concentrations. The serum levels of CTZ at the end of the longest procedures were found to be below the MICs for some of the suspected pathogens. We recommend to use higher antibiotic doses for prophylaxis and to administer the second dose with protamin sulphate to obtain maximum concentration in newly formed blood clots.

Serum levels of gastric acid stimulating factors in children undergoing open heart surgery

2009 ◽  
Author(s):  
Christian Breuer ◽  
Manfred Rauh ◽  
Stefan Zink ◽  
Andreas Koch ◽  
Michael Weyand ◽  
...  
Keyword(s):  
Gastric Acid ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Serum Levels ◽  
Open Heart

Soluble VCAM-1 is a very early marker of endothelial cell activation in cardiopulmonary bypass

Perfusion ◽  
2002 ◽  
Vol 17 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Tonje Katrine Andresen ◽  
Jan L Svennevig ◽  
Vibeke Videm
Keyword(s):  
Endothelial Cells ◽  
Cardiopulmonary Bypass ◽  
Adhesion Molecules ◽  
Time Course ◽  
Heart Surgery ◽  
Culture Media ◽  
Open Heart Surgery ◽  
Endothelial Activation ◽  
Open Heart ◽  
Early Marker

Cardiopulmonary bypass causes a systemic inflammatory reaction, which leads to endothelial activation with increased expression of adhesion molecules. The study aim was to test whether activated endothelial cells secrete measurable amounts of soluble adhesion molecules during the time course of routine heart surgery, and whether these markers correlate with cellular activation responses. Endothelial cells from human umbilical cords were cultured by standard methods and stimulated with endotoxin. After 2 h, the expression of membrane-bound E-selectin on the cells had increased significantly ( p= 0.04), whereas soluble VCAM-1 (sVCAM-1) had increased significantly in the culture media ( p= 0.03). In agreement with these findings, sVCAM-1 increased from 399 ng/ml (median) to 581 ng/ml within 3 h postoperatively in sera from 11 patients undergoing open heart surgery ( p= 0.003). sVCAM-1, therefore, may be suitable as an early marker of endothelial activation related to the systemic inflammation after open heart surgery. The clinical significance of sVCAM-1 measurements must be further evaluated in future patient studies.

Time Course of Oxidative Stress During Open-Heart Surgery

1995 ◽  
Vol 29 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Joel Starkopf ◽  
Kersti Zilmer ◽  
Tiiu Vihalemm ◽  
Tiiu Kullisaar ◽  
Mihkel Zilmer ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Time Course ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart

scholarly journals Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
A. Thaler ◽  
H. Kanety ◽  
T. Avni ◽  
D. Mishali ◽  
R. Hemi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Time Course ◽  
Inflammatory Process ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Pediatric Intensive Care ◽  
Open Heart ◽  
Endocrine Organ ◽  
Reactive Protein ◽  
Inotropic Score

Background. Adipose tissue is an important endocrine organ that secretes cytokines, including adiponectin, levels of which are negatively correlated with the severity of the inflammatory process.Aim. To assess the time course of adiponectin levels following open heart surgery with cardiopulmonary bypass and its correlation with early postoperative outcomes.Materials and Methods. Blood samples were obtained from 24 children undergoing cardiac surgery and analyzed for adiponectin, C-reactive protein, and other inflammatory markers.Results. Baseline adiponectin levels were negatively correlated with patients’ preoperative weight and age. Postoperative adiponectin levels decreased compared to baseline () and correlated negatively with duration of cardiopulmonary bypass (, ), length of stay in the pediatric intensive care unit (, ), and the inotropic score (, ). Adiponectin levels were positively correlated with sVCAM 1 levels; however, there was no correlation between adiponectin levels and sP selectin, tPA, MCP1, and sCD40.Conclusions. The inflammatory response after open heart surgery with cardiopulmonary bypass is associated with a reduction in adiponectin levels. Prolonged or more complicated surgery induced a more substantial inflammatory process characterized by a significant reduction in adiponectin levels over time and a delayed return to baseline levels.

scholarly journals Penetration of teicoplanin into heart valves and subcutaneous and muscle tissues of patients undergoing open-heart surgery.

1997 ◽  
Vol 41 (11) ◽  
pp. 2559-2561 ◽  
Author(s):  
U K Frank ◽  
E Schmidt-Eisenlohr ◽  
D Mlangeni ◽  
M Schindler ◽  
A Hoh ◽  
...  
Keyword(s):  
Heart Valves ◽  
Heart Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Open Heart Surgery ◽  
Wound Infections ◽  
Open Heart ◽  
Serum Concentrations ◽  
Coagulase Negative Staphylococci ◽  
Muscle Tissues ◽  
Subcutaneous Tissues

Penetration of teicoplanin into serum, heart valves, and subcutaneous and muscle tissues was determined in 22 patients undergoing open-heart surgery. Each patient received 12 mg of teicoplanin per kg of body weight as a 30-min intravenous infusion preoperatively. Within 10 h, serum concentrations of teicoplanin declined from 43.1 to 2.8 microg/ml. Teicoplanin concentrations in subcutaneous tissues reached their peak of 9.2 microg/g after 2 to 3 h and decreased slowly to 2.3 microg/g after 9 to 10 h. Concentrations in muscle decreased from 8.7 microg/g to nondetectable levels. Teicoplanin concentrations in cardiac valvular tissue reached their peak of 6.1 microg/g and decreased thereafter to 1.7 microg/g. Teicoplanin concentrations in heart valves were high enough to inhibit methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, which are known to cause postoperative wound infections and infective endocarditis.

A Comparison of the Serum Concentration Time-Curves of Amikacin-Administered Patients before and after Open Heart Surgery

1994 ◽  
Vol 22 (1) ◽  
pp. 33-39 ◽  
Author(s):  
H Guven ◽  
O Oto ◽  
U Acikel ◽  
S Gidener ◽  
S Apaydin ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Heart Surgery ◽  
Cardiovascular Surgery ◽  
Open Heart Surgery ◽  
Serum Levels ◽  
Open Heart ◽  
Concentration Time ◽  
Before And After ◽  
Surgery Department ◽  
Dosing Intervals

The effects of open heart surgery on amikacin concentration time-curves were investigated in eight patients who were scheduled for open heart surgery at a Thoracic and Cardiovascular Surgery Department. A 500 mg single dose of amikacin was administered parenterally to the volunteers pre- and postoperatively and the serum concentration time-curves were compared. Serum amikacin levels after pre-operative intramuscular (IM) administration did not reach therapeutic values. By comparison, preoperative and postoperative IM or intravenously (IV) administration resulted in therapeutic serum amikacin levels. It was concluded that IM administration preoperatively was not appropriate. Serum levels of amikacin were also shown to fall below therapeutic values 8 h after administration. It is recommended that dosing intervals with amikacin should not exceed 8 h.

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