scholarly journals Can Peroperative Neutrophil To Lymphocyte Ratio Change (Deltanlr) Be Used as a Parameter in Predicting Acute Renal Failure Following Coronary Bypass Operations With Cardiopulmonary Bypass?

2021 ◽  
Vol 24 (1) ◽  
pp. E194-E200
Author(s):  
Sefer Usta ◽  
Mustafa Abanoz
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiopulmonary Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Group 2 ◽  
Group 1

Background: Inflammation plays a significant role in the pathogenesis of many diseases as well as postoperative acute renal failure (ARF). Preoperative neutrophil to lymphocyte ratio (NLR) values have a prognostic value for postoperative ARF after cardiovascular surgeries. Methods: Patients who underwent elective coronary artery bypass graft (CABG) with cardiopulmonary bypass in our clinic between December 15, 2015 and December 15, 2019, retrospectively were included in this study. Patients who did not develop ARF after the operation were categorized as Group 1, and patients who did were included in Group 2. NLR was calculated from the hemograms during three periods (Preoperative (Pre), Postcardiotomy (Pc), Postoperative Day 1 (Po1). DeltaNLR1 (PcNLR- PreNLR) and DeltaNLR2 (Po1NLR-PreNLR) values were obtained from these calculated values. Results: The mean ages of patients in Group 1 (N = 274) and Group 2 (N = 61) were 60 ± 9.1 years and 67.7 ± 9.8 years, respectively (P < .001). In the multivariate analysis, being over 65 years of age (Odds ratio [OR]: 1.074, 95% confidence interval [CI]: 1.012-1.194, P = .030), postoperative inotropic need (OR: 0.678, CI 95%: 0.395-0.819, P = .021), increased blood product use (OR: 0.916, CI 95%: 0.779-0.986, P = .034), preoperative creatinine increase (OR: 1.974, CI 95%: 1.389-4.224, P = .007), PcNLR (OR : 1.988, CI 95%: 1.765-3.774, P <.001), Po1NLR (OR: 1.090, CI 95%: 1.007-2.116, P = .028), DeltaNLR1 (OR: 3.090, CI 95%: 1.698-6.430, P < .001) and DeltaNLR2 (OR: 1.676, CI 95%: 1.322-2.764, P = .003) were identified as independent predictors for predicting postoperative ARF. Conclusion: In this study, we have shown that peroperative NLR changes can be used as an effective parameter to predict ARF developing following CABG operations.

Preoperative Platelet to Lymphocyte Ratio Is Associated with Early Morbidity and Mortality after Coronary Artery Bypass Grafting

2015 ◽  
Vol 18 (6) ◽  
pp. 255 ◽  
Author(s):  
Hüseyin Şaşkın ◽  
Çagrı Düzyol ◽  
Kazım Serhan Özcan ◽  
Rezan Aksoy ◽  
Mustafa Idiz
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Platelet To Lymphocyte Ratio ◽  
Artery Bypass Grafting ◽  
Lymphocyte Ratio ◽  
Group 2 ◽  
Group 1

<strong>Objective:</strong> To investigate the association of platelet to lymphocyte ratio to mortality and morbidity after coronary artery bypass grafting operation.<br /><strong>Methods:</strong> We evaluated records of 916 patients who underwent coronary artery bypass grafting operation between January 2009 and May 2014 retrospectively. Patients were grouped as Group 1 (n = 604) if the platelet to lymphocyte ratio was above 142 and Group 2 (n = 312) if platelet to lymphocyte ratio was below 142.<br /><strong>Results:</strong> The number of patients who developed a neurologic event during the hospital stay and in the first postoperative month was 7 (1.2%) in Group 1 and 12 (3.8%) in Group 2 for which the difference was statistically significant (P = .007). Early term mortality occurred in 3 patients (0.5%) in Group 1 and in 10 patients (3.2%) in Group 2 for which the difference was statistically highly significant (P = .001). In univariate and multivariate regression analysis, the preoperative platelet to lymphocyte ratio was determined as an independent risk factor for occurrence of atrial fibrillation in the early postoperative period, reoperation for sternum dehiscence, occurrence of a neurologic event, prolonged stay in the hospital and mortality.<br /><strong>Conclusion:</strong> In this study, elevated levels of platelet to lymphocyte ratio were associated with mortality and morbidity after coronary artery bypass grafting operation.

The neutrophil to lymphocyte ratio in patients supported with extracorporeal membrane oxygenation

Perfusion ◽  
2018 ◽  
Vol 33 (7) ◽  
pp. 562-567 ◽  
Author(s):  
Gardner Yost ◽  
Geetha Bhat ◽  
Patroklos Pappas ◽  
Antone Tatooles
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Myocardial Damage ◽  
Neutrophil Infiltration ◽  
Neutrophil To Lymphocyte Ratio ◽  
Study Cohort ◽  
Lymphocyte Ratio ◽  
Membrane Oxygenation ◽  
Wide Range ◽  
Group 2 ◽  
Group 1

Introduction: The neutrophil to lymphocyte ratio (NLR) has proven to be a robust predictor of mortality in a wide range of cardiovascular diseases. This study investigated the predictive value of the NLR in patients supported by extracorporeal membrane oxygenation (ECMO) systems. Methods: This study included 107 patients who underwent ECMO implantation for cardiogenic shock. Median preoperative NLR was used to divide the cohort, with Group 1 NLR <14.2 and Group 2 with NLR ≥14.2. Survival, the primary outcome, was compared between groups. Results: The study cohort was composed of 64 (60%) males with an average age 53.1 ± 14.9 years. Patients in Group 1 had an average NLR of 7.5 ± 3.5 compared to 27.1 ± 19.9 in Group 2. Additionally, those in Group 2 had significantly higher preoperative blood urea nitrogen (BUN) and age. Survival analysis indicated a thirty-day survival of 56.2%, with significantly worsened mortality in patients with NLR greater than 14.2, p=0.047. Discussion: Our study shows the NLR has prognostic value in patients undergoing ECMO implantation. Leukocytes are known contributors to myocardial damage and neutrophil infiltration is associated with damage caused by myocardial ischemia.

scholarly journals Features and hospital outcomes of coronary artery bypass grafting in patients with calcification of target coronary arteries

2020 ◽  
Vol 25 (8) ◽  
pp. 3687
Author(s):  
R. S. Akchurin ◽  
A. A. Shiryaev ◽  
V. P. Vasiliev ◽  
D. M. Galyautdinov ◽  
E. E. Vlasova ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Early Results ◽  
Group 2 ◽  
Group 1

Aim. To compare strategy and early results of coronary artery bypass grafting (CABG) in patients with and without calcification of target coronary arteries (TCA).Material and methods. The prospective study analyzed the data of patients (n=462) who underwent elective isolated CABG in 2017-2018 using cardiopulmonary bypass and microsurgery. Two groups were distinguished: group 1 — patients with TCA calcification (n=108), group 2 — patients without TCA calcification (n=354). In cases where the distal coronary artery lesion did not allow standard bypass grafting, additional complex anastomoses were provided. A comparison of intraoperative parameters and early results of CABG was carried out.Results. In groups 1 and 2, the revascularization index did not differ significantly and was 4,5 and 4,3, respectively. The frequency of complex surgical interventions in group 1 was higher: for example, ‘Y’ grafts were used in groups 1 and 2, respectively, in 32% (35/108) and 12% (44/354), p<0,05; sequential anastomoses in 14% (15/108) and 7% (26/354), p<0,05; prolonged patch-angioplasty — in 21% (23/108) and 5% (16/354), p<0,05; anastomoses with arteries <1,5 mm in diameter — in 33% (36/108) and 4% (14/354), p<0,05; coronary endarterectomy in 17% (18/108) and 5% (16/354), p<0,05, respectively. The duration of cardiopulmonary bypass was longer in group 1. At the same time, the hospital clinical results did not differ significantly: mortality was not registered; the frequency of perioperative myocardial infarction was 1,8% (group 1) and 1,1% (group 2); the need for inotropes, frequency of arrhythmia, length of stay in the intensive care unit and hospital were similar; there were no cases of in-hospital angina recurrence.Conclusion. CABG in patients with calcification of TCA is associated with surgical challenges and need for complex adjunct techniques. Nevertheless, complete surgical revascularization is real in these cases, and the hospital results are comparable to those in patients without calcification.

scholarly journals Acute Renal Failure in Cardiac Surgical Patients, Potentiated by Gentamicin and Calcium

1996 ◽  
Vol 24 (6) ◽  
pp. 647-650 ◽  
Author(s):  
M. Schneider ◽  
S. Valentine ◽  
G. M. Clarke ◽  
M. A. J. Newman ◽  
J. Peacock
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Retrospective Study ◽  
Coronary Artery ◽  
Calcium Concentration ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Surgical Patients ◽  
Artery Bypass Graft ◽  
High Calcium

A retrospective study in coronary artery bypass graft patients was undertaken to assess the effect of gentamicin and a bypass prime with a high calcium on the incidence of renal failure. Patients who received both Haemaccel (polygeline, Hoechst Marion Roussel) (calcium concentration 6.25 mmol/l) in the bypass prime and gentamicin perioperatively had a higher incidence of renal failure compared with those who received only Haemaccel (P=0.005), only gentamicin (P=0.002) or neither (P=0.0001). We suggest that the combination be avoided in this group of patients.

Abstract 18855: Outcomes after Coronary Artery Bypass Graft Surgery in Patients Treated with Thoracic Radiotherapy for Cancer

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jackson J Liang ◽  
Terence T Sio ◽  
John M Stulak ◽  
Ryan J Lennon ◽  
Abhiram Prasad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Triple Vessel Disease ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction: Thoracic external beam radiation therapy (XRT) for cancer is associated with a multitude of long-term cardiotoxic side effects. Previous studies have suggested worse outcomes in XRT-treated cancer survivors who undergo revascularization with CABG, but sample sizes have been small. In addition, XRT after CABG is thought to portend decreased patency and survival. We aimed to examine outcomes after CABG in patients with XRT compared with to those without XRT. Methods: We identified all patients who were treated with both CABG (between 1999 and 2013) and curative thoracic XRT for cancer (between 1971 and 2013) (>30 Gray). Baseline clinical characteristics and comorbidities at time of CABG, as well as long-term outcomes after CABG and XRT were compared with propensity matched control cohorts. Results: A total of 38 patients underwent CABG following XRT [Group 1] (mean age 67.9, 63% female) and 43 patients underwent XRT after CABG [Group 2] (mean age 69.3, 63% female). Compared with propensity-matched controls (Group 1: n=141; Group 2: n=167), baseline clinical and demographic characteristics between cases and controls were similar in both groups, except a lower incidence of triple vessel disease in XRT cases in Group 2 (64 vs 80%, p=0.02). For Group 1, there was no significant difference in all-cause survival in long-term follow-up after CABG (Fig. 1, p=0.72). Meanwhile, Group 2 cases had significantly higher all-cause mortality following XRT (Fig. 2, p<0.001). Conclusions: Patients previously treated with thoracic XRT who subsequently undergo CABG for coronary artery disease have a similar overall mortality rate compared to patients without prior XRT. This suggests that CABG is an effective method of revascularization in these patients. The higher mortality rates in CABG patients who subsequently develop disease requiring thoracic XRT is likely due to oncologic rather than cardiovascular causes, but more data are necessary to evaluate this finding.

Is Carotid Artery Stenting an Alternative to Simultaneous Carotid Endarterectomy Performed for Carotid Artery Stenosis in Patients Undergoing Isolated Coronary Bypass Surgery?

2015 ◽  
Vol 18 (5) ◽  
pp. 211 ◽  
Author(s):  
Hüseyin Şaşkın ◽  
Cagri Duzyol ◽  
Kazım Serhan Ozcan ◽  
Rezan Aksoy ◽  
Mustafa Idiz
Keyword(s):  
Myocardial Infarction ◽  
Cardiopulmonary Bypass ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Group 2 ◽  
Group 1

<strong>Background:</strong> Treatment method in patients with coronary artery disease undergoing coronary bypass surgery with accompanying carotid artery disease is still a hot topic among clinicians. This study is designed to investigate if there is an effect on myocardial infarction, cerebrovascular events and mortality during postoperative period of simultaneous carotid endarterectomy with coronary bypass surgery compared to staged carotid artery stenting before coronary bypass surgery.<br /><strong>Methods:</strong> 102 patients (79 male, 23 female) who underwent simultaneous carotid endarterectomy with coronary bypass surgery or staged carotid artery stenting with coronary bypass surgery in the same center with the same surgical team were divided into 2 groups and retrospectively reviewed. Group 1 (n = 71) had coronary artery bypass surgery under general anesthesia with carotid endarterectomy followed by cardiopulmonary bypass with heart team decision. Again with heart team decision, Group 2 (n=31), patients at high-risk for carotid endarterectomy (serious cardiac disease, severe chronic obstructive pulmonary disease, superiorly located lesions), received carotid artery stents in the interventional radiology department and a month later, coronary bypass surgery was performed with cardiopulmonary bypass under elective conditions.<br /><strong>Results:</strong> Median of patient age was 67.5 (45-83) years. Twenty-two patients (31%) in Group 1 and 19 patients (56.3%) in Group 2 had neurological symptoms, which was statistically significant (P = .004). During the early postoperative term, three patients (4.2%) in Group 1 and two patients (6.5%) in Group 2 died (P = .64). Five patients (7.0%) in Group 1 and two patients (6.5%) in Group 2 developed neurological symptoms during the early postoperative term <br />(P &gt; .05). Likewise, two patients (2.8%) in Group 1 and five patients (16.1%) in Group 2 developed myocardial infarction following carotid intervention (P = .03).<br /><strong>Conclusions:</strong> In patients with significant carotid artery stenosis undergoing coronary bypass surgery with cardiopulmonary bypass, in comparison to simultaneous carotid endarterectomy with coronary bypass technique and carotid artery stenting followed with coronary bypass technique showed no difference in combined endpoint (postoperative myocardial infarction, neurological events, and mortality). With proper tools and according to the decisions made by heart teams, both management strategies can be safely performed.<br /><br />

scholarly journals Does High Thoracic Epidural Analgesia with Levobupivacaine Preserve Myocardium? A Prospective Randomized Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Serife Gokbulut Bektas ◽  
Sema Turan ◽  
Umit Karadeniz ◽  
Burcin Ozturk ◽  
Soner Yavas ◽  
...  
Keyword(s):  
Troponin I ◽  
Randomized Study ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Thoracic Epidural ◽  
Haemodynamic Parameters ◽  
Total Antioxidant ◽  
Group 2 ◽  
High Thoracic Epidural ◽  
Group 1

Background. Our study aimed to compare HTEA and intravenous patient-controlled analgesia (PCA) in patients undergoing coronary bypass graft surgery (CABG), based on haemodynamic parameters and myocardial functions.Materials and Methods. The study included 34 patients that were scheduled for elective CABG, who were randomly divided into 2 groups. Anesthesia was induced and maintained with total intravenous anesthesia in both groups while intravenous PCA with morphine was administered in Group 1 and infusion of levobupivacaine was administered from the beginning of the anesthesia in Group 2 by thoracic epidural catheter. Blood samples were obtained presurgically, at 6 and 24 hours after surgery for troponin I, creatinine kinase-MB (CK-MB), total antioxidant capacity, and malondialdehyde. Postoperative pain was evaluated every 4 hours until 24 hours via VAS.Results. There were significant differences in troponin I or CK-MB values between the groups at postsurgery 6 h and 24 h. Heart rate and mean arterial pressure in Group 1 were significantly higher than in Group 2 at all measurements. Cardiac index in Group 2 was significantly higher than in Group 1 at all measurements.Conclusion. Patients that underwent CABG and received HTEA had better myocardial function and perioperative haemodynamic parameters than those who did not receive HTEA.

Cardiac Tamponade After Removal of Temporary Pacer Wires

2012 ◽  
Vol 21 (6) ◽  
pp. 432-440 ◽  
Author(s):  
Linda Mahon ◽  
James F. Bena ◽  
Shannon M. Morrison ◽  
Nancy M. Albert
Keyword(s):  
Cardiac Tamponade ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Vital Signs ◽  
Smoking History ◽  
Initial Surgery ◽  
Temporary Pacemaker ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background After removal of temporary pacemaker wires, nurses measure vital signs frequently to assess for cardiac tamponade; however, evidence for this procedure is limited. Objectives To determine risk factors for cardiac tamponade after temporary pacemaker wire removal. Methods Retrospective review of data for coronary artery bypass graft and valve surgery (N = 23 717) performed from January 1999 to December 2008. Patients were categorized by reason for reoperation: bleeding less than 3 days after initial surgery (n = 812, group 1), bleeding 3 days or more after index surgery but not for cardiac tamponade (n = 171, group 2), bleeding 3 days or more after index surgery for cardiac tamponade after temporary pacemaker wire removal (n = 23, group 3), and no reoperation (n = 22 711, group 4). Results Less than 1% (9.7 cases/10 000) of patients required reoperation for cardiac tamponade after removal of temporary pacer wires. Of patient-related factors studied, only smoking history differed for group 3 vs group 1 (P = .03) and group 2 (P = .01). Of vital sign changes, 1 patient (4%) had tachycardia and 3 patients had cardiac arrest, but only 1 of the 3 had hypotension before the arrest. In total, 12 patients (52%) had hypotension; however, it was mild or intermittent in 5 cases, and did not occur within the 4 hours after wire removal in 3 cases. After removal of temporary pacing wires, common early signs/symptoms were bleeding (26%) and dyspnea (26%). Other documented changes were pressure in the chest, diaphoresis, cold and clammy skin, dizziness, and mental status changes. Conclusions Tamponade related to pacer wire removal was rare and not consistently associated with changes in vital signs. Dyspnea, bleeding, and other factors may indicate early onset of cardiac tamponade after removal of temporary pacer wires.

scholarly journals The Differences requency of Lower Extremities Muscle Strength and Functional Capacity on the difference Supervised Exercise Frequency in Post Cardiac Bypass Graft Surgery

2017 ◽  
Vol 6 (01) ◽  
pp. 34
Author(s):  
Dewi Nur Fiana ◽  
Sunaryo B Sastradimaja ◽  
Badai Bhatara Tiksnadi
Keyword(s):  
Muscle Strength ◽  
Functional Capacity ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Optimal Time ◽  
Supervised Exercise ◽  
Cardiac Bypass ◽  
Group 2 ◽  
Adaptation Phase ◽  
Group 1

Introduction: The optimal time to do exercise in adaptation phase was 36 to 72 hours. Patients with cardiovasculardisease may have an extended adaptation phase to 96 hours and above. It was necessary to know the mosteffective supervised exercise in phase II cardiac rehabilitation between three times/week for 36-hours, and twotimes/week for 96-hours.Method: This study involved 30 patients post-Cardiac Bypass Graft Surgery (CABG) participated in phase IIcardiac rehabilitation at Hasan Sadikin Hospital, Bandung. Subjects divided into two groups; that have done twotimes/week (group 1) and three times/week of the supervised exercised (group 2) for four weeks. The Lowerextremity muscle strength (LEMS) examined by conducting a chair standing test, while functional capacity (FC)evaluated by the 6-minute walking test.Result:Subjects were 58,54±5,90 y.o (group 1) and 61,66±6,36(group 2). The FC and the LEMS before andafter exercise were 10,98 and 15,96 ml/kg(<0,001) on the FC; 7,8 and 12,9 times (<0,001) on the LEMS in group1, besides 9,6 and 14,9 ml/kg(<0,001) on the FC; 8,7 and 13,0 times (<0,001) on group 2,Conclusion. Both groups have increased of the FC and the LEMS after exercise. There were no differencebetween 2 times and 3 times of supervised exercises a week on post CABG pasientsKeywords: coronary artery bypass graft, the frequency of exercise, functional capacity, muscle strength =

Does Mild Renal Failure Affect Coronary Flow Reserve after Coronary Artery Bypass Graft Surgery?

2014 ◽  
Vol 17 (1) ◽  
pp. 18 ◽  
Author(s):  
Murat Günday ◽  
Özgür Çiftçi ◽  
Mustafa Çalışkan ◽  
Mehmet Özülkü ◽  
Hakan Bingöl ◽  
...  
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Creatinine Clearance ◽  
Artery Bypass ◽  
Estimated Gfr ◽  
Flow Reserve ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

<p><strong>Introduction</strong>: There are only a limited number of studies on the link between mild renal failure and coronary artery disease. The purpose of this study is to investigate the effects of mild renal failure on the distal vascular bed by measuring the coronary flow reserve (CFR) in transthoracic echocar-diography after coronary artery bypass grafting (CABG)</p><p><strong>Methods</strong>: The study included 52 consecutive patients (12 women and 40 men) who had undergone uncomplicated CABG. The patients were divided into 2 groups. Group 1 included patients with a preoperative glomerular filtra-tion rate (GFR) of 60-90 (mild renal failure), and group 2 included those with a GFR &gt;90. The CFR measurements were carried out through a second harmonic transthoracic Doppler echocardiography.</p><p><strong>Results</strong>: The mean age was 60.08 ± 1.56 years in group 1 and 60.33 ± 1.19 in group 2. The mean preoperative CFR was 1.79 ± 0.06 in group 1 and 2.05 ± 0.09 in group 2. The mean postoperative CFR was 2.09 ± 0.08 in group 1 and 2.37 ± 0.06 in group 2. There was a statistically significant difference between the 2 groups as to preoperative creatinine clearance, preopera-tive estimated GFR, postoperative day 7 creatinine clearance, postoperative month 6 creatinine clearance, postoperative day 7 estimated GFR, postoperative month 6 estimated GFR, pre-operative CFR, and postoperative CFR (P &lt; .05). After bypass surgery, there was a significant increase in the mean postopera-tive CFR, when compared with the mean preoperative CFR (P = .001).</p><p><strong>Conclusion</strong>: In our study, we detected a decrease in CFR in patients with mild renal failure. We believe that in patients undergoing CABG for coronary artery disease, mild renal failure can produce adverse effects due to deterioration of the microvascular bed.</p>

Sign in / Sign up

Export Citation Format

Share Document