scholarly journals N-Terminal Pro-B-Type Natriuretic Peptide as a Predictor of Adverse Outcomes After Off-Pump Coronary Artery Bypass Surgery: A Prospective Study

2021 ◽  
Vol 24 (6) ◽  
pp. E935-E939
Author(s):  
Mohamed Fawzy Abdel-Aleem ◽  
Ibrahim Ahmed Elsedeeq ◽  
Gamal Hamid Ahmed ◽  
Tarek El- Tawil ◽  
Amal Rizk ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Artery Bypass ◽  
Adverse Outcomes ◽  
Low Cardiac Output ◽  
Off Pump ◽  
Postoperative Myocardial Infarction ◽  
The Mean ◽  
Pump Coronary Artery Bypass

Background: The strength of association between preoperative natriuretic peptide levels and adverse outcomes after cardiac surgery recently has been studied in different research, but results still are diversely variable. Methods: Sixty-five consecutive patients undergoing elective off-pump coronary artery bypass grafting prospectively were recruited. Preoperative levels of NTproBNP were measured in venous blood samples collected before induction of anesthesia. Results: The average age was 57.62 ± 7.21. Of the patients, 86.15% were male. Euro-scoreII averaged 1.76 ± 0.34. The mean preoperative NTproBNP levels were 312.41 ± 329.93 pg/mL. Only two patients died (3%). Three patients required prolonged mechanical ventilation (4.6%). Four patients (6%) suffered from new onset postoperative AF. Five patients (7.6%) had low cardiac output, of which three needed IABP, and four patients (6%) had postoperative myocardial infarction. The mean ICU stay was 3.37 ± 0.84 days, and the mean hospital stay was 6.38 ± 1.3 days. There were no significant differences in preoperative NTproBNP levels in patients who had or didn’t have any of the postoperative complications or in-hospital mortality (P > .05). Conclusion: Our study showed no significant correlation between preoperative NTproBNP levels and postoperative low cardiac output, atrial fibrillation, postoperative myocardial infarction, length of ICU stay, prolonged mechanical ventilation, length of hospital stay as well as in-hospital mortality following elective off-pump CABG. Therefore, more prospective specific studies are needed to delineate the role of preoperative natriuretic peptides as significant predictors of poor outcomes after CABG surgery.

scholarly journals Predictors of prolonged mechanical ventilation following aorta no-touch off-pump coronary artery bypass surgery

2007 ◽  
Vol 32 (3) ◽  
pp. 488-492 ◽  
Author(s):  
Sotirios N. Prapas ◽  
Ioannis A. Panagiotopoulos ◽  
Ashraf Hamed Abdelsalam ◽  
Vasilios N. Kotsis ◽  
Dimitrios A. Protogeros ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Prolonged Mechanical Ventilation ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

scholarly journals Influence of Body Temperature on Bispectral Index-Guided Anesthetic Management in Off-Pump Coronary Artery Bypass Grafting

2020 ◽  
Vol 4 (02) ◽  
pp. 079-085
Author(s):  
Muralidhar Kanchi ◽  
Priya Nair ◽  
Rudresh Manjunath ◽  
Kumar Belani
Keyword(s):  
Coronary Artery ◽  
Body Temperature ◽  
Artery Bypass ◽  
Anesthetic Depth ◽  
Off Pump ◽  
Anesthetic Concentration ◽  
The Mean ◽  
Anesthetic Requirement ◽  
Pump Coronary Artery Bypass ◽  
End Tidal

Abstract Background Perioperative hypothermia is not uncommon in surgical patients due to anesthetic-induced inhibition of thermoregulatory mechanisms and exposure of patients to cold environment in the operating rooms. Core temperature reduction up to 35°C is often seen in off-pump coronary artery bypass graft (OP-CABG) surgery. Anesthetic depth can be monitored by using bispectral (BIS) index. The present study was performed to evaluate the influence of mild hypothermia on the anesthetic depth using BIS monitoring and correlation of BIS with end-tidal anesthetic concentration at varying temperatures during OP-CABG. Materials and Methods In a prospective observational study design in a tertiary care teaching hospital, patients who underwent elective OP-CABG under endotracheal general anesthesia, were included in the study. Standard technique of anesthesia was followed. BIS, nasopharyngeal temperature, and end-tidal anesthetic concentration of inhaled isoflurane was recorded every 10 minutes. The BIS was adjusted to between 45 and 50 during surgery. Results There were 40 patients who underwent OP-CABG during the study period. The mean age was 51.2 ± 8.7 years, mean body mass index 29.8 ± 2.2, and mean left ventricular ejection fraction was 55.4 ± 4.2%. Anesthetic requirement as guided by BIS between 45 and 50 correlated linearly with core body temperature (r = 0.999; p < 0.001). The mean decrease in the body temperature at the end of 300 minutes was 2.2°C with a mean decrease in end-tidal anesthetic concentration of 0.29%. The reduction in end-tidal anesthetic concentration per degree decrease in temperature was 0.13%. None of the patients reported intraoperative recall. Conclusion In this study, BIS monitoring was used to guide the delivery concentration of inhaled anesthetic using a targeted range of 45 to 50. BIS monitoring allowed the appropriate reduction of anesthetic dosing requirements in patients undergoing OP-CABG without risk of awareness. There was a significant reduction in anesthetic requirements associated with reduction of core temperature. The routine use of BIS is recommended in OP-CABG to titrate anesthetic requirement during occurrence of hypothermia and facilitate fast-track anesthesia in this patient population.

scholarly journals Prophylactic Application of an Intra-Aortic Balloon Pump in High-Risk Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

Cardiology ◽  
2015 ◽  
Vol 131 (2) ◽  
pp. 109-115 ◽  
Author(s):  
WenJun Ding ◽  
Qiang Ji ◽  
Qiang Wei ◽  
YunQing Shi ◽  
RunHua Ma ◽  
...  
Keyword(s):  
High Risk ◽  
Artery Bypass ◽  
Control Group ◽  
Bypass Grafting ◽  
Surgical Mortality ◽  
Low Cardiac Output ◽  
Off Pump ◽  
High Risk Patients ◽  
Risk Patients ◽  
Pump Coronary Artery Bypass

Background: An intra-aortic balloon pump (IABP) is the most commonly used circulatory assist device in cardiac surgery. We hypothesized that prophylactic application of an IABP improves early clinical outcome of high-risk patients undergoing scheduled off-pump coronary artery bypass grafting (OPCABG). Methods: From January 2010 to December 2013, hemodynamically stable, high-risk patients undergoing scheduled OPCABG with preincision use of an IABP were recruited to the IABP group. Using the propensity score-matching method, every patient in the IABP group was matched with another patient (the control group) with a similar propensity score who received an IABP on an as-needed basis during or after OPCABG. Surgical mortality and major morbidity rates were compared between groups. Results: A total of 116 patient pairs were included in this study. In patients in the IABP group, postoperative low cardiac output and respiratory as well as renal failure were less frequent, intensive care unit stay was shorter, and surgical mortality was lower compared to patients in the control group. In multivariate logistic regression, timing of IABP implantation, as an independent risk factor, was associated with postoperative low cardiac output (OR = 2.02, 95% CI 1.28-5.76), respiratory failure (OR = 1.86, 95% CI 1.19-4.27), renal failure (OR = 2.96, 95% CI 1.51-6.63) and surgical mortality (OR = 2.45, 95% CI 1.42-6.07). Conclusions: Prophylactic application of an IABP improves postoperative cardiac performance, reduces respiratory and renal complications, and consequently lowers surgical mortality in high-risk patients undergoing scheduled OPCABG.

Preoperative intra-aortic balloon pump inserted in acute myocardial infarction patients without cardiogenic shock undergoing surgical coronary revascularization

Perfusion ◽  
2019 ◽  
Vol 35 (2) ◽  
pp. 145-153
Author(s):  
Feng Yang ◽  
Liangshan Wang ◽  
Dengbang Hou ◽  
Jinhong Wang ◽  
Xiaomeng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Intra Aortic Balloon Pump ◽  
Pump Coronary Artery Bypass

Objectives: The benefit of preoperative intra-aortic balloon pump implantation in high-risk cardiac surgery patients is still debated. The role of preoperative intra-aortic balloon pump insertion in acute myocardial infarction patients without cardiogenic shock undergoing off-pump coronary artery bypass grafting remains unknown. This study aimed to determine the efficacy and safety of the preoperative intra-aortic balloon pump insertion in those patients undergoing off-pump coronary artery bypass grafting. Methods: A total of 421 consecutive acute myocardial infarction patients without cardiogenic shock who underwent isolated off-pump coronary artery bypass grafting were enrolled in this retrospective observational propensity score–matched analysis study. Patients who received intra-aortic balloon pump before off-pump coronary artery bypass grafting (the intra-aortic balloon pump group, n = 157) were compared with those who had not (control group, n = 264). The 30-day postoperative survival, postoperative complications, and postoperative hospital length of stay were compared between the two groups. Results: A total of 99 pairs of patients were matched. The preoperative intra-aortic balloon pump did not show a 30-day postoperative survival benefit compared with the control group (hazard ratio, 0.9; 95% confidence interval, 0.2-4.2; p = 0.92). Patients with preoperative intra-aortic balloon pump were more likely to have shorter postoperative lengths of stay (8 (6-11) days vs. 10 (6-15) days, p = 0.02) and decreased total days in the hospital (median days: 18.2 vs. 21.8, p = 0.02) compared to patients without balloon pumps. Conclusion: Preoperative intra-aortic balloon pump insertion in acute myocardial infarction patients without cardiogenic shock undergoing off-pump coronary artery bypass grafting improved convalescence as shown by significantly shorter postoperative lengths of hospital stay.

scholarly journals Off-Pump Coronary Artery Bypass Grafting for Acute Myocardial Infarction

2006 ◽  
Vol 70 (10) ◽  
pp. 1303-1306 ◽  
Author(s):  
Hideaki Takai ◽  
Junjiro Kobayashi ◽  
Osamu Tagusari ◽  
Ko Bando ◽  
Kazuo Niwaya ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Coronary Artery Bypass
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