The Relationship Between the Duration of Cardiopulmonary Bypass (CPB) Use on Elevated Lactic Acid Post Operative of Open Heart Surgery at H. Adam Malik General Hospital Medan

2017 ◽  
Vol 4 (10) ◽  
Author(s):  
Farhan Syarif, ◽  
Keyword(s):  
Lactic Acid ◽  
Cardiopulmonary Bypass ◽  
General Hospital ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
The Relationship

scholarly journals The Relation Of Intraoperative Renal Oxygen Saturation Change With Postoperative Acute Kidney Injury

2021 ◽  
Author(s):  
Mustafa Emre Gürcü ◽  
Atakan Erkılınç ◽  
Pınar Karaca Baysal ◽  
Fatih Yılmaz ◽  
Tuncer Koçak
Keyword(s):  
Acute Kidney Injury ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Kidney Injury ◽  
Left Ventricular Ejection ◽  
Open Heart ◽  
The Relationship ◽  
Renal Oxygen

Objective: Acute kidney injury seen in 25-30 % of the cases after open heart surgery where cardiopulmonary bypass was performed, is one of the most important factors that affect the success of the on- pump open heart surgery by increasing the rates of postoperative morbidity, and mortality. Near infrared spectroscopy (NIRS) is a noninvasive monitoring that frequently used method that allows correction of imbalances in oxygen supply to the brain and vital organs. We aimed to investigate the relationship between renal oxygen saturation values and postoperative acute kidney injury. Method: Fifty patients who underwent on- pump open heart surgery between July 2020 and January 2021 by using cardiopulmonary bypass were included in the study. Demographic data included age, gender, body mass index (BMI), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, other chronic diseases and left ventricular ejection fraction. The definition of acute kidney injury was defined according to the criteria of KDIGO. At the end of the postoperative 48th hour the relationship between intraoperative renal rSO2 changes in patients with or without acute kidney injury was evaluated. Results: Fifty patients were included in the current study. The median (IQR) age of 50 patients was 62 (54.3-66.5), and mostly male patients constituted the study populatio,. When we evaluated the intraoperative data, there were statistically significant differences in changes in renal rSO2 values in patients who had and had not developed postoperative acute kidney injury (-12%, -3%, respectively) (p: 0.001). In the multivariate logistic regression analysis, the change in rSO2 values in the intraoperative period [(from - 10% to 0.5%), OR: 0.18 (0.04-0.76) p: 0.03] were found to be an independent predictor of postoperative acute kidney injury. Conclusion: We found that the decrease of renal rSO2 measurements during surgery may predict the development of acute kidney injury in the postoperative period. We think that renal oxygen saturation monitoring with NIRS is a very effective method for predicting postoperative renal dysfunction, because it is both noninvasive and reflects simultaneous data.

scholarly journals Normothermic versus hypothermic cardiopulmonary bypass in low-risk paediatric heart surgery: a randomised controlled trial

Heart ◽  
2018 ◽  
Vol 105 (6) ◽  
pp. 455-464 ◽  
Author(s):  
Massimo Caputo ◽  
Katie Pike ◽  
Sarah Baos ◽  
Karen Sheehan ◽  
Kathleen Selway ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Hospital Stay ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Postoperative Hospital Stay ◽  
Low Risk ◽  
Open Heart ◽  
Intubation Time ◽  
Organ Systems ◽  
Randomised Controlled

ObjectiveTo compare normothermic (35°C–36°C) versus hypothermic (28°C) cardiopulmonary bypass (CPB) in paediatric patients undergoing open heart surgery to test the hypothesis that normothermic CPB perfusion maintains the functional integrity of major organ systems leading to faster recovery.MethodsTwo single-centre, randomised controlled trials (known as Thermic-1 and Thermic-2, respectively) were carried out to compare the effectiveness and acceptability of normothermic versus hypothermic CPB in children with congenital heart disease undergoing open heart surgery. In both studies, the co-primary clinical outcomes were duration of inotropic support, intubation time and postoperative hospital stay.ResultsIn total, 200 participants were recruited; 59 to the Thermic-1 study and 141 to the Thermic-2 study. 98 patients received normothermic CPB and 102 patients received hypothermic CPB. There were no significant differences between the treatment groups for any of the co-primary outcomes: inotrope duration HR=1.01, 95% CI (0.72 to 1.41); intubation time HR=1.14, 95% CI (0.86 to 1.51); postoperative hospital stay HR=1.06, 95% CI (0.80 to 1.40). Differences favouring normothermia were found in urea nitrogen at 2 days geometric mean ratio (GMR)=0.86 95% CI (0.77 to 0.97); serum creatinine at 3 days GMR=0.89, 95% CI (0.81 to 0.98); urinary albumin at 48 hours GMR=0.32, 95% CI (0.14 to 0.74) and neutrophil gelatinase-associated lipocalin at 4 hours GMR=0.47, 95% CI (0.22 to 1.02), but not at other postoperative time points.ConclusionsNormothermic CPB is as safe and effective as hypothermic CPB and can be routinely adopted as a perfusion strategy in low-risk infants and children undergoing open heart surgery.Trial registration numberISRCTN93129502.

scholarly journals Relationship Between Selenium Trace and Patient Outcome After Open-Heart Surgery

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Gohar Eslami ◽  
Roya Salehi ◽  
Hamidreza Samaee ◽  
Vallialah Habibi ◽  
Mohammad Shokrzadeh ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Heart Surgery ◽  
Acute Stress ◽  
Open Heart Surgery ◽  
Selenium Level ◽  
Serum Selenium ◽  
Open Heart ◽  
Duration Of Surgery ◽  
The Relationship ◽  
Serum Selenium Level

Background: Acute stress response to heart surgery can cause major morbidity in patients. The trace of selenium is useful for preventing heart damage. Although the trend of selenium changes is of high importance for body balance, the usefulness of routine use and effectiveness of this element for patients under open-heart surgery is still unclear. Objectives: This study aimed at assessing serum selenium level before and after open-heart surgery and the relationship between selenium trace and patient outcome. Methods: This prospective analytical study was performed on 100 patients undergoing open-heart surgery using cardiopulmonary bypass (CPB). In all patients, the serum level was measured at a predetermined time (before surgery and one and two days after surgery). Then, the relationship between serum selenium and patient outcome was assessed. Results: The mean serum selenium level in patients on admission was 72.90 ± 14.62 μg/L, one day after surgery was 71.20 ± 15.84 μg/L, and two days after surgery was 71.54 ± 15.97 μg/L. Serum selenium levels were inversely and significantly associated with age (r = -0.183; P = 0.034, 013) duration of surgery (r = -221 and P = 0.014), duration of intensive care unit stay (r = 0.204, P = 0.021), and duration of CPB (r = 0.223, P = 013). Conclusions: Based on this study’s results, a low level of selenium can affect patients’ outcomes after open-heart surgery.

scholarly journals Pre-operative and peri operative predictors of acute renal failure after cardiac surgery

2019 ◽  
Vol 6 (3) ◽  
pp. 756
Author(s):  
Praveen Dhaulta ◽  
Vikas Panwar
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Ejection Fraction ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Variable ◽  
Open Heart ◽  
Multiple Variables

Background: Acute kidney injury (AKI) is one of the most serious complications during the postoperative period of cardiac surgery. Multiple variables predict the ARF after cardiac surgery. Objective of this study was to evaluate the significance of pre and peri-operative variables which may help in predicting the chances of developing ARF after cardiac surgery.Methods: This study was an observational, prospective study conducted among patients who were scheduled to undergo open heart surgery under cardiopulmonary bypass.Results: In total, 50 patients who underwent open-heart surgery, ARF was seen in 5 patients, with the incidence rate of 10%. Acute renal failure was present in one patient with ejection fraction <35, 2 patients had ejection fraction between 35 to 50 and 2 patients with ejection fraction >50. It was seen in 4 patients with 1-2 hrs of cardiopulmonary bypass and in 1 patient with >2 hrs of cardiopulmonary bypass. ARF was also seen in 4 patients with hematocrit between 22-26% and in 1 patient with >26%.Conclusions: The study provided a clinical variable score that can predict ARF after open-heart surgery. The score enhances the accuracy of prediction by accounting for the effect of all major risk factors of ARF.

scholarly journals Influence of biomarkers level during follow-up when operating under cardiopulmonary bypass

2015 ◽  
Vol 18 (3) ◽  
pp. 39
Author(s):  
Yu. I. Petrishchev ◽  
A. L. Levit ◽  
I. N. Leyderman
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Plasma Levels ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Cardiac Surgeons ◽  
The Given ◽  
The Relationship

Systemic inflammatory response was first determined in 1980 and cardiac surgeons turned to it in 1996. At present, there are a lot of publications on this issue, however, the extent of operation and duration of CPB are considered in clinical practice as crucial indicators of severity of patient's condition following cardiac surgery. In our study we tried to look at this problem from a different perspective and draw a parallel between the severity of patient's condition resulting from operational trauma and CPB. We included 48 patients who under-went cardiac surgery under CPB. Plasma levels of procalcitonin (PCT), lactate and interleukin-6 were investigated before the operation, after CPB and at 24 hours. Also revealed was the relationship between the plasma levels of IL-6, lactate and PCT (r = 0.53; p = 0.000 in both cases). The level of PCT at the 3rd stage was found to relate to the duration of CPB (r = 0.4; p = 0.005), ALV (r = 0.44; p = 0.001) and length of stay at ICU (r = 0.53; p = 0.000). We didn't manage to find any relationship between the length of stay at ICU and the duration of CPB. Correlation between the PCT plasma level and the duration of intensive care indicates the importance of dynamics of the given biomarker for early prediction of follow-up course after open-heart surgery.

Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial

2020 ◽  
pp. 215013512095908
Author(s):  
Abdul Rauf ◽  
Reena K. Joshi ◽  
Neeraj Aggarwal ◽  
Mridul Agarwal ◽  
Manendra Kumar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Risk Category ◽  
Open Heart ◽  
Oncotic Pressure ◽  
Randomized Controlled

Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes. Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation. Results: We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category. Conclusion: High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.

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