scholarly journals Anesthesia for Off Pump Coronary Artery Bypass Surgery in a Patient with Brain Tumor

2019 ◽  
Vol 16 (2) ◽  
pp. 69-71
Author(s):  
Sarwan K S Rawat ◽  
Battu Kumar Shrestha ◽  
Rajiv Juneja ◽  
Yatin Mehta ◽  
Naresh Trehan

The outcome after off pump coronary artery bypass grafting (OPCAB) surgery has been promising. These good outcomes relate to the benefits of avoiding extra corporeal circulation. Some of the reported advantages include a lower incidence of renal complications, pulmonary complication, adverse neurological event, reduced transfusions requirement and attenuation of the systemic inflammatory response. If the patient has associated preoperative complicated neurological issues, then perioperative management will be more challenging and requires extensive care and precautions.We present a case with symptomatic meningioma and unstable angina who underwent successful urgent OPCAB surgery without further neurological deterioration.

2021 ◽  
pp. 021849232110195
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Achim Haeussler ◽  
Dragan Odavic ◽  
Patricia Fodor ◽  
...  

Background Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery. Methods A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching. Results Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups. Conclusions Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.


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