scholarly journals HbA1c as a Predictor of Postoperative Infection in Type 2 Diabetic Patients after Coronary Artery Bypass Grafting

2020 ◽  
pp. 21-24
Author(s):  
Patricia Veloso Facury Lasmar Ferreira ◽  
Wagner José Martorina ◽  
Bruno Bastos Godoi
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Complex Disease ◽  
Artery Bypass ◽  
P Value ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Coronary artery disease (CAD) is one of the leading causes of morbimortality worldwide. In patients with diabetes mellitus type 2 (DM2), CAD is more likely to be a complex disease and often requires cardiac surgery. Furthermore, perioperative blood glucoselevels control is associated with the following outcomes: surgery success, mortality, and infection postoperative. This is a retrospective study, we have collected data form, 43 patients, between 2015 and 2017, with diabetes type 2 and who had passed through a Coronary Artery Bypass Grafting. Those with infection postoperative had a glycohemoglobin 7,9 (SD ±1,4), and those without infection had an HbA1c 7,25 (SD ±0,94) and a p-value from 0,039. Adding this was identified that the average of creatinine clearance in patients with the infectious disease was 59 (SD ±21,3) and 67(SD ±26)in those without infection, calculated a p-value from 0,039. High levels of Hb1Ac are a predictor of infection disease postoperative.

scholarly journals The effect of using the minimized cardio-pulmonary bypass Systems for Coronary Artery Bypass Grafting in diabetic patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Turki B. Albacker ◽  
Mohammed Fouda ◽  
Bakir M. Bakir ◽  
Ahmed Eldemerdash
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Perioperative Myocardial Infarction ◽  
Artery Bypass Grafting ◽  
Bypass Group

Abstract Introduction Multiple studies have shown a decrease in the inflammatory response with minimized bypass circuits leading to less complications and mortality rate. On the other hand, some other studies showed that there is no difference in post-operative outcomes. So, the aim of this study is to investigate the clinical benefits of using the Minimized cardiopulmonary Bypass system in Coronary Artery Bypass Grafting and its effect on postoperative morbidity and mortality in diabetic patients as one of the high-risk groups that may benefit from these systems. Methods This is a retrospective study that included 114 diabetic patients who underwent Coronary artery bypass grafting (67 patients with conventional cardiopulmonary bypass system and 47 with Minimized cardiopulmonary bypass system). The patients’ demographics, intra-operative characteristics and postoperative complications were compared between the two groups. Results Coronary artery bypass grafting was done on a beating heart less commonly in the conventional cardiopulmonary bypass group (44.78% vs. 63.83%, p = 0.045). There was no difference between the two groups in blood loss or transfusion requirements. Four patients in the conventional cardiopulmonary bypass group suffered perioperative myocardial infarction while no one had perioperative myocardial infarction in the Minimized cardiopulmonary bypass group. On the other hand, less patients in the conventional group had postoperative Atrial Fibrillation (4.55% vs. 27.5%, p = 0.001). The requirements for Adrenaline and Nor-Adrenaline infusions were more common the conventional group than the Minimized group. Conclusion The use of conventional cardiopulmonary bypass for Coronary Artery Bypass Grafting in diabetic patients was associated with higher use of postoperative vasogenic and inotropic support. However, that did not translate into higher complications rate or mortality.

scholarly journals Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ghada Mohamed Samir ◽  
Omar Mohamed Ali Mohamed Omar ◽  
Madiha Metwally Zidan ◽  
Hazem Abd El Rahman Fawzy ◽  
Marwa Mamdouh Mohamed El Far
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Hemoglobin A1c ◽  
Artery Bypass ◽  
Kidney Injury ◽  
P Value ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (< 0.0001) and cut of value (≥ 7) with sensitivity 81.82 and specificity 93.10. Conclusion This study revealed that elevated preoperative HbA1c level above 7% showed an increase in incidence of post CABG acute kidney injury along with increase length of postoperative ICU stay.

scholarly journals Neutrophil-endothelial cells modulation in diabetic patients undergoing coronary artery bypass grafting

1998 ◽  
Vol 14 (4) ◽  
pp. 373-379 ◽  
Author(s):  
Massimo Chello ◽  
Pasquale Mastroroberto ◽  
Francesco Cirillo ◽  
E. Bevacqua ◽  
Antonio Carrano ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

scholarly journals Intermittent Subcutaneous Morphine for Postoperative Analgesia Following Coronary Artery Bypass Grafting

2020 ◽  
Author(s):  
CN Namitha ◽  
Manjunath R Kamath ◽  
Ananda Bangera ◽  
M Gopala Krishnan ◽  
B Amith Kiran
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Side Effects ◽  
Postoperative Pain ◽  
Coronary Artery Bypass ◽  
Postoperative Analgesia ◽  
Artery Bypass ◽  
P Value ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: An effective postoperative pain management is of utmost importance following cardiac surgery. Various agents, routes and modes are available for the treatment of postoperative pain. Subcutaneous route of administration is an easy and effective method of postoperative analgesia with improved patient satisfaction and lesser side effects compared to intravenous route. Aim: To evaluate the efficacy of Subcutaneous Morphine (SCM) as postoperative analgesia following Coronary Artery Bypass Grafting (CABG). Materials and Methods: This study was designed as a retrospective analytical survey from June 2015 to June 2017. Medical records of all patients over 18 years of age who underwent coronary artery bypass grafting were reviewed. Patients belonging to ASA PS I, II and III, patients above 18 years of age and those posted for coronary artery bypass grafting were included in the study. Patients were divided into two groups: SCM group and Paracetamol (PCT) group, depending on the primary analgesia they received. The two groups were compared using Student’s t-test for normally distributed continuous data or non-parametric tests if the data were not normally distributed. Categorical data were compared by Fisher’s-exact test. The p-values <0.05 were considered statistically significant. Results: A total of 102 records were reviewed, out of which 49 patients received SCM and 53 patients had received PCT as their primary postoperative analgesia. It was observed that PCT group required more additional analgesia (intravenous fentanyl/ tramadol) than SCM group which was statistically significant with p-value of <0.001 and the duration of Cardiac Intensive Care Unit (CICU) stay was more in PCT group with p-value of 0.001. Postoperative side effects were significantly more in PCT group. Conclusion: SCM can be effectively administered intermittently for postoperative analgesia following CABG with similar haemodynamic stability and minimal side effects as compared to intermittent intravenous PCT.

scholarly journals Neuropsychological dynamics in patients with type 2 diabetes mellitus undergone coronary artery bypass grafting

2012 ◽  
Vol 15 (4) ◽  
pp. 33-38 ◽  
Author(s):  
Olga Alexandrovna Trubnikova ◽  
Anastasia Sergeevna Mamontova ◽  
Irina Danilovna Syrova ◽  
Olga Valer'evna Maleva ◽  
Olga Leonidovna Barbarash
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting

AIM: The study was aimed at evaluation of hospital neuropsychological dynamics in ischemic heart disease patients with comorbid type 2 diabetes mellitus (T2DM) undergone on-pump coronary artery bypass grafting. MATERIALS AND METHODS: 14 from a total of 37 examined patients had T2DM. Diabetic patients were found to have lower attention parameters prior to the intervention in comparison to non-diabetic controls. At days 7-10 after the surgery all patients demonstrated deterioration of cognitive functions. RESULTS: We observed deeper deterioration in diabetic patients, regarding attention, memory, sensorimotor speed and quantity of erroneous test responses, as measured against individuals with normal glucose tolerance. CONCLUSIONS: Diabetic patients undergone coronary artery bypass surgery show lower cognitive characteristics when compared to controls without T2DM, suggesting this cohort to be a high-risk group for further cognitive decline.

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