scholarly journals Comparing the protective effect of ascorbic acid and sodium bicarbonate in the prevention of acute renal complication after cardiac surgery using cardiopulmonary bypass

2019 ◽  
Vol 41 (1) ◽  
pp. 21-29
Author(s):  
Eissa Bilehjani ◽  
Solmaz Fakhari ◽  
Fariba Mirzaee Bavil ◽  
Saeed Bakhshalizadeh
Keyword(s):  
Ascorbic Acid ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Sodium Bicarbonate ◽  
Protective Effect ◽  
Renal Complication

scholarly journals Preoperative Use of Statins Is Associated with Reduced Early Delirium Rates after Cardiac Surgery

2009 ◽  
Vol 110 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Rita Katznelson ◽  
George N. Djaiani ◽  
Michael A. Borger ◽  
Zeev Friedman ◽  
Susan E. Abbey ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Protective Effect ◽  
Postoperative Delirium ◽  
Characteristic Curve ◽  
Assessment Method ◽  
Multivariable Logistic Regression Analysis ◽  
Preoperative Administration

Background Delirium is an acute deterioration of brain function characterized by fluctuating consciousness and an inability to maintain attention. Use of statins has been shown to decrease morbidity and mortality after major surgical procedures. The objective of this study was to determine an association between preoperative administration of statins and postoperative delirium in a large prospective cohort of patients undergoing cardiac surgery with cardiopulmonary bypass. Methods After Institutional Review Board approval, data were prospectively collected on consecutive patients undergoing cardiac surgery with cardiopulmonary bypass from April 2005 to June 2006 in an academic hospital. All patients were screened for delirium during their hospitalization using the Confusion Assessment Method in the intensive care unit. Multivariable logistic regression analysis was used to identify independent perioperative predictors of delirium after cardiac surgery. Statins were tested for a potential protective effect. Results Of the 1,059 patients analyzed, 122 patients (11.5%) had delirium at any time during their cardiovascular intensive care unit stay. Administration of statins had a protective effect, reducing the odds of delirium by 46%. Independent predictors of postoperative delirium included older age, preoperative depression, preoperative renal dysfunction, complex cardiac surgery, perioperative intraaortic balloon pump support, and massive blood transfusion. The model was reliable (Hosmer-Lemeshow test, P = 0.3) and discriminative (area under receiver operating characteristic curve = 0.77). Conclusions Preoperative administration of statins is associated with the reduced risk of postoperative delirium after cardiac surgery with cardiopulmonary bypass.

scholarly journals Effect of Perioperative Lipid Status on Clinical Outcomes after Cardiac Surgery

Cells ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 2717
Author(s):  
Maks Mihalj ◽  
Paul Philipp Heinisch ◽  
Markus Huber ◽  
Joerg Schefold ◽  
Alexander Hartmann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Protective Effect ◽  
Clinical Outcomes ◽  
Plasma Levels ◽  
Plasma Lipid ◽  
Lipid Levels ◽  
Lipid Status ◽  
Postoperative Stroke

Patients undergoing cardiac surgery are at increased cardiovascular risk, which includes altered lipid status. However, data on the effect of cardiac surgery and cardiopulmonary bypass (CPB) on plasma levels of key lipids are scarce. We investigated potential effects of CPB on plasma lipid levels and associations with early postoperative clinical outcomes. This is a prospective bio-bank study of patients undergoing elective cardiac surgery at our center January to December 2019. The follow-up period was 1 year after surgery. Blood sampling was performed before induction of general anesthesia, upon weaning from cardiopulmonary bypass (CPB), and on the first day after surgery. Clinical end points included the incidence of postoperative stroke, myocardial infarction, and death of any cause at 30 days after surgery as well as 1-year all-cause mortality. A total of 192 cardiac surgery patients (75% male, median age 67.0 years (interquartile range 60.0–73.0), median BMI 26.1 kg/m2 (23.7–30.4)) were included. A significant intraoperative decrease in plasma levels compared with preoperative levels (all p < 0.0001) was observed for total cholesterol (TC) (Cliff’s delta d: 0.75 (0.68–0.82; 95% CI)), LDL-Cholesterol (LDL-C) (d: 0.66 (0.57–0.73)) and HDL-Cholesterol (HDL-C) (d: 0.72 (0.64–0.79)). At 24h after surgery, the plasma levels of LDL-C (d: 0.73 (0.650.79)) and TC (d: 0.77 (0.69–0.82)) continued to decrease compared to preoperative levels, while the plasma levels of HDL-C (d: 0.46 (0.36–0.55)) and TG (d: 0.40 (0.29–0.50)) rebounded, but all remained below the preoperative levels (p < 0.001). Mortality at 30 days was 1.0% (N = 2/192), and 1-year mortality was 3.8% (N= 7/186). Postoperative myocardial infarction occurred in 3.1% of patients (N = 6/192) and postoperative stroke in 5.8% (N = 11/190). Adjusting for age, sex, BMI, and statin therapy, we noted a protective effect of postoperative occurrence of stroke for pre-to-post-operative changes in TC (adjusted odds ratio (OR) 0.29 (0.07–0.90), p = 0.047), in LDL-C (aOR 0.19 (0.03–0.88), p = 0.045), and in HDL-C (aOR 0.01 (0.00–0.78), p = 0.039). No associations were observed between lipid levels and 1-year mortality. In conclusion, cardiac surgery induces a significant sudden drop in levels of key plasma lipids. This effect was pronounced during the operation, and levels remained significantly lowered at 24 h after surgery. The intraoperative drops in LDL-C, TC, and HDL-C were associated with a protective effect against occurrence of postoperative stroke in adjusted models. We demonstrate that the changes in key plasma lipid levels during surgery are strongly correlated, which makes attributing the impact of each lipid to the clinical end points, such as postoperative stroke, a challenging task. Large-scale analyses should investigate additional clinical outcome measures.

Protective Effect of Propofol and Its Relation to Postoperation Recovery in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass

2011 ◽  
Vol 32 (7) ◽  
pp. 940-946 ◽  
Author(s):  
Wen-fang Xia ◽  
Yu Liu ◽  
Qing-shan Zhou ◽  
Qi-zhu Tang ◽  
Han-dong Zou
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Protective Effect
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