Background Acute kidney injury (AKI) is a major determinant of short‐ and long‐term morbidity and mortality following cardiac surgery. The present study examines the effect of preoperative nutritional status and frailty on this significant adverse event. Methods The data of 455 patients who underwent on‐pump coronary artery bypass grafting (CABG) were analyzed retrospectively. Demographic data were recorded, and intraoperative and postoperative parameters, frailty score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI) were calculated. Risk factors for AKI within 7 postoperative days were investigated in accordance with the kidney disease improving global outcomes classification. Results Preoperative urea and creatinine values were significantly higher (p = .006 vs. p = .006), while hemoglobin, hematocrit, and estimated glomerular filtration rate values were significantly lower (p = .011, p = .008 vs. p = .006) in the AKI group than no AKI group. In the intraoperative period, the cardiopulmonary bypass time was longer in the AKI group (p = .031), and the need for dopamine, steradine, and red blood cells transfusion was greater (p = .026, p = .038 vs. p = .015) than no AKI group. The number of patients with a frailty score of 1–3 was significantly higher in the AKI group (p = .042). Similarly, the GNRI and PNI values, indicating nutritional status, were higher in the AKI group (p = .047 vs. p = .024). The independent risk factors for AKI were a GNRI of <91, the intraoperative need for dobutamine, preoperative serum creatinine of >1.3, and hemoglobin of <10 (p < .05). Conclusions Malnutrition and frailty are strongly associated with AKI after CABG. Clinicians can effectively predict the risk of AKI through an evaluation of frailty and nutritional scores, which can be easily calculated in the preoperative period.
Bu çalışmada geleneksel heparin rejimi ile yağsız vücut ağırlığına göre hesaplanan heparin doz rejimi yeterli antikoagülasyonun sağlanması ve perioperatif kanama ile ilişkili komplikasyonlar açısından karşılaştırıldı. Ça lış ma pla nı: Bu prospektif, tek kör, randomize çalışmaya Haziran 2016-Ocak 2017 tarihleri arasında kardiyopulmoner baypas ile elektif kapak ameliyatı yapılan toplam 100 erişkin hasta (42 erkek, 58 kadın; ort. yaş 52.7 yıl; dağılım, 22-84 yıl) alındı. Kardiyopulmoner baypas öncesinde heparin dozu, aktüel vücut ağırlığına göre (n=50) ve yağsız vücut ağırlığına göre (n=50) olmak üzere 4 mg/kg olarak ayarlandı. Kardiyopulmoner baypasa başlanması için minimum aktive pıhtılaşma zamanı hedef değeri 480 sn. olarak kabul edildi. Demografik ve hemodinamik veriler, heparin sonrası aktive pıhtılaşma zamanı, ek heparin ve perioperatif transfüzyon, ameliyat sonrası drenaj miktarları, yeniden ameliyatlar ve mortalite kaydedildi. Bul gu lar: Demografik veriler, kros klemp ve kardiyopulmoner baypas süreleri ve ameliyat sırası transfüzyon ihtiyacı gruplar arasında anlamlı düzeyde farklı değildi. Heparinin başlangıç ve toplam dozlarının yanı sıra toplam protamin dozu, aktüel vücut ağırlığı grubunda anlamlı düzeyde daha yüksekti. Ameliyat sonrası transfüzyon oranları da, bu grupta daha yüksekti. Yağsız vücut ağırlığı grubunda hiçbir hastada yeniden ameliyat gerekli olmaz iken, aktüel vücut ağırlığı grubunda üç hasta yeniden ameliyat edildi. So nuç: Çalışma sonuçlarımız kardiyopulmoner baypas sırasında yağsız vücut ağırlığına göre hesaplanan heparin doz titrasyonu ile yeterli antikoagülasyon sağlanabileceğini ve toplam heparin ve protamin dozlarının düşürülmesi ile ameliyat sonrası kanama ve kan ürünü transfüzyonu gereksinimin azaltılabileceğini göstermiştir. Anah tarsöz cük ler: Aktüel vücut ağırlığı; kan yönetimi; kardiyak anestezi; kalp cerrahisi; kardiyopulmoner baypas; heparin; yağsız vücut ağırlığı; protamin; tamponad.
Objective: The aim of this study is to evaluate short-term complications and mortality in patients undergoing isolated coronary artery bypass surgery with preoperative predictors commonly used in the literature. Methods: A total of 518 patients who underwent coronary artery bypass surgery using cardiopulmonary bypass pump were retrospectively investigated. Preoperative fasting blood glucose, hemoglobin, neutrophil, platelet count, erythrocyte distribution width, mean platelet volume, platelet lymphocyte ratio, neutrophil lymphocyte ratio, metabolic syndrome criteria were recorded. These preoperative data have been investigated in relation to postoperative short term complications and mortality. Results: Twenty-six (5%) out of 518 patients exited within postoperative 30 days. Mortality was associated with advanced age, presence of hypertension, fasting blood glucose and platelet lymphocyte ratio. However, in multivariate analyzes, only advanced age was seen as an independent predictor of mortality. At least one postoperative complication was seen in 66 (12.7%) patients. Age, fasting blood glucose, hemoglobin value, mean platelet volume, neutrophil lymphocyte ratio were found to be associated with the development of complications. However, in multivariate analyzes only age was seen as independent predictor of development of complications. Conclusion: It is not possible to predict mortality and complications in patients undergoing coronary artery bypass surgery using only preoperative data.
Background/aim: This study aims to investigate the relationship between emotion regulation characteristics and the efficacy of midazolam premedication.Materials and methods: Sixty-three children, aged 3 to 8 years old, with tonsillectomy and/or adenoidectomy and taking premedication with midazolam (Group 2) or without premedication (Group 1), were included in this study. The behavioral and emotional status of the children was evaluated with the Conners Parent Rating Scale-48 (CPRS-48) and Emotion Regulation Checklist (ERC). Age, sex, body weight, response to intravenous (IV) cannulation and mask, hemodynamic data, preoperative sedation scores [Wilton Sedation Scale (WSS)], postoperative pain intensity [Objective Pain Scale (OPS)], and emergence agitation (EA) level [Pediatric Anesthesia Emergence Delirium (PAED)] were recorded.Results: A total of 90.6% patients were quiet and sleepy in Group 2, and 25.8% in Group 1. The mean scores of OPS and PAED were higher in Group 1, and the percentage of patients with PAED score of >10 was 51.6% in Group 1 and 18.8% in Group 2 (P < 0.05). In Group 1, a significant correlation was found between PAED scores and WSS and the subfactors of the CPRS-48 (P < 0.05). A correlation was found between WSS and subfactors of ERS in Group 1 (P < 0.05). Conclusion:The incidence of anxiety and postoperative EA is increased in children with emotion regulation disorder, and midazolam premedication reduced the frequency of EA.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.