The triple combination of parameters obtained as part of the hemogram, NLR-RDW-MPV, indicated a much more predictive power than two parameters coupled. This combination of three parameters, NLR-RDW-MPV, is to be considered as a sensitive, high-quality, low-cost outcome prediction marker for cardiac surgery patients that is less time consuming and easy to use.

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Sugammadex encapsulates and inactivates rocuronium and vecuronium. It is used to reverse neuromuscular blockade from these nondepolarizing agents. The safety of sugammadex in patients with neuromuscular disease has not been established. Guillain-Barre Syndrome (GBS) is a neuromuscular disease characterized by acute inflammatory polyneuropathy. Patients with GBS may exhibit autonomic dysfunction, chronic pain, abnormal reactions to neuromuscular blocking agents, and may require postoperative mechanical ventilation. We report the successful use of sugammadex to reverse rocuronium in a patient with chronic GBS, who presented for a hemicolectomy.

Introduction Maintenance of microcirculatory homeostasis is essential for the preservation of organ function [1]. Cardiac surgery is associated with an inflammatory reaction that may promote alterations in the microcirculatory level, in addition to the general impact on hemodynamic status [2]. The use of cardiopulmonary bypass (CPB) additionally causes a broad range of changes in microcirculatory perfusion and oxygenation [1]. Anemia and transfusion not only make patients more prone to the deleterious effects of CPB but also aggravate the inflammatory response, oxidative stress, and renal hypoxia [3,4]. An intraoperative transfusion of red blood cells (RBCs) increases the risk of mortality and several morbidities. These risks are substantial for even one unit in general surgery patients [5]. The aim of this study was to compare tissue oxygenation, which was evaluated by blood lactate concentration, central venous oxygen saturation (S cv O 2), and venoarterial carbon dioxide pressure difference (ΔpCO 2), between patients who had dilutional anemia resulting from CPB and could be treated with a minimal RBC transfusion (1-2 units) and the patients who did not. Our hypothesis was that a minimal transfusion would lead to normalized Background/aim: Cardiac surgery, especially in the presence of cardiopulmonary bypass (CPB), is associated with an inflammatory reaction that may promote microcirculatory alterations, in addition to the general impact on system hemodynamics. Anemia and transfusion make patients more susceptible to the deleterious effects of CPB. In this study, it was aimed to evaluate the effect of dilutional anemia, which is caused by CPB and can be treated with 1-2 units of red blood cell (RBC) transfusion, on global tissue oxygenation parameters in cardiac surgery patients. Materials and methods: This prospective observational study comprised 127 patients who had a relatively stable operation period without any major anesthetic or surgical complications (e.g., operation duration >5 h, bleeding or hemodilution requiring more than 1-2 units of RBCs, or unstable hemodynamics, requiring inotropic support of more than 5 µg/kg/min dopamine). Patients were observationally divided into two groups: minimally transfused (Group Tr) and nontransfused (Group NTr). Global tissue oxygenation parameters were evaluated after anesthesia induction (T 1) and at the end of the operation (T 3) and compared between the groups. Results: Group Tr consisted of patients who had significantly lower preoperative hemoglobin values than Group NTr patients. The dilutional anemia of all Group Tr patients could be corrected with 1 unit of RBCs. The lactate levels at T 3 , increment rates of lactate, and venoarterial carbon dioxide pressure difference (ΔpCO 2) levels [(T 3-T 1) : T 1 ] in Group Tr were significantly higher than those in Group NTr. Conclusion: Dilutional anemia as a result of CPB mostly occurs in patients with borderline preoperative hemoglobin concentrations and its correction with RBC transfusion does not normalize the de...