Nitric Oxide: Renoprotective in Cardiac Surgery!

Magoon, Rohan; Dey, Souvik; Walian, Ashish; Kashav, Ramesh

doi:10.21470/1678-9741-2020-0080

Cited by 8 publications

(7 citation statements)

References 6 publications

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“…The isolated evaluation of OPCABG patients additionally obviates the possible deleterious renal effects of extracorporeal circulatory conduct. 33 34 However, the study had a few limitations. First, the retrospective study design is prone to residual confounding.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…35 This is particularly pertinent in the context of CSA-AKI which is essentially multifactorial. 33 34 Second, the lack of availability of the renal oxygenation monitoring trends (near-infrared spectroscopy based) for all the included cases, is an additional limitation. 36 Third, the inclusion of other markers of malnutrition, frailty, and/or inflammation could have enhanced the lucidity of the study findings.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Malnutrition-Inflammation Liaison in Predicting AKI following OPCABG in Diabetics: Role of a Novel Monocyte/High-Density Lipoprotein × Albumin Ratio

Singh

Magoon

Dey

et al. 2022

Journal of Cardiac Critical Care TSS

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Background Monocyte/high-density lipoprotein ratio (MHR) has been recently proposed as a parsimonious inflammatory marker. Akin to MHR, hypoalbuminemia (a malnutrition marker) has a considerable proinflammatory potential and confers an accentuated risk of postcardiac surgery complications, like acute kidney injury (AKI). The present study evaluated the AKI-predictive value of the preoperative monocyte/high-density lipoprotein × albumin ratio (MHAR) in diabetic patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods The retrospective study conducted at our tertiary cardiac care center included 687 diabetic OPCABG patients. Forty-eight hours postoperative data was evaluated for the occurrence of AKI, as defined by the Acute Kidney Injury Network criteria. The perioperative attributes of the AKI and non-AKI groups were compared to evaluate the predictors of AKI, by employing a regression analysis. Results A total of 109 patients (15.87%) developed AKI postoperatively. On univariate analysis: age, EuroSCORE II, preoperative congestive heart failure, systemic hypertension, serum albumin, MHR, MHAR, intraoperative packed red blood cell transfusion, postoperative low cardiac output syndrome, and vasoactive-inotropic score (VIS) predicted AKI. AKI subsequent to multivariate analysis, age (odds ratio [OR]: 1.029), EuroSCORE II (OR: 1.264), MHAR (OR: 1.403), and VIS (OR: 1.07) were the independent predictors (p-values: 0.020, < 0.001, 0.013, 0.002, respectively). The AKI predictive cutoffs of albumin, MHR, and MHAR were ≤ 2.95, ≥ 15.25, and ≥ 4.08 (area under the curve:sensitivity:specificity of 0.761:84.86%:89.62%; 0.754:93.12%:86.68%; 0.798:89.63%:88.34%, respectively). MHAR ≥ 4.08 was also associated with a higher incidence of postoperative atrial fibrillation and major adverse cardiac events. Conclusion Preoperative elevated MHAR independently predicts AKI following OPCABG in diabetics, implying a malnutrition-inflammation liaison at heart of the matter.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Malnutrition-Inflammation Liaison in Predicting AKI following OPCABG in Diabetics: Role of a Novel Monocyte/High-Density Lipoprotein × Albumin Ratio

Singh

Magoon

Dey

et al. 2022

Journal of Cardiac Critical Care TSS

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“…On one hand, mechanical shear stress and exposure to non-endothelial CPB surfaces predispose to hemolysis [ 7 ] . On the other hand, plausible viral-erythrocytic interactions are equally conducive to an aggravated red blood corpuscular lysis [ 7 ] .…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Positive Cohort Undergoing Cardiac Surgery: A Possible Un(3H)oly Trinity of HypoxiaHemolysis-Hyperinflammation

Magoon¹,

Kashav²,

Jose³

et al. 2022

Braz J Cardiovasc Surg

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While the fraternity continues to ponder on the mechanisms by which coronavirus disease (COVID-19) positivity affects the outcome of cardiac surgical subset, we put forth a 3H (Hypoxia-Hemolysis-Hyperinflammation) trilogy aimed at elucidating the liaison between cardiopulmonary bypass (commonly employed for cardiac surgical conduct) and COVID-19 infection. A sound comprehension of the same can doubtlessly assist the perioperative team in staging a well-directed pathophysiology-driven management approach.

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“…Across the cardiac surgical population, the risk of AKI doubles once the postoperative CVP reaches a threshold value of 14 mmHg [ 5 ] . Ahead of the fact that estimated CVP at 6 h postoperatively has been found to be significantly associated with CS-AKI in the non-congested cardiac surgical subset [ 6 ] , possible links should definitely not be overlooked in valvular heart disease patients included in the present study who can be particularly prone to postoperative systemic venous congestion [ 7 ] .…”

mentioning

confidence: 99%

Nitric Oxide: Renoprotective in Cardiac Surgery!

Cited by 8 publications

References 6 publications

Malnutrition-Inflammation Liaison in Predicting AKI following OPCABG in Diabetics: Role of a Novel Monocyte/High-Density Lipoprotein × Albumin Ratio

Malnutrition-Inflammation Liaison in Predicting AKI following OPCABG in Diabetics: Role of a Novel Monocyte/High-Density Lipoprotein × Albumin Ratio

COVID-19 Positive Cohort Undergoing Cardiac Surgery: A Possible Un(3H)oly Trinity of HypoxiaHemolysis-Hyperinflammation

Predicting Kidney Injury Following Valvular Heart Surgery in An Elderly Cohort: The Missing Links…

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