Papel pronóstico de los nuevos biomarcadores en la cirugía coronaria sin circulación extracorpórea

Arribas-Leal, José María; Pascual-Figal, Domingo A.; Tornel-Osorio, Pedro L.; Ruipérez-Abizanda, Juan A.; Valdés‐Chávarri, Mariano; Arcas-Meca, Ramón

doi:10.1157/13086087

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Despite the fact that clinical findings are the most valuable data, it should be noted while using these tests that CRP is preferable to ESR 25. Arribas-Leal et al26 reported that no recognizable association exists among CRP, acute myocardial infarction (AMI) and postoperative mortality rate. Sahin et al27 reported that preoperative CRP does not have any correlation with complications such as early renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

Bilehjani

Fakhari

Farzin

et al. 2017

IJGM

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IntroductionOver the past decades, it has been recommended that preoperative assessment mainly relies on history and physical examination rather than unnecessary laboratory tests. In Iranian hospitals, erythrocyte sedimentation rate (ESR) has been routinely measured in most of the patients awaiting major surgery, which has in turn exacted heavy costs on the health system. Therefore, the aim of the present study was to assess the preoperative routine measurement of ESR in such patients.Materials and methodsThis is a retrospective study, in which we evaluated the medical files of 620 patients. Patients older than 18 years, who had undergone elective heart surgery in our hospital in 2014, were included in the study. The data associated with demography, heart disease diagnosis, type of surgery, significant preoperative tests, delay or postponing of surgery and the reason for it, type and characteristics of the subspecialty consultation, and finally, postoperative complication and mortality rate were collected and analyzed. The patients were categorized into four groups according to ESR value: normal (<15 mm/h in females or <20 mm/h in males), moderately increased (<40 mm/h), severely increased (≥40 mm/h), and not measured.ResultsOf the 620 patients’ files, 402 were of males and 218 were of females. Demographic values and preoperative characteristics were similar in the four groups. A total of 105 consultations were given to 79 patients preoperatively, where only in five cases, the elevation in ESR was the main reason for consultation. In no other cases did the consultations result in new diagnoses. Overall, postoperative complication and mortality rate were the same in all four groups; in severely increased ESR group, on the other hand, the need for long periods of intensive care unit (ICU) and hospital stays was higher than that of other groups.ConclusionIt is concluded that elevated preoperative ESR does not cancel or defer the surgery, nor does it help diagnose a new, previously undiagnosed disease. Furthermore, it does not generally affect postoperative morbidity or mortality rate unless increased to ≥40 mm/h, where it can increase postoperative ICU and hospital stay. Ultimately, routine preoperative ESR measurement in patients is not conducive to elective heart surgery.

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Section: Discussionmentioning

confidence: 99%

The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

Bilehjani

Fakhari

Farzin

et al. 2017

IJGM

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The minimized extracorporeal circulation system causes less inflammation and organ damage

et al. 2008

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The minimized extracorporeal circulation system (MECC) is being used to reduce priming volume and blood/polymer contact during cardiac procedures. In this study, we evaluated the efficacy and potential advantages of the system in coronary artery bypass graft (CABG) patients. We included two groups of patients destined for CABG in a prospective, randomized study: Group A was operated on the usual pump (n = 30) while Group B was operated using the MECC (n = 50). Pre-operative demographics, intra-operative times and values as well as a series of post-operative outcome data (blood loss, transfusion requirements, ventilation time, ICU and hospital stay) were recorded. CK, CK-MB, troponin-T, IL-6 and IL-8 were measured. Pre-operative and post-operative lung function were assessed. In the MECC-operated group, patients developed less post-operative troponin-T (0.2 +/- 0.3 vs. 0.5 +/- 0.5 ng/mL, p=0.031) and less IL-8 (13.8 +/- 5 vs. 22.5 +/- 0.5 microg/L, p = 0.05). While blood loss was comparable in both groups, packed red blood cells and fresh frozen plasma were given less frequently in the MECC group (p = 0.015 resp. 0.022). The one-tailed Student's t-test revealed shorter bypass time in the MECC group (74 +/- 17 vs. 82 +/- 24 min). There was no difference in ventilation and ICU-time (patients were not treated in a fast-track fashion). The FEV1 was better in the MECC group (relative values: 70.1 +/- 18.2% vs. 61.1 +/- 12.3%, p = 0.02). Utilization of the MECC may cause less cytokine (IL-8) liberation, owing to less blood/tubing contact, as well as less red blood cell and fresh frozen plasma demand. It may also be the circuit in patients with chronic obstructive pulmonary disease (COPD).

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Papel pronóstico de los nuevos biomarcadores en la cirugía coronaria sin circulación extracorpórea

Cited by 2 publications

References 18 publications

The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

The minimized extracorporeal circulation system causes less inflammation and organ damage

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