Systemic Inflammatory Stress Response During Cardiac Surgery

Sugita, Junichi; Fujiu, Katsuhito

doi:10.1536/ihj.18-210

Cited by 17 publications

(12 citation statements)

References 29 publications

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“…As we all know, surgery can contribute to the development of a systemic inflammatory response that can cause multi-organ dysfunction. Post-surgical neuro-inflammation is associated with synaptic plasticity impairments and neuronal dysfunction which may illustrate the occurring of post-operative delirium [18][19][20]. Certain studies indicated that Hs-CRP and IL-6 may have the potential to predict the onset of delirium [21,22], whereas we did not find the correlation ship between Hs-CRP or IL-6 with delirium.…”

Section: Discussioncontrasting

confidence: 78%

The Predictive Role of QEEG in the Post-Operative Delirium and Prognosis of Cardiac Surgery Patients

Guo

Liu

Yang

et al. 2021

Preprint

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Objective To determine whether qEEG has the capable of predicting the onset of post-operative delirium (POD) and prognosis of cardiac surgery patients. Methods We prospectively studied a cohort of cardiac surgery patients undergoing EEG for evaluation of altered mental status. Patients were assessed for delirium with the CAM-ICU or CAM. EEG were interpreted clinically by clinician, and reports were reviewed to identify features such as aEEG，alpha，beta，theta or delta relative band energy, alpha variability and spectral entropy. Generalized linear models were used to quantify associations among EEG findings, delirium, and clinical outcomes, including length of stay and mortality. Results 60 patients were evaluated and 29 (48.33%) met delirium criteria. The EEG finding most strongly associated with delirium presence was aEEG, whether the peak value or valley value less than lower quartile or greater than upper quartile. Conclusions The peak or valley value of aEEG in F3-P3/F4-P4 derivation is a good predictor of post-operative delirium in cardiac surgery patients.Trial registration: Clinical Trials.gov Identifier, NCT03351985. Registered 1 December 201

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Section: Discussioncontrasting

confidence: 78%

The Predictive Role of QEEG in the Post-Operative Delirium and Prognosis of Cardiac Surgery Patients

Guo

Liu

Yang

et al. 2021

Preprint

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“…It can reduce indicators of cardiac damage, and improves hemodynamic condition. This property of vitamin C affects the amount of drainage (bleeding) and the duration of hospitalization and staying in ICU (33, 34). Several factors such as smoking, aspirin, alcohol, obesity and aging may affect the complex network of mechanisms regulating vitamin C and its transmission and its physiological effects also considering that parameters of oxidative stress increase significantly during and after cardiac bypass surgery and it is the cause of damage to tissues (35, 36).…”

Section: Discussionmentioning

confidence: 99%

Comparison Effect of Tranexamic Acid (TA) and Tranexamic Acid Combined with Vitamin C (TXC) on Drainage Volume and Atrial Fibrillation Arrhythmia in Patients Undergoing Cardiac Bypass Surgery: Randomized Clinical Trial

et al. 2019

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BackgroundTranexamic acid and vitamin C are potent antifibrinolytic and oxidative stress agents that reduce blood loss and transfusion blood in cardiopulmonary bypass (CPB).ObjectivesThe aim of this study was to evaluate the efficacy of tranexamic acid (TA) and tranexamic acid combined with vitamin C (TXC) on drainage volume (blood loss) and atrial fibrillation (AF) in patients undergoing cardiac bypass surgery in Gorgan, Shafa hospital, Iran.MethodsThis study is a double-blind randomized clinical trial. A sample size of 120 candidates of cardiac bypass surgery were included in this prospective study. Patients were randomly assigned to treatments in two groups. In both groups, 50 mg/kg tranexamic acid was administered intravenously directly before sternotomy: group A (N = 58) patients received tranexamic acid (TA) only and group B (N = 62) tranexamic acid with vitamin C (TXC) half an hour before surgery and 2 g vitamin C with 100 mL 0.9% saline were injected. Subsequently, during 4 days after surgery, 1000 mg of vitamin C and 100 cc 0.9% saline was infused every day. Intraoperative and postoperative blood loss (volume of blood in the drain) and atrial fibrillation complications were recorded for 24 hours after the operation.ResultsThe patients who received vitamin C had less bleeding during operation and in the early hours post-operation. Patients in (TA) group had mean drainage of 34.41 milliliter more than patients in (TXC) group (P < 0.001). Chi-square test showed that arrhythmia (AF) condition was the same in the two groups during 14 times of study (four times during operation and ten times up to 24 hours after the operation), and AF arrhythmia in the two groups was less than 5%.ConclusionsIn this study tranexamic acid with vitamin C have a positive effect on the amount of drainage (blood loss) and there was no significant difference in the incidence of AF between two groups.

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“…During the first 36 hours after a surgical incision, inflammation is activated in the form of increased involvement of immune cells, increased expression of adhesion molecules and increased synthesis of proinflammatory cytokines, such as IL-1, IL-6, IL-8 and TNF-α. In the second phase of this process, lasting approximately 2 days, there is a decrease in inflammatory activity through immunosuppression, with participation of among others IL-10 and IL-1RA, which regulate both humoral and cellular responses [223]. Surgical traumatization of tissue inducing acute inflammation leads to a cascade of regenerating processes.…”

Section: Wound Healingmentioning

confidence: 99%

Modeling of the immune response in the pathogenesis of solid tumors and its prognostic significance

2020

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Background Tumor initiation and subsequent progression are usually long-term processes, spread over time and conditioned by diverse aspects. Many cancers develop on the basis of chronic inflammation; however, despite dozens of years of research, little is known about the factors triggering neoplastic transformation under these conditions. Molecular characterization of both pathogenetic states, i.e., similarities and differences between chronic inflammation and cancer, is also poorly defined. The secretory activity of tumor cells may change the immunophenotype of immune cells and modify the extracellular microenvironment, which allows the bypass of host defense mechanisms and seems to have diagnostic and prognostic value. The phenomenon of immunosuppression is also present during chronic inflammation, and the development of cancer, due to its duration, predisposes patients to the promotion of chronic inflammation. The aim of our work was to discuss the above issues based on the latest scientific insights. A theoretical mechanism of cancer immunosuppression is also proposed. Conclusions Development of solid tumors may occur both during acute and chronic phases of inflammation. Differences in the regulation of immune responses between precancerous states and the cancers resulting from them emphasize the importance of immunosuppressive factors in oncogenesis. Cancer cells may, through their secretory activity and extracellular transport mechanisms, enhance deterioration of the immune system which, in turn, may have prognostic implications.

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Systemic Inflammatory Stress Response During Cardiac Surgery

Cited by 17 publications

References 29 publications

The Predictive Role of QEEG in the Post-Operative Delirium and Prognosis of Cardiac Surgery Patients

The Predictive Role of QEEG in the Post-Operative Delirium and Prognosis of Cardiac Surgery Patients

Comparison Effect of Tranexamic Acid (TA) and Tranexamic Acid Combined with Vitamin C (TXC) on Drainage Volume and Atrial Fibrillation Arrhythmia in Patients Undergoing Cardiac Bypass Surgery: Randomized Clinical Trial

Modeling of the immune response in the pathogenesis of solid tumors and its prognostic significance

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