J Cardiovasc Surg
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Randomized Controlled Trial
The effect of combined preinduction thoracic epidural anaesthesia and glucocorticoid administration on perioperative interleukin-10 levels and hyperglycemia. A randomized controlled trial.
Anti-inflammatory cytokines such as interleukin-10 (IL-10) play a key role in the anti-inflammatory cascade after cardiopulmonary bypass (CPB). Even moderate hyperglycemia can increase mortality/morbidity, stroke, and myocardial infarction after coronary artery bypass grafting (CABG). The purpose of our study was to investigate whether preinduction thoracic epidural anesthesia (TEA) and preinduction glucocorticoid have an effect on perioperative anti-inflammatory and perioperative hyperglycemia in patients undergoing CABG with CPB. ⋯ The study results show that preinduction TEA improves glucose homeostasis during the perioperative 24-h period in CABG surgery. In addition, we found that while preinduction TEA reduced blood IL-10 levels, preinduction glucocorticoid and TEA+S increased the circulating levels of IL-10.
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Controlled Clinical Trial
The effect of milrinone on metabolism after cardiopulmonary bypass.
The aim of this study was to examine the effects of milrinone on tissue metabolism perioperatively in cardiac surgery patients using extracorporeal circulation, in comparison to adrenaline and placebo. These effects were measured indirectly by measuring serum lactate, base excess and glucose levels at standard intervals. ⋯ These findings suggest that milrinone has a beneficiary effect on aerobic tissue metabolism after extracorporeal circulation, reflected on serum lactate, base excess and glucose levels, possibly due to a combination of positive inotropic and peripheral vasodilatory effect of the drug.
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Comparative Study
Cardiac troponin I versus creatine kinase-MB in the detection of postoperative cardiac events after coronary artery bypass grafting surgery.
Several studies suggest that postoperarive concentrations of cardiac troponin-I (cTnI) may increase in patients undergoing aorto-coronary bypass grafting (CABG). The degree and pattern of release appears to be associated with perioperative myocardial damage. ⋯ CTnI seems to be more valuable compared to CK-MB in the detection of PCEs in patients undergoing coronary surgery.
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The intra-aortic balloon pump (IABP) is commonly used for decreasing myocardial oxygen demand by systolic unloading in perioperative heart failure. The aim of this study was to determine perioperative prognostic factors for in-hospital mortality in coronary artery bypass grafting patients who received the intraaortic balloon pump. ⋯ According to our study the mortality of IABP group is low compared to other studies, as well as IABP-associated complications. Also it revealed that there is no correlation between IABP-associated complications and early mortality.