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Albumin, cardiac bypass surgery

Kathirvel Subramaniam, Diana S DeAndrade, Daniel R Mandell, Andrew D Althouse, Rajan Manmohan, Stephen A Esper, Jeffrey M Varga, Vinay Badhwar
OBJECTIVE: The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. METHODS: All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
Christian Cereghetti, Martin Siegemund, Sabine Schaedelin, Jens Fassl, Manfred D Seeberger, Friedrich S Eckstein, Luzius A Steiner, Nicolai Goettel
OBJECTIVE: Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013...
March 31, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Richard Crook, Richard Issitt
OBJECTIVES: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very few baseline data are available for those patients requiring surgery within the first few weeks and months of life. Our aim was to determine if our CHD population exhibited COP similar to that of other extremely ill subsets of patients and, if so, whether this related to risk stratification model scores...
January 1, 2017: Perfusion
Pieter A J G De Cock, Hussain Mulla, Sarah Desmet, Filip De Somer, Brett C McWhinney, Jacobus P J Ungerer, Annelies Moerman, Sabrina Commeyne, Johan Vande Walle, Katrien Francois, Johan G C Van Hasselt, Peter De Paepe
Objectives: The objective of this study was to characterize cefazolin serum pharmacokinetics in children before, during and after cardiopulmonary bypass (CPB), in order to derive an evidence-based dosing regimen. Patients and methods: This study included children who received cefazolin before surgical incision, before cessation of CPB and after surgery. Blood samples of total and unbound cefazolin concentrations were collected before, during and after CPB. The cefazolin concentration-time profiles were analysed using population pharmacokinetic modelling and predictors for interindividual variability in pharmacokinetic parameters were investigated...
March 1, 2017: Journal of Antimicrobial Chemotherapy
Shu-Rong Gong, Ying-Rui Zhang, Rong-Guo Yu
OBJECTIVE: To explore the risk factors for acute respiratory distress syndrome (ARDS) in children receiving surgeries for critical and complex congenital heart disease (CCHD). METHODS: According to the 2011's Berlin definition of ARDS, the clinical data were collected from 75 children without ARDS (group I) and 80 children with ARDS (group II) following surgeries for CCHD performed in the Department of Cardiac Surgery of our hospital from January, 2009 to May, 2014...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Anita K Patel, Katherine V Biagas, Eunice C Clarke, Linda M Gerber, Elizabeth Mauer, Gabrielle Silver, Paul Chai, Rozelle Corda, Chani Traube
OBJECTIVES: To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. DESIGN: Prospective observational single-center study. SETTING: Fourteen-bed pediatric cardiothoracic ICU. PATIENTS: One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. INTERVENTIONS: Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium...
February 2017: Pediatric Critical Care Medicine
Jason H Greenberg, Michael Zappitelli, Prasad Devarajan, Heather R Thiessen-Philbrook, Catherine Krawczeski, Simon Li, Amit X Garg, Steve Coca, Chirag R Parikh
Importance: Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. Objective: To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. Design, Setting, and Participants: This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009...
November 1, 2016: JAMA Pediatrics
Jigar Patel, Mrugesh Prajapati, Atul Solanki, Himani Pandya
INTRODUCTION: In paediatric cardiac surgery, there is still not any information with regard to the best choice of priming fluids for Cardiopulmonary Bypass (CPB). Albumin, Hydroxyethyl Starch (HES) & ringer lactate are equally used, but each has its advantages & disadvantages. Albumin & HES had better fluid balance which affect outcome in paediatric cardiac surgery significantly. AIM: To compare priming solution containing albumin, hydroxyethyl starch and ringer lactate during elective open-heart surgery in paediatrics aged up to 3 years...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
T K Susheel Kumar, Jerry Allen Ccp, Thomas Spentzas Md, Lindsay Berrios Ccp, Samir Shah Md, Vijaya M Joshi Md, Jean A Ballweg Md, Christopher J Knott-Craig Md
OBJECTIVE: Acute kidney injury (AKI) following cardiac surgery is a serious complication with a reported incidence of 30% to 50%. This study sought to determine the prevalence and risk factors for AKI among neonates and young infants undergoing repair of cardiac defects at an institution using novel perioperative strategies. METHODS: A retrospective analysis of 102 consecutive infants (<2 months) undergoing repair of cardiac defects on cardiopulmonary bypass formed the study group...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
Orhan Findik, Ufuk Aydin, Ozgur Baris, Hakan Parlar, Gokcen Atilboz Alagoz, Yusuf Ata, Tamer Turk, Atike Tekeli Kunt
BACKGROUND: Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG). METHODS: We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function...
June 23, 2016: Heart Surgery Forum
Christian Lanckohr, Dagmar Horn, Swantje Voeller, Georg Hempel, Manfred Fobker, Henryk Welp, Robin Koeck, Bjoern Ellger
OBJECTIVE: Adequate levels of perioperative antibiotic prophylaxis are essential for prevention of surgical site infections. We examined pharmacokinetic details of 2 g cefazolin administered during induction of anesthesia with repeat dosing shortly after initiation of cardiopulmonary bypass (CPB) in cardiac surgery. METHODS: To identify the microbiologic flora targeted with prophylaxis, pre-, and postoperative swabs were taken from sternal skin. Blood samples for measurement of cefazolin were obtained in 24 patients...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Firat H Altin, Hayriye A Yildirim, Ibrahim C Tanidir, Okan Yildiz, Meliha Z Kahraman, Erkut Ozturk, Sinem B Celebi, Mugisha Kyaruzi, İhsan Bakir
OBJECTIVE: Oxidative stress refers to an imbalance between reactive oxidative species and antioxidants. In this case-controlled, prospective, observational study, we investigated the total oxidant status, total antioxidant status, oxidative stress index, and albumin and C-reactive protein levels of children with cyanotic and acyanotic congenital heart diseases who had undergone on-pump cardiac surgery. METHOD: The study groups consisted of 60 patients with congenital heart disease, who were operated under cardiopulmonary bypass, and a control group of 30 healthy individuals...
March 2017: Cardiology in the Young
G W Fu, Y F Nie, Z Y Jiao, W Z Zhao
Retrograde autologous priming (RAP) has been routinely applied in cardiac pediatric cardiopulmonary bypass (CPB). However, this technique is performed in pediatric patients weighing more than 20 kg, and research about its application in pediatric patients weighing less than 20 kg is still scarce. This study explored the clinical application of RAP in CPB in pediatric patients undergoing cardiac surgery. Sixty pediatric patients scheduled for cardiac surgery were randomly divided into control and experimental groups...
2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Mahmood Hosseinzadeh Maleki, Pooya Derakhshan, Amir Rahmanian Sharifabad, Ahmad Amouzeshi
BACKGROUND: The ideal strategy to prime the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery is still a matter of debate. OBJECTIVES: In this retrospective study, we examined Albumin solution and hydroxyethyl starch (HES) for priming the CPB circuit and evaluated the differences in kidney function and bleeding and coagulation status in the two groups of patients. PATIENTS AND METHODS: Sixty consecutive patients undergoing elective coronary artery bypass grafting were studied...
February 2016: Anesthesiology and Pain Medicine
Poonam Malhotra Kapoor, Jitin Narula, Ujjwal Kumar Chowdhury, Usha Kiran, Sameer Taneja
INTRODUCTION: Hypoalbuminemia is a well-recognized predictor of general surgical risk and frequently occurs in patients with cyanotic congenital heart disease (CCHD). Moreover, cardiopulmonary bypass (CPB)-induced an inflammatory response, and the overall surgical stress can effect albumin concentration greatly. The objective of his study was to track CPB-induced changes in albumin concentration in patients with CCHD and to determine the effect of hypoalbuminemia on postoperative outcomes...
April 2016: Annals of Cardiac Anaesthesia
Chantal L I Gielen, Anneke Brand, Waander L van Heerde, Theo Stijnen, Robert J M Klautz, Jeroen Eikenboom
INTRODUCTION: The origination of blood loss after cardiac surgery is not fully explained, but is related to operation trauma and use of cardiopulmonary bypass (CPB). However, the extent of their contribution is incompletely known and might differ between distinct operation procedures. MATERIALS AND METHODS: Three groups of CABG procedures were studied: 1) off-pump coronary artery bypass surgery (OPCAB, n=11) without CPB, 2) CABG with use of CPB (CABG, n=11) and 3) CABG with use of CPB combined with aortic valve replacement (AVR, n=11)...
April 2016: Thrombosis Research
Gunnar Schley, Carmen Köberle, Ekaterina Manuilova, Sandra Rutz, Christian Forster, Michael Weyand, Ivan Formentini, Rosemarie Kientsch-Engel, Kai-Uwe Eckardt, Carsten Willam
BACKGROUND: New renal biomarkers measured in urine promise to increase specificity for risk stratification and early diagnosis of acute kidney injury (AKI) but concomitantly may be altered by urine concentration effects and chronic renal insufficiency. This study therefore directly compared the performance of AKI biomarkers in urine and plasma. METHODS: This single-center, prospective cohort study included 110 unselected adults undergoing cardiac surgery with cardiopulmonary bypass between 2009 and 2010...
2015: PloS One
Rafael González, Javier Urbano, Jorge López, Maria J Solana, Marta Botrán, Ana García, Sarah N Fernández, Jesús López-Herce
BACKGROUND: Haemorrhagic shock is frequent in paediatric trauma patients and after cardiac surgery, especially after cardiopulmonary bypass. It has demonstrated to be related to bad outcome. OBJECTIVES: To evaluate changes on microcirculatory parameters during haemorrhagic shock and resuscitation in a paediatric animal model. To determine correlation between microcirculatory parameters and other variables routinely used in the monitoring of haemorrhagic shock. METHODS: Experimental study on 17 Maryland pigs...
February 2016: Injury
Poonam Malhotra Kapoor, Sameer Taneja, Usha Kiran, P Rajashekhar
OBJECTIVE (S): The aim of this study was to compare the effects of using inhalational anesthesia with desflurane with that of a total intravenous (iv) anesthetic technique using midazolam-fentanyl-propofol on the release of cardiac biomarkers after aortic valve replacement (AVR) for aortic stenosis (AS). The specific objectives included (a) determination of the levels of ischemia-modified albumin (IMA) and cardiac troponin I (cTnI) as markers of myocardial injury, (b) effect on mortality, morbidity, duration of mechanical ventilation, length of Intensive Care Unit (ICU) and hospital stay, incidence of arrhythmias, pacing, cardioversion, urine output, and serum creatinine...
October 2015: Annals of Cardiac Anaesthesia
Kentaro Sugimoto, Yuichiro Toda, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomoyuki Kanazawa, Noriko Muto, Hirokazu Kawase, Hiroshi Morimatsu, Kiyoshi Morita, Yohei Maeshima, Kiyoshi Mori, Shunji Sano
OBJECTIVE: Mortality and morbidity of acute kidney injury (AKI) after cardiac surgery still remain high. The authors undertook the present study to evaluate the utility of early postoperative urinary albumin (uAlb) as a diagnostic marker for predicting occurrence of AKI and its severity in pediatric patients undergoing cardiac surgery. DESIGN: A prospective observational study. SETTING: A single-institution university hospital. PARTICIPANTS: All patients<18 years of age who underwent repair of congenital heart disease with cardiopulmonary bypass between July 2010 and July 2012 were included in the study...
January 2016: Journal of Cardiothoracic and Vascular Anesthesia
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