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Albumin, cardiac bypass surgery

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...
September 12, 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...
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...
May 19, 2016: 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
Rianne M Jongman, Jan van Klarenbosch, Grietje Molema, Jan G Zijlstra, Adrianus J de Vries, Matijs van Meurs
INTRODUCTION: The pathophysiology of acute kidney injury (AKI) after cardiac surgery is not completely understood. Recent evidence suggests a pivotal role for the endothelium in AKI. In experimental models of AKI, the endothelial specific receptor Tie2 with its ligands Angiopoietin (Ang) 1 and Ang2 are deranged. This study investigates their status after cardiac surgery, and a possible relation between angiopoietins and AKI. METHODS: From a cohort of 541 patients that underwent cardiac surgery, blood and urine was collected at 5 predefined time points...
2015: PloS One
Zhamak Khorgami, Amin Andalib, Ali Aminian, Matthew D Kroh, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Readmission rate is an indicator of quality in surgical practice. We aimed to determine the predictors of unplanned early readmissions following stapling bariatric surgeries. METHODS: From the American College of Surgeons National Surgical Quality Improvement Program database, we identified morbidly obese patients, who underwent either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in 2012 and 2013. Demographic, comorbidities, operative and postoperative parameters of the readmitted (within 30 days) and non-readmitted patients were evaluated using a multivariate logistic regression analysis...
June 2016: Surgical Endoscopy
Vincent G Geukers, Monique E Dijsselhof, Nicolaas J G Jansen, Johannes M P J Breur, Dewi van Harskamp, Henk Schierbeek, Johannes B van Goudoever, Albert P Bos, Hans P Sauerwein
BACKGROUND: Infants undergoing cardiac surgery are at risk of a negative protein balance, due to increased proteolysis in response to surgery and the cardiopulmonary bypass circuit, and limited intake. The aim of the study was to quantify the effect on protein kinetics of a short-term high-protein (HP) diet in infants following cardiac surgery. METHODS: In a prospective, double-blinded, randomized trial we compared the effects of a HP (5 g · kg(-1) · d(-1)) versus normal protein (NP, 2 g · kg(-1) · d(-1)) enteral diet on protein kinetics in children <24 months, on day 2 following surgical repair of congenital heart disease...
2015: Nutrition Journal
Feng Qian, Edward L Hannan, Michael Pine, Donald E Fry, Kay Whitman, Barbara A Dennison
BACKGROUND: Registry data for percutaneous coronary intervention (PCI) are being used in New York and Massachusetts and by the American College of Cardiology to risk-adjust provider mortality rates. These registries contain very few numerical laboratory data for risk adjustment. METHODS: For 20 hospitals, New York's PCI registry data from 2008-2010 were used to develop statistic models for predicting in-hospital/30-day mortality with and without appended laboratory data...
July 2015: Journal of Invasive Cardiology
Chantal L I Gielen, Jos Grimbergen, Robert J M Klautz, Jaap Koopman, Paul H A Quax
Fibrinogen as precursor of fibrin plays an essential role in clot formation. There are three main mechanisms associated with a reduction in fibrinogen concentration during cardiac surgery: hemodilution, consumption, and degradation. Moreover, early fibrinogen degradation products (FgDPs) can interfere with normal fibrin formation of intact fibrinogen. The aim of this study was to determine the relative contributions of hemodilution, consumption, and degradation to fibrinogen loss in cardiac surgery and to evaluate the effects fibrinogen degradation products on blood clot formation in vitro...
September 2015: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Yuichiro Sato, Tomoko S Kato, Atsumi Oishi, Taira Yamamoto, Kenji Kuwaki, Hirotaka Inaba, Atsushi Amano
Renal dysfunction is a major adverse event after cardiovascular surgery. Therefore, the preoperative prediction of which patients will require renal replacement therapy (RRT) after cardiac surgery is an important issue. In the present study, 1,822 consecutive patients who underwent cardiovascular surgery from 2008 and 2013 at a single institution were reviewed. Patients who were already receiving long-term hemodialysis before surgery (n = 134) were excluded. The remaining 1,688 patients were separated into 2 groups: those requiring postoperative RRT and those without RRT requirement...
July 15, 2015: American Journal of Cardiology
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