Comparison of Different Ventilation Strategies during Cardiopulmonary Bypass in Smoker Patients Under Cardiac Surgery

Background: Control of pulmonary ventilation during surgery, especially heart surgery, is very important. Therefore, in this study, we will compare different ventilation strategies during cardiopulmonary bypass in smokers undergoing cardiac surgery. Methods: A total of 42 patients who had a clinical indication for CABG were included in this study. Patients were randomly divided into two groups.  All patients were operated on by the same surgeon and cardiac anesthesia team in the same condition. The patient data includes age, sex, height, weight, and spirometry indices (FEV1, FVC, FEV1 / FVC, MMEF, PEF, PaO2, PaCO2, PaO2 / fio2, PaO2 / fio2, and Pent. T)  were recorded prospectively for each patient. Results: Examines the spirometry indices of patients in the two groups in both pre-procedure and off-pump time, do not show significant changes (P<0.005). Conclusion: The use of different ventilation strategies in smokers undergoing CABG surgery could not cause significant changes in patients' respiratory parameters

Thiamine can decrease Lactate and Creatinine level after Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction

Introduction: During cardiopulmonary bypass, oxidative stress happens in the patient's cells due to blood contact with various levels of synthetic materials. It can activate inflammatory process and release factors such as IL-6, CRP, and Neutrophils witch may hurt different organs. In recent years, many efforts have been made to prevent this type of damage, however, no single treatment has been proposed to reduce this risk. Antioxidant substances such as Thiamine is important in cell defense against free oxygen radicals. Regarding this issue, in this study, the effect of thiamine on lactate levels in patients undergoing coronary artery bypass graft surgery has been investigated.Materials and methods: In this study, 140 patients from 25 to 65 years old with mild systolic dysfunction (EF = 45-55%) who were candidates for elective CABG surgery in two groups: control and purpose (patients receiving Thiamine) were examined. All of these patients were anesthetized in an identical manner, and were subjected to a heart-lung pump. Serum lactate levels were measured before, during and 6, 12, 18, and 24 hours after surgery. All data collected in a questionnaire were recorded and evaluated using spss statistical software.Results: Study groups showed no significant differences regarding demographics and underlying diseases. Serum lactate was significantly lower in thiamine group during the first 24 hours after surgery (except before operation and 2 hours later) (p &lt;0.05).Creatinine level in two groups before surgery was not significantly different ,However, it was significantly lower in case group 24 hours after surgery(1.54±0.14 vs. 1.24±0.19; p: 0.001).Also, dose of Inotropes in  patients who received thiamine, was significantly lower than the control group (p= 0.001). Extubation was longer in control group (15.4±4.9 vs. 13.15±4.1; p=0.003) while ICU stay was not different.Conclusion: It seems that thiamine administration before cardiopulmonary bypass, in patient with decreased left ventricular function, can decrease serum lactate as tissue perfusion marker and also improve kidney function

The relationship between s100β and cerebral oximetry trend in patients undergoing CABG with cardiopulmonary bypass

Background: CABG is among the most common cardiac procedures often done as on pump surgery. There are however, there is always the risk for potential neurologic and neurocognitive insults in CABG. S100β is a biomarker for CNS damage. Cerebral oximetry using NIRS has been developed for CNS monitoring especially cardiac surgery. This study was designed to find the relationship between serum levels of s100β and cerebral oximetry in CABG patients.Methods: in an observational study, 44 adult 40-75 years patients entered the study for elective CABG. Serum levels of s100β were assessed at two times during CPB; i.e. just after aortic clamping and immediately after aortic declamping; while the results were compared with right and left cerebral oximetry readings (NIRS); however, NIRS was measured at baseline, during start of cardiopulmonary bypass (CPB), during aortic clamping, and finally at off-clamping the aorta. Repeated Measures ANCOVA (analysis of covariance), multiple linear regression models and Spearman correlation coefficient with scatter plot were used for data analysis. P value less than 0.05 considered significant.Results: no linear correlation between s100β and NIRS was found according to correlation coefficients. Only among the patients whose s100β was more than 10, the scatter plots demonstrated a positive linear relationship between s100β and right NIRS (spearman correlation coefficient= 0.792; P value=0.006).Conclusions: the study failed to demonstrate a relationship between on-CPB NIRS numbers and serum s100β in adult patients undergoing CABG during the bypass interval; further studies are suggested to evaluate potential predictive value of NIRS in brain ischemia

Pictorial Warning Labels and Quit Intention in Smokers Presenting to a Smoking Cessation Clinic

ABSTRACT Background: At present, cigarette smoking results in the death of more than 5 million people annually and if the curren

The Relationship Between Vitamin E Plasma and BAL Concentrations, SOD Activity and Ventilatory Support Measures in Critically Ill Patients

Abstract Vitamin E is a potent reactive oxygen metabolites (ROM) scavenger. It is a lipid-soluble vitamin and its main function is to protect polyunsaturated fatty acids against oxidative stress. Twenty-five mechanically ventilated Intensive Care Unit (ICU) adult patients participated in a prospective randomized clinical trial receiving either placebo (10 patients) or 3 IM doses (1000 IU each) of vitamin E (15 patients). We determined plasma and bronchoalveolar lavage (BAL) fluid concentrations of vitamin E and superoxide dismutase (SOD). Among these 25 patients, there were 14 men and 11 women, aged 63.16 ±15.48 years (mean ± SD; range = 33 to 87 years). Vitamin E supplementation resulted in significant differences in plasma and BAL vitamin E concentrations between the two groups (p-value = 0.01, 0.01), decrease in SOD activities (not differ significantly in plasma (p-value = 0.23)), but with significant differences in BAL (p-value = 0.016) and progressive reduction in Acute Physiology and Chronic Health Evaluation II (APACHE II) (p-value = 0.52) and Sequential Organ Failure Assessment (SOFA) (p-value = 0.008) score in vitamin E group. From the results of this study, it seems that supplementation of vitamin E as a potent antioxidant, along with other supportive measures, can be beneficial in decreasing SOD total activity, ROM production and risk of organ failure in critically ill patients