Is crystalloid cardioplegia a strong predictor of intra-operative hemodilution?

Introduction: Complications due to hemodilution (hematocrit value less than 22%) after cardiopulmonary bypass inevitably resulted with significantly greater intensive care requirements, long hospital stays, more operative costs, and increased mortality rates. We tried to identify whether crystalloid cardioplegia is the strongest predictor of intraoperative hemodilution or not. Materials and methods: One hundred patients were included into this randomized prospective study. Patients were divided into the two groups. Crystalloid cardioplegia were given to the odd-numbered patients (Group 1, n = 50 patients) and blood cardioplegia were given to the even-numbered patients (Group 2, n = 50 patients). St. Thomas-II solution was used in Group-1 and Calafiore cold blood cardioplegia was in Group-2. Results: Average intraoperative hematocrit value was 18.4% +/- 2.3 in crystalloid group 24.2% +/- 3.4 in blood cardioplegia group (p 60 minutes) (p = 0.001, OD = 0.97), body surface area <1.6 m(2) (p = 0.001, OR = 6.01) and crystalloid cardioplegia (p < 0.001, OR = 0.19) as predictor of intraoperative hemodilution. Conclusion: Crystalloid cardioplegia, compared to blood cardioplegia not only causes much more intra-operative hemodilution but also increases the blood transfusion requirement. Hemodilution and increased transfusion increases the intensive care unit and hospital stay, in the early postoperative period

Effects of Cardiopulmonary Bypass on Mediastinal Drainage and the Use of Blood Products in the Intensive Care Unit in 60-to 80-Year-Old Patients Who Have Undergone Coronary Artery Bypass Grafting

Objective: The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. Methods: The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year. Results: It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs. Group 2; 703.5 +/- 253.8 ml vs. 719.6 +/- 209.4 ml; P=0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs. Group 2; 259.8 +/- 170.6 ml vs. 190.1 +/- 129.1 ml; P=0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs. Group 2; 2.2 +/- 1.3 bag vs. 1.2 +/- 0.9 bag; P<0.001). Conclusion: We can say that CPB influences the amount of second 24-hour drainage which indexed body surface area. In addition, CPB decreases hct, hb, thrombocyte count in ICU arrived, after 24 hours in postoperative period. Reduced thrombocyte counting effect can be appeared after 48 hours in the postoperative period of CPB

Serum uric acid and carotid artery intima media thickness in patients with masked hypertension

Background Serum uric acid is related to hypertension and cardiovascular diseases. Masked hypertension is associated with an increase in cardiovascular risk. The aim of our study was to evaluate the serum uric acid level and its relationship with carotid intima-media thickness (IMT) in patients with masked hypertension