Annals of cardiac anaesthesia
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Antifibrinolytic agents are used during cardiac surgery to minimize bleeding and reduce exposure to blood products. Several reports suggest that tranexamic acid (TA) can induce seizure activity in the postoperative period. To examine factors associated with postoperative seizures in patients undergoing cardiac surgery who received TA. ⋯ An association between high preoperative creatinine value and postoperative seizure was identified. TA may be associated with the development of postoperative seizures in patients with renal dysfunction. Doses of TA should be reduced or even avoided in this population.
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Randomized Controlled Trial Comparative Study
Comparison of S100β levels, and their correlation with hemodynamic indices in patients undergoing coronary artery bypass grafting with three different anesthetic techniques.
Cardiac surgery with aid of cardiopulmonary bypass (CPB) is associated with neurological dysfunction. The presence of cerebrospecific protein S100β in serum is an indicator of cerebral damage. This study was designed to evaluate the influence of three different anesthesia techniques, on S100β levels, in patients undergoing coronary artery bypass grafting on CPB. ⋯ It was concluded that maximum rise in S100β levels occurs immediately after CPB with a gradual decline in next 24 h. The rise in S100β levels is significantly less in patients administered sevoflurane in comparison to isoflurane or TIVA. Hemodynamic parameters had no influence on the S100β levels during the first 24 h after surgery.
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Renal dysfunction is known to occur during cardiac surgery. A few factors such as perioperative hypotension, use of potential nephrotoxic therapeutic agents, radio opaque contrast media in the recent past, intra-aortic balloon pump (IABP) and cardiopulmonary bypass have been blamed as the contributing factors to the causation of postoperative renal dysfunction in cardiac surgical patients. At times, in patients with renal failure and low cardiac output status, one may face the dilemma if the use of IABP is safe. ⋯ Cystatin C levels significantly decreased from the basal level of 0.98 ± 0.29 to 0.89 ± 0.23 (P value <0.05). Contrary to the belief, Cystatin C, the early indicator of renal dysfunction decreases suggesting absence of renal injury after the use of IABP. Absence of elevation of cystatin C levels in our study suggests the lack of potential of the IABP to cause renal dysfunction in patients who received elective IABP therapy preoperatively.