Background and objectives: The relationship between cerebral perfusion and new postoperative ischemic stroke in obese patients is not well defined. The aim of this study
This systematic review and meta-analysis evaluates the effectiveness of remote ischemic preconditioning (RIPC) in preventing cognitive dysfunction after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. Despite hypothesized benefits, the meta-analysis of five studies encompassing 1,843 participants showed that RIPC does not significantly reduce the incidence or severity of postoperative cognitive dysfunction. The findings suggest that RIPC is not effective as a neuroprotective strategy in CABG patients.
This study compares the efficacy of Del Nido cardioplegia (DN) and traditional crystalloid blood cardioplegia in patients undergoing coronary artery bypass surgery, focusing on their effects on arrhythmias and early surgical outcomes. The research involved 175 patients using crystalloid cardioplegia and 150 patients using DN solution. Findings suggest that DN solution, particularly when part of the dose is administered through grafts, leads to better control of arrhythmias post-surgery, reduced need for pacing, and shorter hospital and intensive care unit stays.
This study aims to compare the myocardial protection offered by single-dose cardioplegic solutions (Custodiol, del Nido, and modified del Nido) using histological analysis in a double-blind clinical trial. At least 90 patients undergoing cardiac surgery will be randomly assigned to one of the three solutions, with myocardial biopsies collected before and after cardiopulmonary bypass. The research seeks to determine the most effective solution for minimizing ischemic damage during cardiac surgery, which is critical for patient safety and outcome optimization. Results could influence clinical protocols and cardioplegic solution selection globally.
This retrospective study evaluates the myocardial protective effects of perioperative Nicorandil (NICD) in patients undergoing cardiac surgery with cardiopulmonary bypass. Analyzing data from 2406 patients, the study found that NICD significantly reduced the incidence of myocardial injury and postoperative acute liver injury (ALI), and shortened the duration of mechanical ventilation, ICU and hospital length of stay, and chest drainage. These findings suggest that NICD can offer substantial myocardial protection and improve postoperative outcomes in cardiac surgery patients.
This study compares the effectiveness of del Nido and cold blood cardioplegia in high-risk patients with reduced ejection fraction undergoing isolated coronary artery bypass grafting. With 45 patient pairs matched for several factors, the research found that del Nido cardioplegia resulted in a higher rate of spontaneous return to sinus rhythm post-surgery and showed a trend towards lower creatine kinase release and atrial fibrillation rates, though mortality and major adverse cardiac events were similar between the two groups. The findings suggest del Nido cardioplegia may offer satisfactory myocardial protection in this patient demographic, highlighting the need for further prospective trials.
This study aimed to examine myocardial damage at the molecular level in coronary bypass surgery patients, focusing on autophagy and apoptosis mechanisms. It found no significant difference in myocardial protection between Custodiol cardioplegia (CC) and Blood cardioplegia (BC) solutions, despite variations in BECLIN and CASPASE gene expressions in myocardial tissues.
This study aimed to develop a dynamic predictive model for cardiac surgery-associated acute kidney injury (CSA-AKI), using data from 910 cardiac surgery patients to combine preoperative risks and cardiopulmonary bypass (CPB) related factors into a multifactorial dynamic perfusion index (MDPI). The study found that the MDPI, which includes dynamic CPB quality indices, has better predictive ability for CSA-AKI than existing static models, suggesting its potential as a more effective tool for integrating various risk factors in patient care.
In a study on children undergoing cardiac surgery, remote ischemic preconditioning showed a potential for reducing kidney injury, but there were no significant differences in cardiac markers or secondary clinical outcomes. Although there was a minor trend towards kidney protection, larger studies are needed to confirm the efficacy of this intervention in a high-risk pediatric population.
This study tested if phosphocreatine (PCr) reduces troponin I levels in cardiac surgery patients with prolonged aortic clamping and cardiopulmonary bypass. Although PCr was safely administered, it did not lead to a decrease in troponin I concentration or improve other clinical outcomes after surgery.
