BackgroundPostoperative atrial fibrillation is common after cardiac surgery. In this study, we aimed to investigate the value of interatrial conduction time for the prediction of early postoperative atrial fibrillation, using intra-operative transoesophageal echocardiography.MethodsA total of 65 patients undergoing cardiac surgery in our hospital between January and March 2007 were prospectively evaluated, and 59 patients with sinus rhythm were included in the study. We performed transoesophageal echocardiography on all patients, and intra-operatively measured the interatrial conduction time, as recently described. The patients with episodes of atrial fibrillation during the post-surgery hospitalisation period were defined as group 1 and those without episodes were defined as group 2.ResultsMean interatrial conduction time was 74 ± 15.9 ms in group 1 and 54 ± 7.9 ms in group 2. The difference in interatrial conduction time between the two groups was statistically significant (p < 0.05). In this study we found a statistically significant interatrial conduction delay between the groups. Postoperative atrial fibrillation was more frequent in patients with a longer interatrial conduction time.ConclusionIncreased interatrial conduction time may cause postoperative atrial fibrillation and it can be measured intraoperatively by transoesophageal echocardiography.
Objective: Subclinical chronic inflammation plays an important role in the pathogenesis of type 2 diabetes mellitus (DM) and inflammation-related hemogram parameters have been proposed as an indicator of inflammation. In our study, we aimed to compare the hemogram parameters of normal oral glucose tolerance test (OGTT), prediabetes (preDM) and newly diagnosed type 2 DM patients. Methods: Medical data of the patients who underwent 75 gr OGTT in the endocrinology outpatient clinic of our institution between february 2019 and december 2019 were obtained from the database and analyzed retrospectively. The test results were divided into 3 groups as normal OGTT, preDM and DM. Anthropometric measurements of patients, HbA1c and hemogram parameters were recorded. Results: A total of 496 cases (246 normal OGTT, 105 patients with preDM and 145 patients with DM) were included in the study. Fasting plasma glucose (FPG) and HbA1c levels of men were higher than women (p<0.05). There was no significant difference between the three groups in terms of inflammation-related hemogram parameters. But, there was a positive correlation between FPG and MPV to platelet ratio (MPR) in diabetic patients (r=0.173; p=0.037). Conclusion:Hemogram parameters associated with inflammation are easily calculated and cheap indices. However, they are not strong markers in new diagnosis, HbA1c ≤6.5% diabetic patients and prediabetic patients.
Background: Coronary artery bypass surgery is the most commonly performed cardiac operation and approximately 40-70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. Some preventive perfusion methods to avoid transfusions are described, such as acute normovolemic hemodilution, retrograde autologous priming, and usage of integrated arterial filter oxygenator. Aims: We combined these three techniques (triple combination technique) to evaluate whether it is possible to avoid blood transfusions in adult patients undergoing coronary artery bypass surgery. Materials and Methods: A total of 300 consecutive patients were included in this randomized controlled trial. 150 patients (Group 1) were operated with triple combination technique, The other 150 patients (Group 2) were operated with standard cardiopulmonary bypass technique. The two groups were compared in terms of peroperative and postoperative blood product use. Results: Ninety-two percent (92%) of the patients (Group 1) undergoing coronary artery bypass surgery did not require any blood transfusion. Only 8% of the patients required erythrocyte suspension or fresh frozen plasma transfusion. In Group 2, 58% of patients required blood transfusions. The difference between two groups was statistically significant (p < 0,05). Conclusion: Triple combination technique is safe and cost-effective in coronary artery bypass surgery. We think that most of the patients could be operated without blood transfusion with this technique.
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