Clinical effects of leukofiltration and surface modification on post-cardiopulmonary bypass atrial fibrillation in different risk cohorts

Günaydın, Serdar; Ayrancioglu, Kamil; Di̇kmen, Erkan; McCusker, Kevin; Vijay, Venkataramana; Sarı, Tamer; Tezcaner, Tugan; Zorlutuna, Yaman

doi:10.1177/0267659107084146

Cited by 16 publications

(9 citation statements)

References 34 publications

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“…Sample size ranged from 20 to 82 patients. In two studies , patients underwent valve operations (112 patients); in the remaining studies patients underwent CABG operations . Both systemic arterial and cardioplegic leukofiltration were applied in two studies while only systemic leukofiltration was applied in the remaining RCTs.…”

Section: Resultsmentioning

confidence: 99%

Anti‐Inflammatory Strategies to Reduce Acute Kidney Injury in Cardiac Surgery Patients: A Meta‐Analysis of Randomized Controlled Trials

et al. 2013

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Acute kidney injury (AKI) after cardiac operations is a serious complication associated with postoperative mortality. Multiple factors contribute to AKI development, principally ischemia-reperfusion injury and inflammatory response. It is well proven that glucocorticoid administration, leukocyte filter application, and miniaturized extracorporeal circuits (MECC) modulate inflammatory response. We conducted a systematic review of randomized controlled trials (RCTs) in which one of these inflammatory system modulation strategies was used, with the aim to evaluate the effects on postoperative AKI. MEDLINE and Cochrane Library were screened through November 2011 for RCTs in which an inflammatory system modulation strategy was adopted. Included were trials that reported data about postoperative renal outcomes. Because AKI was defined by different criteria, including biochemical determinations, urine output, or dialysis requirement, we unified renal outcome as worsening renal function (WRF). We identified 14 trials for steroids administration (931 patients, WRF incidence [treatment vs. placebo]: 2.7% vs. 2.4%; OR: 1.13; 95% CI: 0.53-2.43; P = 0.79), 9 trials for MECC (947 patients, WRF incidence: 2.4% vs. 0.9%; OR: 0.47; 95% CI: 0.18-1.25; P = 0.13), 6 trials for leukocyte filters (374 patients, WRF incidence: 1.1% vs. 7.5%; OR: 0.18; 95% CI: 0.05-0.64; P = 0.008). Only leukocyte filters effectively reduced WRF incidence. Not all cardiopulmonary bypass-related anti-inflammatory strategies analyzed reduced renal damage after cardiac operations. In adult patients, probably other factors are predominant on inflammation in determining AKI, and only leukocyte filters were effective. Large multicenter RCTs are needed in order to better evaluate the role of inflammation in AKI development after cardiac operations.

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Section: Resultsmentioning

confidence: 99%

Anti‐Inflammatory Strategies to Reduce Acute Kidney Injury in Cardiac Surgery Patients: A Meta‐Analysis of Randomized Controlled Trials

et al. 2013

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“…It is known that the use of CPB has been associated with a systematic inflammatory response, abnormal heart rhythm, pulmonary complications, disruption of the coagulation system, postoperative bleeding, adverse cerebral effects, and renal dysfunction. [152324252627] These circumstances could compose the clinical profile of a critically ill patient who is possibly going to require readmission to the ICU for more effective therapeutic management. If CPB time reduction can prevent readmission to the ICU, it is an even more important issue in cardiac surgery patients.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of readmission to the cardiac surgery intensive care unit: A retrospective cohort study in Greece

Giakoumidakis¹,

Eltheni²,

Patelarou³

et al. 2014

Ann Thorac Med

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INTRODUCTION:Readmission in the intensive care unit (ICU) is a significant morbidity index, which has been related to poor patient outcomesAIM:To identify the preoperative and intraoperative risk factors for readmission in the cardiac surgery ICU.METHODS:We conducted a retrospective cohort study of 595 consecutive patients who were admitted to the cardiac surgery ICU of a tertiary hospital of Athens — Greece during the one-year period (September 2011-September 2012). Data collection was carried out, retrospectively, by the use of a short questionnaire and based on the review of medical and nursing patient records at December 2012.RESULTS:The incidence of ICU readmission was 3.7% (22/595). Respiratory disorders were the main reason for readmission (45.4%). Readmitted patients had a significantly higher in-hospital mortality compared to those requiring no readmission (P < 0.001). Multivariate analysis revealed that female gender [for males odds ratio (OR) 0.37, 95% confidence interval (CI) 0.15-0.89], high logistic EuroSCORE (OR 1.02, 95% CI 1.00-1.04), prolonged cardiopulmonary (CPB) duration (OR 1.01, 95% CI 1.00-1.02) and preoperative renal failure (OR 1.02, 95% CI 1.00-1.05) were the independent risk factors for readmission to the cardiac surgery ICU.CONCLUSIONS:One intraoperative and three preoperative variables are associated strongly with higher probability for ICU readmission. Shorter CPB duration could contribute to lower ICU readmission incidence. In addition, the early identification of high risk patients for readmission in the cardiac surgery ICU could encourage both the more efficient healthcare planning and resources allocation.

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“…22 Atrial fibrillation is the leading cause of hospital readmissions after cardiac surgery. 23 This literature review failed to reveal a gold standard of correct dose and administration of amiodarone with individualized titration.…”

Section: Resultsmentioning

confidence: 99%

Amiodarone Use to Prevent Postoperative Atrial Fibrillation After Cardiac Surgery

McAlister

Davis

Whitcomb

et al. 2012

Dimensions of Critical Care Nursing

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Clinical effects of leukofiltration and surface modification on post-cardiopulmonary bypass atrial fibrillation in different risk cohorts

Abstract: Leukofiltration and coating significantly reduce the incidence, ventricular rate, and duration of AF after CABG via modulation of systemic inflammatory response and platelet preservation in high risk groups.

Cited by 16 publications

References 34 publications

Anti‐Inflammatory Strategies to Reduce Acute Kidney Injury in Cardiac Surgery Patients: A Meta‐Analysis of Randomized Controlled Trials

Anti‐Inflammatory Strategies to Reduce Acute Kidney Injury in Cardiac Surgery Patients: A Meta‐Analysis of Randomized Controlled Trials

Incidence and predictors of readmission to the cardiac surgery intensive care unit: A retrospective cohort study in Greece

Amiodarone Use to Prevent Postoperative Atrial Fibrillation After Cardiac Surgery

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