Comparison of Inflammatory Responses After Off-Pump and On-Pump Coronary Surgery Using Surface Modifying Additives Circuit

Quaniers, Janine; Leruth, Julie; Albert, Adelin; Limet, Raymond; Defraigne, Jean-Olivier

doi:10.1016/j.athoracsur.2005.11.059

Cited by 31 publications

(17 citation statements)

References 31 publications

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“…In many forms of critical illness, inflammatory cytokines and counter regulatory hormones have been observed to rise (Quaniers et al, 2006). However, whether these rises persist or decrease depends on the study and the treatment, particularly with respect to elements that reduce inflammation -notably the use of insulin and the ability to maintain normoglycemia (Weekers et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Their general persistence and/or decrease over time and treatment has also been studied in some cases (Quaniers et al, 2006), including the impact of insulin (Krogh-Madsen et al, 2004). Changes in whole body glucose uptake and insulin sensitivity due to the impact of counter regulatory hormones and proinflammatory cytokines, captured here by SI, are complex and.may be a (currently unknown) function of the severity of illness, stage or time of the disease or insult, evolution of disease state, as well as a function of the treatment with insulin, whether normo-glycemia is maintained, or other antiinflammatory effects, and/or increased non-insulin mediated glucose uptake.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Insulin Sensitivity, Its Variability and Glycemic Outcome: A model-based analysis of the difficulty in achieving tight glycemic control in critical care

Chase

Compte

Preiser³

et al. 2011

IFAC Proceedings Volumes

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Effective tight glycemic control (TGC) can improve outcomes in intensive care unit (ICU) patients, but is difficult to achieve consistently. Glycemic level and variability, particularly early in a patient's stay, are a function of variability in insulin sensitivity/resistance resulting from the level and evolution of stress response, and are independently associated with mortality. This study examines the daily evolution of variability of insulin sensitivity in ICU patients using patient data (N = 394 patients, 54019 hours) from the SPRINT TGC study. Model-based insulin sensitivity (SI) was identified each hour and hour-to-hour percent changes in SI were assessed for Days 1-3 individually and Day 4 Onward, as well as over all days. Cumulative distribution functions (CDFs), median values, and inter-quartile points (25th and 75th percentiles) are used to assess differences between groups and their evolution over time. Compared to the overall (all days) distributions, ICU patients are more variable on Days 1 and 2 (p < 0.0001), and less variable on Days 4 Onward (p < 0.0001). Day 3 is similar to the overall cohort (p = 0.74). Absolute values of SI start lower and rise for Days 1 and 2, compared to the overall cohort (all days), (p < 0.0001), are similar on Day 3 (p = .72) and are higher on Days 4 Onward (p < 0.0001). ICU patients have lower insulin sensitivity (greater insulin resistance) and it is more variable on Days 1 and 2, compared to an overall cohort on all days. This is the first such model-based analysis of its kind. Greater variability with lower SI early in a patient's stay greatly increases the difficulty in achieving and safely maintaining glycemic control, reducing potential positive outcomes. Clinically, the results imply that TGC patients will require greater measurement frequency, reduced reliance on insulin, and more explicit specification of carbohydrate nutrition in Days 1-3 to safely minimise glycemic variability for best outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Insulin Sensitivity, Its Variability and Glycemic Outcome: A model-based analysis of the difficulty in achieving tight glycemic control in critical care

Chase

Compte

Preiser³

et al. 2011

IFAC Proceedings Volumes

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“…The use of a cardiopulmonary bypass pump has traditionally induced inflammation, but inflammation may be minimized with the advent of biocompatible polymers, as described in three studies. [27][28][29] In a prospective observational study, tumor necrosis factor (TNF)-a and interleukin (IL)-6 concentrations were similar during and after CTS in patients receiving on-pump and off-pump surgery while IL-10 levels were significantly higher at only two of seven time points. 27 In another study (n = 80), differences in elastase levels and the terminal complex of the complement were seen between patients receiving on-pump and off-pump CTS, but no differences in IL-6, IL-8, IL-10, or myeloperoxidase levels were seen.…”

Section: Baseline and Postoperative Values For Inflammatory Mediators Amentioning

confidence: 97%

“…27 In another study (n = 80), differences in elastase levels and the terminal complex of the complement were seen between patients receiving on-pump and off-pump CTS, but no differences in IL-6, IL-8, IL-10, or myeloperoxidase levels were seen. 28 In the final study (n = 22), differences in eotaxin, macrophage inflammatory protein-1-b, and IL-12 were seen between those with on-pump and off-pump CTS, but no differences in IL-6, IL-8, TNF-a, IL-10, IL-15, IL-1Ra, IL-2R, inducible protein-10, monokine induced by interferon gamma, monocyte chemoattractant protein 1, or regulated on activation, normal T cell expressed and secreted levels were observed. 29 Unlike our trial, these studies did not evaluate CRP levels, WBC counts, or fibrinogen levels.…”

Section: Baseline and Postoperative Values For Inflammatory Mediators Amentioning

confidence: 97%

Effect of ascorbic acid on inflammatory markers after cardiothoracic surgery

Colby

Chen

Baker

et al. 2011

American Journal of Health-System Pharmacy

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“…When compared to CPB, the OPCAB operation provides some advantages such as earlier recovery, better postoperative pulmonary function, patient comfort, as well as earlier discharge from hospital (3,11). In this study, OPCAB patients were excluded.…”

Section: Discussionmentioning

confidence: 99%

Does preoperative administration of allopurinol protect the lungs from ischemia–reperfusion injury occuring during cardiopulmonary bypass?

Görmüş¹,

Çelik²,

Ergene³

et al. 2013

BLL

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Abstract:Background: It is investigated whether preoperative allopurinol administration protects lung injury induced by cardiopulmonary bypass (CPB). Methods: Sixty patients with coronary artery disease who need elective coronary artery bypass grafting operations by using CPB were taken into this study. They were divided into two groups; control and allopurinol. Allopurinol (300 mg/day) was administered to the latter group during the preoperative period of 5 days. Standard CPB procedures were used in all cases. Blood was sampled for TNF-alpha, IL-6, IL-8, IL-10 before anesthesia (T0), after anesthesia and before skin incision (T1), before CPB (T2), after aortic declamping (T3), at the end of CPB (T4), 6 hours after operation (T5), 12 hours after operation (T6), and 24 hours after operation (T7). Pulmonary function test (PFT) was performed before and following the 6th day of operation. Results: TNF-alpha, IL-6, IL-8 increased in both groups at T3, T4, T5 and T6 compared to control (p<0.05). TNF-alpha, IL-6, and IL-8 levels were lower in group A at T3, T4, T5 and T6 (p<0.05). Creatinin phosphokinase (CK) levels were lower in group A at T6 (p<0.05). CK-MB levels were lower in group A than in group C (p<0.05). Pulmonary function test (PFT) did not yield any differences between the groups. Conclusions: Preoperative allopurinol administration decreases the infl ammation and myocardial injury according to biochemical markers of ischemia reperfusion injury. However, this biochemical success does not rebound to PFT (Tab. 5, Ref. 15). Full Text in PDF www.elis.sk.

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Comparison of Inflammatory Responses After Off-Pump and On-Pump Coronary Surgery Using Surface Modifying Additives Circuit

Cited by 31 publications

References 31 publications

Insulin Sensitivity, Its Variability and Glycemic Outcome: A model-based analysis of the difficulty in achieving tight glycemic control in critical care

Insulin Sensitivity, Its Variability and Glycemic Outcome: A model-based analysis of the difficulty in achieving tight glycemic control in critical care

Effect of ascorbic acid on inflammatory markers after cardiothoracic surgery

Does preoperative administration of allopurinol protect the lungs from ischemia–reperfusion injury occuring during cardiopulmonary bypass?

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