Impact of preoperative mild renal dysfunction on short term outcome in isolated coronary artery bypass (CABG) patients

Ramakrishna, MN; Kumarswamy, GN; Gupta, Rishabh; Moola, Narayana Swamy; Suresh, K

doi:10.4103/0972-5229.45075

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Additionally, POAF occurred in 60% of hemodialysis patients who underwent CABG, even though landiolol was administered according to the protocol corresponding to the assigned group. In isolated CABG patients with mild renal dysfunction (Creatinine 1.61 ± 0.2 mg/dl), the incidence of POAF was fivefold compared with the patients without mild renal dysfunction [ 33 ]. Thus, renal failure could likely be a confounding factor related to the effectiveness of landiolol administration.…”

Section: Discussionmentioning

confidence: 99%

Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study)

Sasaki

Kumagai

Maeda

et al. 2020

Gen Thorac Cardiovasc Surg

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Objective To investigate the efficacy of prophylactic administration of low-dose landiolol on postoperative atrial fibrillation (POAF) in patients after cardiovascular surgery. Methods Consecutive 150 patients over 70 years of age who underwent cardiovascular surgery for valvular, ischemic heart, and aortic diseases were enrolled in this single-center prospective randomized control study from 2010 to 2014. They were assigned to three treatment groups: 1γ group (landiolol at 1 μg/kg/min), 2γ group (landiolol at 2 μg/kg/min), or control group (no landiolol). In the two landiolol groups, landiolol hydrochloride was intravenously administered for a period of 4 days postoperatively. Electrocardiography was continuously monitored during the study period, and cardiologists eventually assessed whether POAF occurred or not. Results POAF occurred in 24.4% of patients in the control group, 18.2% in 1γ group, and 11.1% in 2γ group (p = 0.256). Multivariate logistic regression analysis showed that the incidence of POAF tended to decrease depending on the dose of landiolol (trend-p = 0.120; 1γ group: OR = 0.786, 95% CI 0.257–2.404; 2γ group: OR = 0.379, 95% CI 0.112–1.287). Subgroup analysis showed a significant dose-dependent reduction in POAF among categories of female sex, non-use of angiotensin II receptor blockers (ARBs) before surgery, and valve surgery (each trend-p = 0.02, 0.03, and 0.004). Conclusions These findings indicate that prophylactic administration of low-dose landiolol may not be effective for preventing the occurrence of POAF in overall patients after cardiovascular surgery, but the administration could be beneficial to female patients, patients not using ARBs preoperatively, and those after valvular surgery.

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Section: Discussionmentioning

confidence: 99%

Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study)

Sasaki

Kumagai

Maeda

et al. 2020

Gen Thorac Cardiovasc Surg

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“…There is increased risk of sepsis, prolonged ventilation and prolong ICU stay and re-admission. 12 In the present study we intend to find out the effect of postoperative renal dysfunction on patients’ outcomes.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery

et al. 2021

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Objectives: In this study we determined the frequency of renal dysfunction and its outcomes in terms of morbidity and mortality in patients who underwent open heart surgery at the Aga Khan University Hospital, Karachi, Pakistan. Methods: A total of 175 patients aged between 15-80 years having open heart Surgery(OHS) were included. Preoperative and postoperative serum creatinine (SCr) was noted and the glomerular filtration rate (GFR) calculated by Cockcroft-Gault equation. Their hospital course was charted and followed-up for 30-day. Results: The mean age and mean BMI were 58.1±12.6 years and 26.4±4.3 kg/m2 respectively. Females were 18.3%, out of which 51.4% hypertensive, 46.9% diabetics, 45.1% had dyslipidemia, 2.9% had preoperative renal dysfunction and 40% had moderate ejection fraction. On follow up, 30.3% developed postoperative renal dysfunction within 30-days after OHS with mean SCr and GFR as 1.6±0.7 and 56.9±24.5, respectively. In RD group more patients showed positive outcomes i.e. prolonged inotropic requirement (75.5% vs. 18%, p-value <0.005), diuretic infusion usage (47.2% vs. 3.3%, p-value <0.005), dialysis/renal replacement therapy (17% vs. 0%, p-value <0.005), requirement for prolonged ventilation (35.8% vs. 6.6%, p-value <0.005), prolonged ICU and hospital stay (15.4% vs. 1.6%, p-value <0.005 and 41.5% vs. 17.2%, p-value <0.005), sepsis (20.8% vs. 1.6%, p-value <0.005) and death (9.4% vs. 2.5%, p-value 0.05). Conclusion: Timely recognition of renal dysfunction, early renal replacement therapy, diuretics or dialysis and proper nutritional and inotropic support to maintain adequate hemostasis shows survival benefits. doi: https://doi.org/10.12669/pjms.37.7.3865 How to cite this:Ali TA, Tariq K, Salim A, Fatimi S. Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3865 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pulmonary Function Testing

Gold¹,

Koth²

2016

Murray and Nadel's Textbook of Respiratory Medicine

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Impact of preoperative mild renal dysfunction on short term outcome in isolated coronary artery bypass (CABG) patients

Cited by 4 publications

References 18 publications

Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study)

Preventive effect of low-dose landiolol on postoperative atrial fibrillation study (PELTA study)

Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery

Pulmonary Function Testing

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