Revascularização miocárdica com circulação extracorpórea; aspectos bioquímicos, hormonais e celulares

Abstract

Revascularização miocárdica com circulação extracorpórea; aspectos bioquímicos, hormonais e celularesOn-pump coronary artery bypass graft surgery: biochemical, hormonal and cellular features This study was carried out at Federal University of São Paulo, Discipline of Cardiovascular Surgery, São Paulo, SP, Brazil. Methods: Eighteen patients underwent on-pump CABG surgery. Mean time of CPB was 80.3 minutes. Hormonal, biochemical and cellular measurements were taken in some time points -preoperatively, immediately after coming off CPB, 24 and 48 hours postoperatively. Friedman and Wilcoxon tests were applied based on significance level of 5%.Results: There was activation and significant elevation of total leukocytes and neutrophils count over CPB, remaining this way up to 48 hours postoperatively. Total platelets count, in turn, was marked by relevant reduction immediately after coming off CPB as well as in two postoperative time points. Serum levels of total proteins and albumin, immediately after coming off CPB and also in two postoperative time points, were significantly decreased comparing with preoperative status. There was remarkable reduction of total T3, free T3 and total T4 particularly up to first 24 hours postoperatively.Conclusion: In on-pump CABG surgery, inflammatory effects encompass activation of total leukocytes, neutrophils and platelets, reduction of serum level of total proteins and albumin and decreased thyroid hormones levels, especially within first postoperative 24 hours.

Principais Complicações Da Circulação Extracorpórea Em Cirurgias Cardíacas Em Um Hospital Da Região Norte

“…Dado este foi confirmado no estudo de Gabriel et al (2011) realizado com 18 pacientes submetidos à CRM com utilização da CEC, revelou que houve ativação significante do número de leucócitos durante e após o período de CEC, mantendo-se assim até 48 horas de pós-operatório, chegando a valores de 23.980 mm3.…”

Responses of human body attached to use the bypass: literature review / Respostas do organismo humano inerentes ao uso da circulação extracorpórea: revisão de literatura

“…As hemácias, os leucócitos e as plaquetas podem ser profundamente afetadas na CEC, tanto pelo trauma como pelo contato com as superfícies não endoteliais do circuito (3) .…”

“…A reação inflamatória sistêmica inerente à CEC é responsável por uma variedade de alterações orgânicas, dentre elas o desajuste da concentração sérica de proteínas totais e albumina, desequilíbrio dos níveis séricos dos hormônios tireoidianos e modificações quantitativas e qualitativas quanto aos leucócitos totais, neutrófilos e plaquetas (3) .…”

Delirium after cardiac surgery: Have we overlooked obstructive sleep apnea?

“…Plashcke et al showed that patients who had undergone CABG and developed delirium had greater levels of cortisol and interleukin-6 [37]. Indeed, CABG is associated with an increased inflammatory response during the early post-operative period [38], activation of white blood cells and a decrease in thyroid hormone levels [39]. A decrease in the levels of iodine-containing thyroid hormones may predispose individuals to cognitive deficits after surgery [40].…”