Acute Normovolemic Hemodilution, Off-Pump Coronary Artery Bypass Surgery
Conditions
Keywords
Perfusion
Brief summary
To study the effects of Acute normovolemic hemodilution on central and peripheral perfusion in patients Undergoing off-pump coronary artery bypass grafting surgery
Detailed description
Off-pump coronary artery bypass surgery is an alternative to conventional coronary artery bypass grafting using cardiopulmonary bypass (CPB). It avoids adverse effects of CPB such as systemic inflammatory response, impaired myocardial protection, and air or plaque embolism. However, OPCAB surgery involves displacement and manipulation of the heart to expose target coronary arteries. These manipulations cause hemodynamic instability as a result of transient annulo-mitral distortion and acute mitral regurgitation, compression of the right ventricle, and impaired cardiac contractility due to epicardial stabilizers. signs of impaired perfusion such as metabolic acidosis, increased serum lactate and decreased urine output are commonly seen intraoperatively Excessive surgical bleeding causes hypovolemia and hemodynamic instability, anemia, and reduced oxygen delivery to tissues Acute normovolemic hemodilution (ANH) is an alternative method of management of intraoperative blood loss, in which a certain volume of blood is collected from the patient, stored at room temperature and replaced by an equal volume of colloid solution. By the end of surgery, this blood is returned to the patient, usually within eight hours of collection, with little deterioration of platelets or coagulation factors This work aims to study the effects of Acute normovolemic hemodilution on central and peripheral perfusion in patients Undergoing off-pump coronary artery bypass grafting surgery
Interventions
500 ml of blood will be taken from the patient with simultaneous replacement with hydroxyethyl starch (HES 130/0.4) in another IV line
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients scheduled for off- pump CABG surgery
Exclusion criteria
* Ejection fraction less than 40% * Hematocrit less than 11 g/dl * patients with severe renal impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Central venous oxygen saturation | Intraoperative | Central venous blood gas analysis |
| The perfusion index | Intraoperative | perfusion index derived from pulseoximetry |
| Serum lactate | Intraoperative | from arterial blood gas analysis |
Countries
Egypt