Anesthesia, Coronary Artery Disease, Postoperative Complications
Conditions
Brief summary
The goal of this observational study is to evaluate effect of total intravenous anesthesia or inhalation anesthesia on inflammatory biomarkers in coronary artery bypass surgery and their relationship with early postoperative complications. The main questions it aims to answer are * Does the type of anesthesia have a relationship with inflammatory biomarkers? * Are inflammatory biomarkers associated with postoperative complications?
Detailed description
This study is planned to be a prospective observational clinical study. Patients who will undergo on-pump coronary artery bypass surgery, meet the eligibility criteria and agree to participate in the study and sign the informed patient consent form will be included in the study.Systemic immune inflammatory index, systemic inflammatory response index, neurophile lymphocyte ratio, platelet lymphocyte ratio will be calculated in the routine complete blood count of patients in the last 3 preoperative days and in the first 24 hours postoperatively.It will be evaluated whether these biomarkers are related to the anesthesia technique used, patients comorbidities and the complications that develop in the first 24 hours postoperatively. Patients will be evaluated preoperatively, intraoperatively and postoperatively; preoperative comorbidities, intraoperative anesthesia management, cross clamp, pump and surgery times, blood and blood product transfusion, inotrope use and complications that develop up to the first 24 hours postoperatively will be recorded.The anesthetic technique to be used will be determined according to the anesthesiologist's preference and will be recorded.
Interventions
None listed
Sponsors
Ankara City Hospital Bilkent
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* On-pump bypass surgery * Del-Nido cardioplegia used in operation * ASA (American Society of Anesthesiologists) II- III patients
Exclusion criteria
* Patients with active malignancy * Diagnosed with systemic inflammatory disease or autoimmune disease * Chronic liver and kidney disease * History of cerebrovascular disease within 6 months * EF (Ejection Fraction) \< 45% * Non-cooperative or patients who do not agree to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative complications | within the first 24 hours after surgery | Postoperative complications consisting of: * newly developed atrial fibrillation * need for cardiac pacing * need for ECMO (Extracorporeal membrane oxygenation) * need for IABP (Intra-Aortic Balloon Pump) * prolonged mechanical ventilation * pericardial effusion * cardiac arrest * cerebrovascular event * delirium * exitus * other complications. |
| Preoperative procalcitonin | within 3 days preoperatively | from routine preoperative blood sample ( microgram/litre) |
| Postoperative c-reactive protein | in the first 24 hours postoperatively | from routine postoperative blood sample ( milligram/decilitre) |
| Postoperative procalcitonin | in the first 24 hours postoperatively | from routine postoperative blood sample ( microgram/litre) |
| Preoperative systemic immune inflammatory index (SII) | within 3 days preoperatively | It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count |
| Postoperative systemic immune inflammatory index (SII) | in the first 24 hours postoperatively | It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count |
| Preoperative systemic inflammatory response index (SIRI) | within 3 days preoperatively | It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count |
| Postoperative systemic inflammatory response index (SIRI) | in the first 24 hours postoperatively | It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count |
| Preoperative neutrophile lymphocyte ratio (NLR) | within 3 days preoperatively | It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count |
| Postoperative neutrophile lymphocyte ratio (NLR) | in the first 24 hours postoperatively | It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count |
| Preoperative platelet lymphocyte ratio (PLR) | within 3 days preoperatively | It will be calculated as: platelet count/lymphocyte count from routine complete blood count |
| Postoperative platelet lymphocyte ratio (PLR) | in the first 24 hours postoperatively | It will be calculated as: platelet count/lymphocyte count from routine complete blood count |
| Preoperative c-reactive protein | within 3 days preoperatively | from routine preoperative blood sample ( milligram/decilitre) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Transfusion requirement | during the operation | Incidence of transfusion of blood and blood products to the patient |
| Inotrope requirement | during the operation | Incidence of inotrope usage, inotropes consisting of: * noradrenaline * dopamine * dobutamine |
| Patient comorbidities | preoperative within 48 hours | Patient comorbidities will be assessed |
Countries
Turkey (Türkiye)
Outcome results
None listed