heart failure.
Conditions
Interventions
54 patients with coronary artery disease who underwent an elective coronary artery bypass grafting submitted an anesthesia and mechanical ventilation, under anesthesia with etomidate and midazolam an
Procedure/surgery
Other
Sponsors
Univerdidade Federal de São Paulo
Hospital Santa Rosa
Hospital São Mateus
Eligibility
Age
35 Years to 75 Years
Inclusion criteria
Inclusion criteria: Both gender, age between 35 and 75 years; proven coronary disease by coronary angiography; Surgery elective CABG with CPB and use of the LITA; ventricular ejection fraction greater than 50%; Absence of acute pulmonary disease or chronic, patients who, after surgery, keep in spontaneous ventilation on the first day after surgery.
Exclusion criteria
Exclusion criteria: Inability to perform spirometry; Presence of acute or chronic lung disease; Required urgent surgery; Chronic inflammatory disease; Kidney or liver disease; Patients using corticosteroids, acetyl salicylic acid or other anti-inflammatory drugs; Clinical or laboratory evidence of infection; Morbid obesity; Hemodynamic instability at the time of spirometry; Change the surgical technique during surgery; Death during surgery or before the fifth day after surgery; Patients who remain in prolonged mechanical ventilation for more than twelve hours; Request of the patient or legal guardian at any time during the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Outcome expected: 1)-Reduction of the inflammatory response in postoperative coronary artery bypass grafting, assessed by serum levels of Interleukin (IL1, IL6, IL8) and TNFa, C3a, ICAM, CRP, through the samples in the intra-surgery, after induction of anesthesia and postoperative immediately after extubation and after NIV protocol. | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected Outcomes: 1)-Accelerated recovery of volumes and capacities in postoperative coronary artery bypass grafting, assessed by increased forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) compared preoperatively, 1st. 3rd. and 5th. day postoperatively. 2)-Accelerated recovery of respiratory muscle strength in postoperative coronary artery bypass grafting, assessed by increased maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) compared preoperatively, 1st. 3rd. and 5th. day postoperatively. 3)-Improved functional capacity in postoperative coronary artery bypass grafting, assessed by the distance walked during the 6-minute walk test (6MWT) compared preoperatively and 5th. postoperative day. 4)-Improved tissue perfusion and reduced tissue hypoxia in postoperative coronary artery bypass grafting, assessed by reduced dosages of blood lactate and increased central venous oxygen saturation (ScVO2) collected directly from the central venous catheter in intra-surgery after induction of anesthesia and postoperative immediately after extubation and after NIV protocol.;Outcomes found: 1)-Improvement of volumes and capacities in postoperative coronary artery bypass grafting assessed by increased forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) compared preoperatively, 1st. 3rd. and 5th. day postoperatively 2)-recovery of respiratory muscle strength in postoperative coronary artery bypass grafting assessed by increased maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) compared preoperatively, 1st. 3rd. and 5th. day postoperatively 3)-Was not found improvement in functional capacity in postoperative coronary artery bypass grafting, assessed by the distance walked during the 6-minute walk test (6MWT) compared preoperatively and 5th. postoperative day. 4)-Improved tissue perfusion and reduced tissue hypoxia in postoperative coronary artery bypass grafting, assessed | — |
Countries
Brazil
Contacts
Public ContactMara Lilian Nasrala
Universidade Federal de São Paulo
Outcome results
None listed