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Introduction: Preventing acid-base and electrolyte disturbance is crucial in coronary artery bypass graft (CABG) surgery, since any of these conditions can affect outcome. The type of crystalloid solution used during and after the surgery can affect these disturbances. Methods: In this study, 90 patients who candidates for CABG surgery were randomly allocated to either ringer's lactate (RL) or ringer's group. In order to provide essential blood volume before and after the start of CPB fluid administration with either ringer's or RL solution was started during operation and continued for 18 hours after the patient was transferred to ICU. ABG, serum electrolytes and Lactate level were measured before and at the end of CPB, upon arrival to the ICU, and 6, 12 and 18 hours after ICU admission and compared between the two groups. Results: Blood PH level was significantly different between the two groups upon arrival to ICU, 6 and 18 hours after ICU admission (P < 0.05) which was clinically closer to the normal range in the RL group. Serum bicarbonate level showed a significantly difference between the two groups (P < 0.05). There were no significantly differences between the two groups in terms of lactate level, serum electrolytes, blood loss, intake and output of fluids and blood products transfusion. Conclusion: In this study, ringer's lactate solution creates a more favorable acid-base balance without a significant increase in blood lactate level which is attributed to the buffering effect of existing lactate, and can be used as an appropriate alternative to ringer's solution during and after CABG. [ABSTRACT FROM AUTHOR]

Introduction: Sleep quality is the main concern of patients after cardiac surgery. We compared the effect of two routinely used sedatives on the sleep quality of patients admitted to the intensive care unit (ICU) after cardiovascular surgery. Methods: It is a prospective, controlled, randomized clinical trial. A total of 120 patients, after cardiac surgery were enrolled. During extubating, patients were randomized into two groups: 60 patients received an infusion of dexmedetomidine (precede; 0.5 μg/kg/h), and 60 patients received 50 μg/kg/min propofol for 6 hours. Baseline characteristics were compared between the groups. The patients completed the St. Mary's Hospital Sleep Questionnaire, and the scores were compared between the groups. Results: The groups were not different in terms of demographics, underlying diseases, smoking/drug abuse/alcohol, number of vessels involved, history of non-cardiac surgery, and mean levels of serum parameters (P >0.05). Most of the medications used were similar between the groups (P >0.05), except calcium channel blockers (more frequently used in the propofol group [ P =0.027). The details of surgery were not statistically significant different (P >0.05); but, the mean volume of platelet received after the surgery was higher in propofol group (P =0.03). The propofol group had less problems with last night's sleep (0 vs 0.1±0.66), felt more clear-headed (4.9±0.6 vs 4.68±0.58, were more satisfied with their last night's sleep (52.1% vs 47.9%), but spent more time getting into sleep (0.38±1.67 vs 0) (P <0.5).> Conclusion: The sleep quality of patients under the influence of propofol seemed to be better than dexmedetomidine after cardiac surgery. [ABSTRACT FROM AUTHOR]