Search

Background. Despite a large number of publications on the influence of anesthesia components on the development of postoperative complications, the choice of the optimal anesthesia scheme during coronary artery bypass grafting (CABG) in patients with coronary heart disease remains unclear. The study was aimed to compare the effect of low-opioid and high-opioid anesthesia schemes on early clinical outcomes in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Mate­rials and methods. The study included 120 patients who underwent CABG with cardiopulmonary bypass (CPB). The median operational risk for EuroSCORE II is 3.45 % (2.15 %; 4.05 %). Accor­ding to the scheme of anesthesia, all patients were divided into two groups: the first group (60 patients) — low-opioid scheme of anesthesia; the second group (60 patients) is a standard scheme of anes­thesia. Results. Patients in the first group were more than twice as likely to develop postoperative atrial fibrillation (POAF) compared with the second group (9 (15.0 %) vs. 19 (31.7 %), p = 0.031). In addition, patients in the first group were 2.3 times significantly less likely to have low cardiac output syndrome (LCOS) compared to the second group (11.7 % vs. 26.7 %, p = 0.037). The duration of CPB (p = 0.032) and the level of IL-6 after CPB (p = 0.004) were reliable indicators for predicting LCOS. The final statistical model [F (4, N = 120) = 12.52, p

The aim – to identify if body mass index is one of the predictors of postoperative atrial fibrillation in patients undergoing isolated surgical aortic valve replacement. Materials and methods. In this single center study, we evaluated 1191 patients requiring isolated surgical aortic valve replacement between January 2000 and June 2014. The patients were followed during the early postoperative period, until their discharge. Results. Atrial fibrillation occurred in 342 patients (28.71 %). We developed a multivariate prediction model combining six variables associated with increased risk of postoperative atrial fibrillation (advanced age, body mass index, moderate tricuspid regurgitation, prolonged ventilation, longer staying in the intensive care units and dilated left atrium (≥ 35 ml/m2)) that has moderate predictive value (64.7 %). We also developed a tree decision model, also with moderate predictive value, including body mass index as a variable that influences arrhythmic risk in patients undergoing valvular aortic surgery. Conclusion. The body mass index is an important variable influencing the postoperative outcome. It should be included in preoperative evaluating scores.