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Serum albumin perturbations in cyanotics after cardiac surgery: Patterns and predictions.
- Source :
- Annals of Cardiac Anaesthesia; Apr-Jun2016, Vol. 19 Issue 2, p300-305, 6p
- Publication Year :
- 2016
-
Abstract
- <bold>Introduction: </bold>Hypoalbuminemia is a well-recognized predictor of general surgical risk and frequently occurs in patients with cyanotic congenital heart disease (CCHD). Moreover, cardiopulmonary bypass (CPB)-induced an inflammatory response, and the overall surgical stress can effect albumin concentration greatly. The objective of his study was to track CPB-induced changes in albumin concentration in patients with CCHD and to determine the effect of hypoalbuminemia on postoperative outcomes.<bold>Materials and Methods: </bold>Prospective observational study conducted in 150 patients, Group 1 ≤18 years (n = 75) and Group 2 >18 years (n = 75) of age. Albumin levels were measured preoperatively (T1), after termination of CPB (T2) and 48 h post-CPB (T3). Primary parameters (mortality, duration of postoperative ventilation, duration of inotropes and duration of Intensive Care Unit [ICU] stay) and secondary parameters (urine output, oliguria, arrhythmias, and hemodynamic parameters) were recorded.<bold>Results: </bold>The albumin levels in Group 1 at T1, T2, and T3 were 3.8 ± 0.48, 3.2 ± 0.45 and 2.6 ± 0.71 mg/dL; and in Group 2 were 3.7 ± 0.50, 3.2 ± 0.49 and 2.7 ± 0.62 mg/dL respectively. All patients showed a significant decrease in albumin concentration 48 h after surgery (P < 0.01). Analysis between the groups, however, showed no statistical difference. Eleven patients expired during the study period, and nonsurvivors showed significantly lower serum albumin concentration 48 h after surgery 2.3 ± 0.62 mg/dL versus 3.7 ± 0.56 mg/dL in the survivors (P < 0.05). Receiver operating characteristic curve showed that a baseline albumin cut-off value of 3.3 g/dL predicts mortality with a positive predictive value 47.6% and a negative predictive value of 99.2% (P < 0.05). A strong correlation was seen between albumin levels at 48 h with duration of CPB (r2 = 0.6321), ICU stay (r2 = 0.7447) and incidence of oliguria (r2 = 0.8803).<bold>Conclusions: </bold>The study demonstrated similar fall in albumin concentration in cyanotic patients (both adult and pediatric) in response to CPB. Low preoperative serum albumin concentrations (<3.3 g/dL) can be used to identify and prognosticate subset of cyanotics predisposed to additional surgical risk. [ABSTRACT FROM AUTHOR]
- Subjects :
- SERUM albumin
CONGENITAL heart disease
CARDIOPULMONARY bypass
ARRHYTHMIA
OLIGURIA
POSTOPERATIVE period
CARDIOTONIC agents
ARTIFICIAL respiration
BLOOD protein disorders
CARDIAC surgery
CYANOSIS
INFLAMMATION
LONGITUDINAL method
POSTOPERATIVE care
SURGICAL complications
TETRALOGY of Fallot
PREDICTIVE tests
RECEIVER operating characteristic curves
DIAGNOSIS
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 09719784
- Volume :
- 19
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Annals of Cardiac Anaesthesia
- Publication Type :
- Academic Journal
- Accession number :
- 114199822
- Full Text :
- https://doi.org/10.4103/0971-9784.179633