The Effect of Total Intravenous Anesthesia or Inhalation Anesthesia on Inflammatory Biomarkers in Coronary Artery Bypass Surgery and Their Relationship With Early Postoperative Complications a Prospective Observational Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Coronary Artery Disease
- Sponsor
- Ankara City Hospital Bilkent
- Enrollment
- 228
- Locations
- 1
- Primary Endpoint
- Preoperative neutrophile lymphocyte ratio (NLR)
- Status
- Completed
- Last Updated
- last year
Overview
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.
Investigators
Eligibility Criteria
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
Outcomes
Primary Outcomes
Preoperative neutrophile lymphocyte ratio (NLR)
Time Frame: within 3 days preoperatively
It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count
Preoperative systemic immune inflammatory index (SII)
Time Frame: within 3 days preoperatively
It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count
Preoperative platelet lymphocyte ratio (PLR)
Time Frame: within 3 days preoperatively
It will be calculated as: platelet count/lymphocyte count from routine complete blood count
Preoperative systemic inflammatory response index (SIRI)
Time Frame: within 3 days preoperatively
It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count
Postoperative procalcitonin
Time Frame: in the first 24 hours postoperatively
from routine postoperative blood sample ( microgram/litre)
Postoperative platelet lymphocyte ratio (PLR)
Time Frame: in the first 24 hours postoperatively
It will be calculated as: platelet count/lymphocyte count from routine complete blood count
Postoperative systemic immune inflammatory index (SII)
Time Frame: in the first 24 hours postoperatively
It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count
Preoperative c-reactive protein
Time Frame: within 3 days preoperatively
from routine preoperative blood sample ( milligram/decilitre)
Postoperative complications
Time Frame: 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.
Postoperative systemic inflammatory response index (SIRI)
Time Frame: in the first 24 hours postoperatively
It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count
Postoperative neutrophile lymphocyte ratio (NLR)
Time Frame: in the first 24 hours postoperatively
It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count
Preoperative procalcitonin
Time Frame: within 3 days preoperatively
from routine preoperative blood sample ( microgram/litre)
Postoperative c-reactive protein
Time Frame: in the first 24 hours postoperatively
from routine postoperative blood sample ( milligram/decilitre)
Secondary Outcomes
- Inotrope requirement(during the operation)
- Patient comorbidities(preoperative within 48 hours)
- Transfusion requirement(during the operation)