Anesthesia Management of Coronary Artery Bypass Surgery and Inflammatory Biomarkers

Completed

• Conditions: Coronary Artery Disease; Anesthesia; Postoperative Complications

• Registration Number: NCT06209437
• Lead Sponsor: Ankara City Hospital Bilkent

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.

Study Timeline

• Study First Submitted: 2024-01-05
• Study First Submitted QC: 2024-01-05
• Study Start: 2024-01-08
• Study First Posted: 2024-01-17
• Primary Completion: 2024-05-01
• Status Verified: 2024-06
• Study Completion: 2024-06-01
• Last Update Submitted: 2024-06-03
• Last Update Posted: 2024-06-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 228

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Preoperative neutrophile lymphocyte ratio (NLR)	within 3 days preoperatively	It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count
Preoperative systemic immune inflammatory index (SII)	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)	within 3 days preoperatively	It will be calculated as: platelet count/lymphocyte count from routine complete blood count
Preoperative systemic inflammatory response index (SIRI)	within 3 days preoperatively	It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count
Postoperative procalcitonin	in the first 24 hours postoperatively	from routine postoperative blood sample ( microgram/litre)
Postoperative platelet lymphocyte ratio (PLR)	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)	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	within 3 days preoperatively	from routine preoperative blood sample ( milligram/decilitre)
Postoperative complications	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)	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)	in the first 24 hours postoperatively	It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count
Preoperative procalcitonin	within 3 days preoperatively	from routine preoperative blood sample ( microgram/litre)
Postoperative c-reactive protein	in the first 24 hours postoperatively	from routine postoperative blood sample ( milligram/decilitre)

Secondary Outcome Measures

Name	Time	Method
Inotrope requirement	during the operation	Incidence of inotrope usage, inotropes consisting of: * noradrenaline; * dopamine; * dobutamine
Patient comorbidities	preoperative within 48 hours	Patient comorbidities will be assessed
Transfusion requirement	during the operation	Incidence of transfusion of blood and blood products to the patient

Trial Locations

Locations (1)

Ankara city hospital bilkent; 🇹🇷 Ankara, Çankaya, Turkey