Revista da Associacao Medica Brasileira (1992) · 2025
Comparison of clinical outcomes of open and closed cardioplegia sets used during cardiopulmonary bypass.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Padak Mahmut, Amaç Bişar, Dikme Reşat, Ersoy Murat
Аннотация
OBJECTIVE: The aim of this retrospective study was to evaluate early clinical outcomes and inflammatory responses associated with the use of open and closed cardioplegia sets in patients undergoing cardiac surgery with cardiopulmonary bypass.
METHODS: A total of 123 adult patients who underwent elective cardiac surgery with cardiopulmonary bypass between 2023 and 2024 were included. Patients were divided into two groups based on the cardioplegia system used: Group 1 (open system, n=63) and Group 2 (closed system, n=60). Demographic features, intraoperative variables, and preoperative and postoperative biochemical parameters (white blood cell count, C-reactive protein, glucose, and liver and renal function tests) were analyzed. Statistical significance was set at p<0.05.
RESULTS: Preoperative characteristics and most laboratory parameters were comparable between the groups (p>0.05). Postoperatively, white blood cell (12.64±3.47 vs. 8.43±4.43, p=0.031), C-reactive protein (28.00±32.28 vs. 8.42±6.37, p<0.0001), glucose (150.66±82.40 vs. 174.19±51.89, p=0.043), aspartate aminotransferase (p=0.001), and gamma-glutamyl transferase (p<0.0001) levels were significantly lower in the closed system group. Extubation time was longer in the closed group (8.56±3.18 vs. 5.15±0.66 h, p<0.0001), while urine output was significantly lower (554.16±401.50 vs. 916.34±709.58 mL, p=0.001). No differences were observed in hospital or intensive care unit stay.
CONCLUSION: Closed cardioplegia systems may offer better control of inflammatory and hepatic responses during cardiac surgery with cardiopulmonary bypass. Despite favorable biochemical outcomes, the longer extubation time and reduced urine output observed in the closed system group warrant further investigation. Future prospective randomized studies are required to validate these findings and assess long-term clinical outcomes such as morbidity and mortality.
METHODS: A total of 123 adult patients who underwent elective cardiac surgery with cardiopulmonary bypass between 2023 and 2024 were included. Patients were divided into two groups based on the cardioplegia system used: Group 1 (open system, n=63) and Group 2 (closed system, n=60). Demographic features, intraoperative variables, and preoperative and postoperative biochemical parameters (white blood cell count, C-reactive protein, glucose, and liver and renal function tests) were analyzed. Statistical significance was set at p<0.05.
RESULTS: Preoperative characteristics and most laboratory parameters were comparable between the groups (p>0.05). Postoperatively, white blood cell (12.64±3.47 vs. 8.43±4.43, p=0.031), C-reactive protein (28.00±32.28 vs. 8.42±6.37, p<0.0001), glucose (150.66±82.40 vs. 174.19±51.89, p=0.043), aspartate aminotransferase (p=0.001), and gamma-glutamyl transferase (p<0.0001) levels were significantly lower in the closed system group. Extubation time was longer in the closed group (8.56±3.18 vs. 5.15±0.66 h, p<0.0001), while urine output was significantly lower (554.16±401.50 vs. 916.34±709.58 mL, p=0.001). No differences were observed in hospital or intensive care unit stay.
CONCLUSION: Closed cardioplegia systems may offer better control of inflammatory and hepatic responses during cardiac surgery with cardiopulmonary bypass. Despite favorable biochemical outcomes, the longer extubation time and reduced urine output observed in the closed system group warrant further investigation. Future prospective randomized studies are required to validate these findings and assess long-term clinical outcomes such as morbidity and mortality.