Thiamine Could Decrease Lactate and Creatinine Level After Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction

Publish Year: 1397
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:

JR_SBMU-3-4_001

تاریخ نمایه سازی: 6 اسفند 1398

Abstract:

Background: During cardiopulmonary bypass, oxidative stress happens in the patient s cells due to blood contact with various levels of synthetic materials. It can activate inflammatory process and release factors such as interleukin 6 (IL-6), C reactive protein (CRP) and neutrophilia, which may hurt different organs. In recent years, many efforts have been made to prevent this type of damage; however, no single treatment has been proposed to reduce this risk. Antioxidant substances such as Thiamine is important in cell defense against free oxygen radicals. Regarding this issue, in this study, effect of Thiamine on lactate levels in patients undergoing coronary artery bypass graft (CABG) surgery has been investigated.Methods and materials: In this study, 140 patients, 25 to 65 years with mild systolic dysfunction (EF=45-55%) who were candidates for elective CABG surgery in two groups, control and purpose (patients receiving Thiamine), were examined. All of these patients anesthetized in an identical manner, and subjected to a heart-lung pump. Serum lactate levels were measured before, during and six, 12, 18, 24 hours after surgery. All data collected in a questionnaire recorded and evaluated using SPSS statistical software.Results: Study groups showed no significant differences regarding demographics and underlying diseases. Serum lactate was significantly lower in Thiamine group during the first 24 hours after surgery (except before operation and 2 hours later) (p <0.05). Creatinine level in two groups beforesurgery was not significantly difference, however, it was significantly lower in case group 24 hours after surgery (1.54±0.14 vs. 1.24±0.19; p: 0.001). In addition, dose of Inotropes in patients who received Thiamine, was significantly lower than the control group (p= 0.001). Extubation was longer in control group (15.4±4.9 vs. 13.15±4.1; p=0.003) while intensive care unit stay was not different.Conclusion: It seems that Thiamine administration before cardiopulmonary bypass in patients with decreased left ventricular function could decrease serum lactate as tissue perfusion marker and improve kidney function.

Keywords:

Thiamine , Coronary artery bypass graft , Systolic dysfunction , Lactate

Authors

Alireza Jahangirifard

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

Shirin Salajegheh

Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran

Sarvenaz Arab

Anesthesiology Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran

Seyed Bashir Mirtajani

Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

Behrooz Farzanegan

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran