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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
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inhalation Anesthesia Group | After induction, anesthesia will be provided with sevoflurane (2.0 mac) and intravenous remifentanil infusion (0.05-0.2 mcg/kg/min). Depth of anesthesia will be evaluated with Bispectral Index (BIS). | ||
| Total Intravenous Anesthesia Group | After induction, anesthesia will be provided with intravenous propofol infusion (50-150 mcg/kg/min) and intravenous remifentanil infusion (0.05-0.2 mcg/kg/min). Depth of anesthesia will be evaluated with Bispectral Index (BIS). |
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| Measure | Description | Time Frame |
|---|---|---|
| Preoperative systemic immune inflammatory index (SII) | It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count | within 3 days preoperatively |
| Postoperative systemic immune inflammatory index (SII) | It will be calculated as: platelet count x neutrophil count / lymphocyte count from routine complete blood count | in the first 24 hours postoperatively |
| Preoperative systemic inflammatory response index (SIRI) | It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count | within 3 days preoperatively |
| Postoperative systemic inflammatory response index (SIRI) | It will be calculated as: neutrophil count x monocyte count/lymphocyte count from routine complete blood count | in the first 24 hours postoperatively |
| Preoperative neutrophile lymphocyte ratio (NLR) | It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count | within 3 days preoperatively |
| Postoperative neutrophile lymphocyte ratio (NLR) | It will be calculated as:neutrophil count/lymphocyte count from routine complete blood count | in the first 24 hours postoperatively |
| Preoperative platelet lymphocyte ratio (PLR) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient comorbidities | Patient comorbidities will be assessed | preoperative within 48 hours |
| Transfusion requirement | Incidence of transfusion of blood and blood products to the patient |
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Inclusion Criteria:
Exclusion Criteria:
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ASA (American Society of Anesthesiologists) II- III patients over the age of 18 who will undergo on-pump bypass surgery in Ankara City Hospital Bilkent and who agree to participate in the study
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara city hospital bilkent | Ankara | Çankaya | 06800 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D011183 | Postoperative Complications |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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It will be calculated as: platelet count/lymphocyte count from routine complete blood count
| within 3 days preoperatively |
| Postoperative platelet lymphocyte ratio (PLR) | It will be calculated as: platelet count/lymphocyte count from routine complete blood count | in the first 24 hours postoperatively |
| Preoperative c-reactive protein | from routine preoperative blood sample ( milligram/decilitre) | within 3 days preoperatively |
| Preoperative procalcitonin | from routine preoperative blood sample ( microgram/litre) | within 3 days preoperatively |
| Postoperative c-reactive protein | from routine postoperative blood sample ( milligram/decilitre) | in the first 24 hours postoperatively |
| Postoperative procalcitonin | from routine postoperative blood sample ( microgram/litre) | in the first 24 hours postoperatively |
| Postoperative complications | Postoperative complications consisting of:
| within the first 24 hours after surgery |
| during the operation |
| Inotrope requirement | Incidence of inotrope usage, inotropes consisting of:
| during the operation |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |