Frequency of hypoalbuminemia in perioperative period for patients having elective open heart surgery in cardiopulmonary baypass and factors influencing it.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Mērķis: Pēcoperācijas hipoalbuminēmijas klātbūtne var būt saistīta ar sliktākiem rezultātiem un vājākiem iznākumiem ilgtermiņā. Šī pētījuma mērķis bija novērtēt hipoalbuminēmijas biežumu pacientiem pirms un pēc plānveida atvērtas sirds operācijas mākslīgajā asinsritē un analizēt iespējamos ietekmējošos faktorus.
Materiāli un metodes: Retrospektīvi analizēti dati par 120 pacientiem, kuri no 2021. gada 1. novembra līdz 2021. gada 28. decembrim tika uzņemti Paula Stradiņa Klīniskās universitātes slimnīcas Kardioķirurģijas centrā uz plānveida atvērtas sirds operācijas veikšanu mākslīgajā asinsritē. Mēs analizējām pacientu dzimumu, vecumu, ĶMI, blakusslimības, plānotās operācijas veidu, pirmsoperācijas asins analīzes, intraoperatīvos mainīgos un pēcoperācijas asins analīzes 6 un 12 stundas pēc operācijas. Statistiskajai analīzei tika izmantota IBM SPSS Statistics 27.0 versija.
Rezultāti: No 120 pacientiem 23 tika izslēgti pieejamo datu trūkuma dēļ. No 97 pacientiem tikai 1 (1,03%), iestājoties slimnīcā, bija hipoalbuminēmija. Hipoalbuminēmija attīstījās 38 (39,2%) pacientiem 6 stundas pēc operācijas un 50 (51,5%) pacientiem pēc 12 stundām. Pirmsoperācijas faktoriem (dzimums, vecums, ĶMI, blakusslimības, asins analīzes) nebija statistiski nozīmīgas ietekmes uz hipoalbuminēmiju.
50 pacientiem attīstījās hipoalbuminēmija 12 stundas pēc operācijas, no kuriem nevienam nebija smags seruma albumīna deficīts (<25 g/L), 4 bija mērens (25-29,9 g/L), 46 bija zems deficīts (30-34,9 g/L).
Intraoperatīvajās vērtībās tika konstatēta statistiski nozīmīga korelācija pacientiem ar garāku mākslīgās asinsrites laiku (vidēji (Q1-Q3). 90 (74-119) hipoalbuminēmijai pret 82 (69-102) min normālu albumīna līmeni; r = -0,207, p = 0,042), kā arī augstākam intraoperatīvajam šķidruma līdzsvaram (853 (77 - 1100) pret 647 (181 - 1065) ml; r = -200, p = 0,049) bija zemāks albumīna līmenis 6 stundas pēc operācijas.
Secinājumi: hipoalbuminēmija pacientiem pirms plānveida atvērtas sirds operācijas nav izplatīta. Tomēr 51,5% pacientu 12 stundas pēc operācijas attīstās hipoalbuminēmija. Pirmsoperācijas faktori būtiski neietekmē hipoalbuminēmijas biežumu. Hipoalbuminēmija galvenokārt ir saistīta ar intraoperatīviem faktoriem, piemēram, mākslīgās asinsrites laiku un intraoperatīvo šķidruma līdzsvaru.
Objectives: The presence of postoperative hypoalbuminemia may be associated with worst outcomes and long-term scenario. The aim of this study was to estimate frequency of hypoalbuminemia in patients before and after elective open-heart surgery in cardiopulmonary bypass (CPB) and analyze possible factors influencing it. Materials and Methods: A data of 120 patients who were admitted to Pauls Stradins Clinical University Hospital, Center of Cardiac Surgery for elective open-heart surgery in CPB between 1st November 2021 and 28th December 2021 was retrospectively analyzed. We analyzed patients gender, age, BMI, co-morbidities, planed surgery type, pre-operative blood tests, intra-operative variables and post-operative blood tests 6 and 12 hours after surgery. For statistical analysis IBM SPSS Statistics 27.0 was used. Results: From 120 patients, 23 were excluded due to lack of available data. From 97 patients, only 1 (1.03%) had hypoalbuminemia when admitted to hospital. HB was developed in 38 (39.2%) patients 6 hours after surgery and in 50 (51.5%) patients after 12 hours. There was no statistically significant influence by pre-operative factors (gender, age, BMI, co-morbidities, blood tests) on hypoalbuminemia. There were 50 patients who developed hypoalbuminemia 12 hours after surgery from which none had severe serum albumin deficit (<25 g/L), 4 had moderate (25-29.9 g/L), 46 had low deficit (30-34.9 g/L). In intra-operative values statistically significant correlation was found for patients with longer CPB time (Median (Q1-Q3). 90 (74-119) for hypoalbuminemia vs 82 (69-102) min for normal albumin level; r = -0.207, p = 0.042) as well as higher intra-operative fluid balance (853 (77 - 1100) vs 647 (181 - 1065) ml; r = -200, p = 0.049)) had lower albumin levels 6 hours after surgery. Conclusions: hypoalbuminemia in patients before elective open-heart surgery is not common. However, 51.5% of patients develop hypoalbuminemia 12 hours after surgery. Pre-operative factors do not significantly affect hypoalbuminemia’s frequency. hypoalbuminemia is mainly associated with intra-operative factors, like CPB time and intra-operative fluid balance.
Objectives: The presence of postoperative hypoalbuminemia may be associated with worst outcomes and long-term scenario. The aim of this study was to estimate frequency of hypoalbuminemia in patients before and after elective open-heart surgery in cardiopulmonary bypass (CPB) and analyze possible factors influencing it. Materials and Methods: A data of 120 patients who were admitted to Pauls Stradins Clinical University Hospital, Center of Cardiac Surgery for elective open-heart surgery in CPB between 1st November 2021 and 28th December 2021 was retrospectively analyzed. We analyzed patients gender, age, BMI, co-morbidities, planed surgery type, pre-operative blood tests, intra-operative variables and post-operative blood tests 6 and 12 hours after surgery. For statistical analysis IBM SPSS Statistics 27.0 was used. Results: From 120 patients, 23 were excluded due to lack of available data. From 97 patients, only 1 (1.03%) had hypoalbuminemia when admitted to hospital. HB was developed in 38 (39.2%) patients 6 hours after surgery and in 50 (51.5%) patients after 12 hours. There was no statistically significant influence by pre-operative factors (gender, age, BMI, co-morbidities, blood tests) on hypoalbuminemia. There were 50 patients who developed hypoalbuminemia 12 hours after surgery from which none had severe serum albumin deficit (<25 g/L), 4 had moderate (25-29.9 g/L), 46 had low deficit (30-34.9 g/L). In intra-operative values statistically significant correlation was found for patients with longer CPB time (Median (Q1-Q3). 90 (74-119) for hypoalbuminemia vs 82 (69-102) min for normal albumin level; r = -0.207, p = 0.042) as well as higher intra-operative fluid balance (853 (77 - 1100) vs 647 (181 - 1065) ml; r = -200, p = 0.049)) had lower albumin levels 6 hours after surgery. Conclusions: hypoalbuminemia in patients before elective open-heart surgery is not common. However, 51.5% of patients develop hypoalbuminemia 12 hours after surgery. Pre-operative factors do not significantly affect hypoalbuminemia’s frequency. hypoalbuminemia is mainly associated with intra-operative factors, like CPB time and intra-operative fluid balance.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Hipoalbuminēmija, mākslīgās asinsrites laiks, šķidruma balanss, preoperatīvie faktori, operācijas laika faktori, Hypoalbuminemia, cardiopulmonary bypass time, fluid balance, pre-operative factors, intra-operative factors