Peri-operative Inotrope Use in Off Pump Coronary Artery Bypass Graft Surgeries
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 12
Abstract
Introduction: Off-Pump Coronary Artery Bypass Graft (OPCABG) surgery is now widely accepted and practiced. The literature on inotrope use in OPCABG is sparse. Aim: To look into the intra-operative and immediate postoperative (up to 12 hours after skin closure) use of inotropes in OPCABG. Materials and Methods: This was a prospective observational study done in the cardiac surgery department of Apollo Hospitals, Greams Road, Chennai, India. All the patients undergoing OPCABG from 1st August 2011 to 31st October 2011 were recruited after getting their informed consent. Data was analysed using SPSS 16.0. Descriptive data were expressed as frequencies (percentages) and chi-square test was done to find association of inotrope use with independent variables. Results: A total of 180 patients with mean age 59±10.18 years and male: female ratio 8.47:1 were included. Intra-operatively 56 (31.1%) received inotropes while 81 (45%) received them in the immediate post-operative period. More than one inotrope was given to 16 (8.89%) patients intraoperatively and 29 (16.11%) post-operatively. The most commonly used inotrope was noradrenaline. Age 46-60 years [Odds Ratio (OR) 2.04], 76-90 years (OR 0.17), Smoking (OR 2.09), moderately reduced ejection fraction (OR 2.68), left main coronary artery disease (OR 1.3) and use of two or more grafts (OR =1.93) were significant predictors of intraoperative inotrope use. Post-operative inotrope indicators were moderately reduced ejection fraction (OR 2.64), left main coronary artery disease (OR 2.5) and use of two or more grafts (OR =7.03). Conclusion: The predictors of inotrope use in OPCABG are not different from that published literature for conventional CABG. Larger cohorts of both off pump and on pump CABG have to be studied to get a wider comparative angle.
Authors and Affiliations
Nidheesh Chooriyil, Dhanya Sasidharan Palappallil
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