1
|
Guerrero-Orriach JL, Ariza-Villanueva D, Florez-Vela A, Garrido-Sánchez L, Moreno-Cortés MI, Galán-Ortega M, Ramírez-Fernández A, Alcaide Torres J, Fernandez CS, Navarro Arce I, Melero-Tejedor JM, Rubio-Navarro M, Cruz-Mañas J. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase. Ther Clin Risk Manag 2016; 12:623-30. [PMID: 27143905 PMCID: PMC4844253 DOI: 10.2147/tcrm.s102772] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. METHODS This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. RESULTS After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL), neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng/mL), or mean ± SD creatinine (1.06±0.24 mg/dL vs 1.25±0.37 mg/dL at 48 hours). RV dilatation decreased from 4.23±0.7 mm to 3.45±0.6 mm and pulmonary artery pressure from 58±18 mmHg to 42±19 mmHg at 48 hours. CONCLUSION Preoperative administration of levosimendan has shown a protective role against cardiac, renal, and neurological damage in patients with a high risk of multiple organ dysfunctions undergoing cardiac surgery.
Collapse
Affiliation(s)
| | - Daniel Ariza-Villanueva
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| | - Ana Florez-Vela
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| | - Lourdes Garrido-Sánchez
- CIBER Fisiología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain
- Department of Nutrition and Endocrinology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), University Hospital Virgen de la Victoria, Málaga, Spain
| | | | - Manuel Galán-Ortega
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| | | | - Juan Alcaide Torres
- Department of Nutrition and Endocrinology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), University Hospital Virgen de la Victoria, Málaga, Spain
| | - Concepción Santiago Fernandez
- Department of Nutrition and Endocrinology, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), University Hospital Virgen de la Victoria, Málaga, Spain
| | - Isabel Navarro Arce
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| | | | - Manuel Rubio-Navarro
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| | - José Cruz-Mañas
- Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Málaga, Spain
| |
Collapse
|
2
|
Neto CN, Iza MPC, Tardelli MA. Paraplegia after Myocardial Revascularization. Case Report. Braz J Anesthesiol 2010. [DOI: 10.1016/s0034-7094(10)70026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|