cihan yücel

and 2 more

Objective: Platelet dysfunction has been shown to play a role in postoperative bleeding; however, it is not clear whether immature platelets (IP) can induce appropriate homeostasis to prevent excessive bleeding in patients undergoing CABG. This study investigated IP count (IPC), IP fraction (IPF) and mean platelet volume (MPV) throughout the hospitalization of patients undergoing CABG to elucidate their impact on postoperative bleeding and need for transfusion. Methods: Fifty consecutive patients undergoing elective CABG were included in this prospective study. All CABGs were performed by the same surgical team in a standardized fashion utilizing on-pump technique. IP and IPF were measured preoperatively, after the completion of surgery and at postoperative 1st,3rd, and 5th days. Whether need for transfusion was associated with IP, IPF, MPV and platelet count was the primary outcome measure of this study. Results: A significant increase in IPC and IPF was observed at the postoperative first day compared to baseline values. Preoperative IP and IPF were negatively correlated with intraoperative blood transfusion (p=0.017, and p=0.049, respectively). Duration of the operation, and preoperative hemoglobin and hematocrit levels were significantly correlated with the length of hospital stay. However, neither IP nor IPF were associated with the total amount of blood components used throughout the hospitalization, and they were also unassociated with the length of hospital stay. Conclusion: Although IPC and IPF are weakly correlated with postoperative drainage and blood transfusion frequency, they appear to have very little use –if any– in the prediction of postoperative bleeding in patients undergoing CABG

Huseyin Gemalmaz

and 1 more

Introduction: In this study, we aimed to compare the early postoperative period results of type 2 diabetes patients taking oral antidiabetics or insulin medications, with microalbuminuria and normal creatinine levels after coronary artery bypass. Materials and methods: Eighty patients with type 2 diabetes and taking oral antidiabetics or receiving insulin medication all with normal creatinine levels with microalbuminuria were included in this study. Preoperative creatinine values of the patients, albumin levels in spot urine, creatinine levels on the postoperative 3rd day, duration of ventilation, amount of drainage, length of stay in the intensive care unit, length of stay in the hospital, mediastinitis and mortality rates were recorded. Results: A statistically significant increase in creatinine was found in both taking oral antidiabetics type 2 diabetes and insulin medication patient groups with microalbuminuria. When the two groups were compared with each other, increase in creatinine levels of the patients using insulin was higher than the patients taking oral antidiabetics, and was statistically significant. Conclusion: According to the result of our study it can be suggested that postoperative creatinine elevation is observed in patients with type 2 diabetes mellitus with microalbuminuria and with normal creatinine levels, either having insulin medication or not. The elevation is higher in patients having insulin medication while other results are similar, except for impaired renal function. Keywords: Type 2 diabetes mellitus, insulin, microalbuminuria, coronary artery bypass.