COLD BLOOD CARDIOPLEGIA VERSUS COLD CRYSTALLOID CARDIOPLEGIA FOR CORONARY ARTERY BYPASS GRAFTING (CABG) IN PATIENTS WITH LOW EJECTION FRACTION -IN THREE LARGE HOSPITAL IN PALESTINE
| dc.contributor.author | Hakeem Mustafa Sholi | |
| dc.date.accessioned | 2024-06-09T19:46:24Z | |
| dc.date.available | 2024-06-09T19:46:24Z | |
| dc.date.issued | 2023-03-15 | |
| dc.description.abstract | Myocardial protection during cardiopulmonary bypass surgery for coronary artery bypass graft surgery (OPCABG) is still a controversial topic. The primary method of protecting the myocardium during cardiac surgery is cardioplegia, which also facilitates surgery by providing a quiet, bloodless surgical field. These cardioplegia solutions include: Cold-crystalloid vs. cold-blood cardioplegia. However, there is still a debate about which solution for cardioplegia in cardiac surgery is the best solution. The Main goal of this study is to Comparing Cold-Blood Versus Cold Crystalloid Cardioplegia for Coronary Artery Bypass Grafting (CABG) Surgery in Patients with Low Ejection Fraction - To Determine Which Type is Appropriate for Surgical Myocardial Conservation in Three Major Palestinian Hospitals, after CABG surgery and reduce complications. A retrospective observational cohort design was used in this study. All patients with multi vessel coronary artery disease, who were admitted to an eligible hospital between January 1st, 2020 and December 30th 2021, aged ≥40 years and <80 years and require OPCABG surgery, were included in this study. Data were collected by reviewing patient medical records from the hospital information system. According to the findings, there is no significant difference between cold blood and cold crystalloid cardioplegia when it comes to intra-operative ejection fraction, cardioplegia volume, cardiopulmonary bypass time, blood loss between 4 and 6 hours after surgery, time spent on mechanical ventilation after surgery, time spent using pharmacological cardiac support after surgery, creatinine level after surgery, or post-operative complications. The findings demonstrate that there are considerable disparities between the Cold Blood Cardioplegia group and the Cold Crystalloid Cardioplegia group only in Ejection fraction pre operation, the mean of the Ejection fraction pre operation in the CBC group is (Mean=38%) which is considerably greater than the average in the CCC group (Mean=36%), the P-value of the test is 0.002, but this difference does not mean anything clinically because it happened before the cardioplegia was given. Significant differences exist at the 0.05 level. in the amount of Blood loss 2 hours post-operation, the mean in the CBC group is (Mean=153.8) which is considerably less than the average in the CCC group (Mean=183.8), the P-value of the test is 0.032.and there are significant differences at 0.05 level in Creatinine levels pre-operation, the mean in the CBC group is (Mean=0.78) which is significantly higher than the mean in the CCC group (Mean=0.63), the P-value of the test is 0.020. when using cold crystalloid cardioplegia as opposed to cold blood cardioplegia at a significant level of P value (0.05),and this difference does not mean anything clinically because it happened before the cardioplegia was given. This study concludes that the use of cold-blooded cardioplegia has the same myocardial preservation and complications as cold crystalloid cardioplegia. For clinical practice, it is recommended that cold crystalloid cardioplegia be used to decrease the cost of cold blood cardioplegia use when using the traditional methods and also it facilitates vision for the surgeon, and presenting the results of this study to the Palestinian Ministry of Health to make a comprehensive protocol and guidelines for all hospitals to follow cold crystalloid cardioplegia. Keywords: Cold Blood Cardioplegia, Cold Crystalloid Cardioplegia, Myocardium Protection, Ejection Fraction, Coronary Artery Bypass Graft. | |
| dc.identifier.uri | https://hdl.handle.net/20.500.11888/19002 | |
| dc.language.iso | en | |
| dc.supervisor | Dr. Eman Alshawish | |
| dc.title | COLD BLOOD CARDIOPLEGIA VERSUS COLD CRYSTALLOID CARDIOPLEGIA FOR CORONARY ARTERY BYPASS GRAFTING (CABG) IN PATIENTS WITH LOW EJECTION FRACTION -IN THREE LARGE HOSPITAL IN PALESTINE | |
| dc.type | Thesis |