مجله دانشکده پزشکی اصفهان
پیاپی 550 (هفته دوم دی 1398)

Coronary artery bypass graft surgery combined with cardiopulmonary bypass causes changes in body physiology. In the meantime, aortic cross clamp time and cardiopulmonary bypass have been implicated in surgical outcomes. The purpose of this study was to determine the association between mean duration of aortic cross clamp opening to end of cardiopulmonary bypass with surgical outcome of patients after coronary artery bypass graft surgery (CABG).

This was a descriptive cross-sectional study on 47 patients with age range of 40 to 65 years who underwent CABG surgery in Shahid Chamran hospital, Isfahan, Iran; they were selected using non-random sampling method over a 5-month period in 2019. In these patients, the aortic-clamp opening period was measured until the end of cardiopulmonary bypass, and evaluated for surgical outcomes such as death, atrial fibrillation, mechanical ventilation time, troponin and creatine kinase-MB (CKMB) levels before surgery, and 12, 24, and 48 hours after it, as well as the length of intensive care unit (ICU) stay.

There was no significant relationship between the mean duration of aortic cross clamp opening to end of cardiopulmonary bypass with death, atrial fibrillation, preoperative and 12, 24, and 48 hours postoperative CKMB level, and ICU stay. Moreover, there was a significant relationship between this time period and preoperative and 12, 24, and 48 hours postoperative troponin levels and the duration of lung mechanical ventilation.

Extending the interval time of opening aortic cross clamp ton the end of the cardiopulmonary bypass, raised the mechanical lung ventilation time. By reducing the duration of this interval, the duration of mechanical ventilation and postoperative pulmonary complications can be reduced. 

The present study aimed to investigate the effects of oral administration of green- and chemicallysynthesized nickel oxide (NiO) nanoparticles on the histopathology of liver, kidney, and testis in rats.

This was a descriptive analytic study, forty rats were allocated into five equal groups. The first group (healthy control) received normal saline. The second and third groups received oral chemically-synthetized NiO nanoparticles (5 and 50 mg/kg, respectively). The green-synthetized NiO nanoparticles were orally fed to the fourth and fifth groups for eight weeks (5 and 50 mg/kg, respectively). Finally, blood was collected from the heart of rats and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine were evaluated. After euthanasia, liver, kidney, and testis samples were stained with hematoxylin-eosin, and examined under a light microscope.

Both groups treated with 50 mg/kg dose showed significantly higher ALT and AST levels compared to the control group (P < 0.050). Serum BUN and creatinine levels were significantly higher in rats received the dose of 50 mg/kg (P < 0.05). In histopathological investigation, necrosis and fat accumulation were observed in the liver of rats treated with the 50 mg/kg dose of NiO nanoparticles. In kidney, proximal tubule swelling was observed and testis tissues showed necrosis, too.

The long-term administration of NiO nanoparticles have toxic effects on liver, kidney, and testis in rats.

Considering the importance of anesthesia in people who are very obese, and the need to take the necessary activities to minimize the complications during and after the operation in these patients, this study aimed to compare ventilation quality by anatomic or nasal mask after induction of general anesthesia in patients with body mass index (BMI) of above 40 kg/m2.

In this randomized clinical trial study, 70 obese patients with a BMI of more than 40 kg/m2 who were candidates for surgery were selected and randomly divided into two groups of 35. The first group were ventilated with oral mask and 100% oxygen for three minutes, and in the second group, ventilation was performed through the nasal mask. The hemodynamic and ventilation parameters and complications during and after surgery were evaluated and compared between the two groups.

Evaluation of hemodynamic parameters during and after surgery did not show any clinical difference between the two groups. However, nasal ventilation patients had better ventilation and oxygenation indexes.

The results of our study showed that the use of nasal mask instead of oral mask have a more favorable ventilation end-tidal CO2 (ETCO2) and oxygenation (SpO2) in patients undergoing surgery, and the same hemodynamic stability after induction of anesthesia in very obese patients.