M.bennett at 08:05, 22 August 2022

2022-08-22T08:05:51Z

Show changes

M.bennett at 03:24, 16 September 2021

2021-09-16T03:24:31Z

Show changes

Gordoben: Imported from Wikispaces

2017-11-15T07:24:01Z

Imported from Wikispaces

New page

=Pre-conditioning with HBO may induce cerebral and cardiac protection in patients undergoing on-pump CABG surgery=

**Clinical Bottom line:'''
**1. Pre-conditioning with HBO resulted in improved clinical outcomes for patients undergoing ''''''on-pump CABG surgery.'''
**2. There were also potential cerebral and cardiac protective effects as determined by proxy outcomes. '''
**3. No protective effects were noted in off-pump CABG'''

'''Citation/s:''' Yang L, Dong H, Chen M et al. Preconditioning with repeated hyperbaric oxygen induces myocardial and cerebral protection in patients undergoing coronary artery bypass graft surgery: a prospective, randomized, controlled clinical trial. Journal of Cardiothoracic and Vascular Anesthesia 2011;25(6):908-916.
'''Lead author's name and email:''' Yang Li: lxiong@fmmu.edu.cn
'''Three-part Clinical Question:''' For patients undergoing CABG, does the addition of hyperbaric oxygen to standard care confer any myocardial and cerebral protection?Search Terms: CABG, preconditioning, cardiopulmonary bypass

'''The Study:'''
Single-blinded randomised controlled trial without intention-to-treat.
'''The Study Patients:''' Male patients under 80 years having CAG either on cardiopulmonary bypass or off-pump.
'''Control group''' (N = 16; 15 analysed): Full orthodox pre-operative care for CABG. No sham treatment.
'''Experimental group''' (N = 15; 14 analysed): As above, but patients were given 5 daily sessions of HBOT at 2ATA breathing 100% ATA for 70 minutes. 

**The Evidence:'''
{|
| '''Outcome''' |||| '''Control Group''' |||| '''HBOT Group''' || '''Difference''' || '''95% CI'''
|-
|^ || Mean || SD || Mean || SD ||^ ||^
|-
| '''Length of ICU Stay in on-pump patients (hrs)''' || 85.9 || 40.3 || 59.4 || 20.9 || 26.5 || 1.8 to 51.2
|-
| '''Serum S100B concentration of on-pump patients at time of ICU arrival (pg/ml)''' || 89.7 || 14.6 || 60.4 || 26.4 || 29.3 || 13.2 to 45.4
|-
| '''Serum NSE concentration of on-pump patients at 24hrs post-op (ng/ml)''' || 38.0 || 8.4 || 30.3 || 6.1 || 7.7 || 2.1 to 13.3
|-
|}
'''Comments:'''
1. Exclusion of female subjects and small numbers may limit external validity of the study
2. Only 2 biochemical markers were analyzed to measure cerebral injury; it may not be fully representative of actual cerebral damage.
3. Early post-operative outcomes may not be representative of long-term morbidity and mortality
4. Values of mean and standard deviation were not provided for non-significant results in off-pump patients.

'''Appraised by:''' Bryan Hui and Michael Bennett, Tuesday, 23 April 2013
'''Email:''' bryan.hui@student.unsw.edu.au
'''Kill or Update By''': April 2020



[[File:sumhorsa.gif|center]]

=[[Myocardial ischaemia | BACK]]=

Yang - Revision history

M.bennett at 08:05, 22 August 2022

M.bennett at 03:24, 16 September 2021

Gordoben: Imported from Wikispaces