Systemic Immune-Inflammation Index: A Novel Predictor for Risk of Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting.

OBJECTIVE: To investigate the utility of systemic immune-inflammation index (SII) and inflammatory panel in predicting the risk of postoperative atrial fibrillation (PoAF) among patients undergoing elective isolated coronary artery bypass grafting (CABG). METHODS: A total of 116 patients (mean age: 61.9 ± 9.8 years, 78.4% were males) undergoing   isolated CABG were included in this retrospective study. Patients were divided into two groups, including those who developed PoAF (N = 26) and those without PoAF (N = 90). Inflammatory panel was evaluated in both groups. RESULTS: Patients with PoAF had significantly higher values for P-wave dispersion (PWD; 53.9 ± 5.9 versus 40.2 ± 5.1, P < .001), HATCH score (2.4 ± 1.3 versus 1 ± 1.1, P < .001), and left atrial dimension (4.0 ± 0.3 versus 3.8 ± 0.2 cm, P = .003). In the multivariate analysis with inclusion of PWD, HATCH score and SII, only SII (OR 1.007, 95% CI 1.002 to 1.012, P = .003) and PWD (OR 1.86, 95% CI 1.225 to 2.757, P = .002) were shown to be independent predictors of increased risk for PoAF. CONCLUSION: Preoperative SII seems to be a non-invasive readily available marker that significantly predicts the risk of PoAF in patients undergoing isolated CABG.

The Effect of Different Intraabdominal Pressures on Thiol/Disulfide Homeostasis in Children Who Underwent Ambulatory Laparoscopic Surgery: A Prospective Randomized Study.

BACKGROUND: Thiol/disulfide homeostasis is a significant parameter in determining the oxidative stress response after ischemia and reperfusion. We aimed to investigate the effects of applying different intraabdominal pressure (IAP) on thiol/disulfide homeostasis, ischemia-modified albumin (IMA) levels, and hemodynamics in pediatric laparoscopic surgery. MATERIALS AND METHODS: Blood samples were collected from 36 pediatric patients who were planned to undergo laparoscopic surgery for nonpalpable testis or varicocele under general anesthesia, immediately after intubation as the baseline and 5 minutes after abdominal desufflation for determining the thiol/disulfide, and IMA levels. The patients were divided into two groups; group 1 received a pneumoperitoneum pressure of 8 mm Hg (n = 18), and group 2 received 12 mm Hg (n = 18). The clinical characteristics and thiol/disulfide homeostasis and IMA levels of the patients were compared. RESULTS: No difference was detected regarding the clinical features between the groups. The comparison after intubation and after desufflation in group 1 demonstrated lower native thiol (453 ± 67 versus 422 ± 57 µmol/L, P = .059) and total thiol (497 ± 73 versus 466 ± 62 µmol/L, P = .061) levels, which was statistically insignificant. The serum native thiol level was found lower than baseline in group 2 where a 12 mm Hg IAP was applied, this difference was not statistically significant (429 ± 47 versus 412 ± 53 µmol/L, P = .078). The comparison of serum IMA levels after desufflation with the baseline (0.505 ± 0.018 versus 0.632 ± 0.022) in group 2 was found statistically significantly high (P = .031). The comparison of the perioperative heart rate and SpO2 levels with before induction was found statistically insignificant. CONCLUSIONS: Neither of 8 nor 12 mm Hg IAPs in pediatric laparoscopic surgery caused any changes in novel indicators of thiol/disulfide homeostasis parameters; however, 12 mm Hg IAP increased the levels of IMA.