Effect of delta carbon dioxide and lactate on prognosis in patients undergoing open-heart surgery.

Background: To identify individuals with an increased mortality and morbidity risk after surgery, different parameters showing impaired tissue perfusion/oxygenation have been investigated, and the balance between tissue oxygen consumption and oxygen delivery has been evaluated in detecting organ failure. Aim: This study aimed to evaluate the efficacy of central venous--arterial partial carbon dioxide difference (ΔPCO2) and lactate (ΔLAC) values within the first week after discharge in predicting mortality in patients undergoing open-heart surgery. Patients and Methods: A total of 102 patients between February and April 2020 were included in the study. The patients' data obtained at the end of cardiopulmonary bypass (hour 0) and during the intensive care follow-up (hour 1, hours 6, and 24) data were prospectively recorded. All statistical analyses were performed using SPSS v. 22.0 for Windows (SPSS Inc, Chicago, IL, USA). Results: The mean age of the patients was 56.88 ± 11.02 (min 18-max 78) years, and 71.6% of the patients were male. It was observed that the area under the curve was not significant for the four measurements performed for ΔLAC. Although the area under the curve of ΔPCO2 measured at hour 6 (0.66) was significant. Conclusion: The ΔPCO2 were found to have a poor ability to predict the development of complications during the intensive care and early postoperative period in patients undergoing open-heart surgery.

A Bibliometric Analysis of the Articles Focusing on the Subject of Brain Death Published in Scientific Citation Index-Expanded Indexed Journals: Analysis of 3487 Articles Published Between 1995-2019.

BACKGROUND: Although the topic of brain death (BD) has been increasing in popularity considerably in recent years by the snowballing number of patients suffering from end-organ failure and waiting for organ transplantation, the literature indicates insufficient information regarding the comparison of scientific articles focusing on BD, authors' and nations', even governments' tendency about this issue. OBJECTIVES: In the present study, we aimed to make a bibliometric analysis of the articles focusing on the subject of BD, which is one of the most trendy topics in organ transplantation. MATERIAL AND METHODS: The terms "brain death," were searched in Thomson Reuters, Web of Science search engine for the years between 1995 and 2019. All the articles found were subjected to bibliometric analysis. RESULTS: Web of Science database included 3487 articles. The United States was found to be the most productive country in all methods, and Transplantation Proceedings was the journal that contributed most to the literature on the subject of BD. A positive correlation between publication productivity and gross domestic product/gross domestic product per capita and human development index was found (r = 0.470, P < .05; r = 0.359, P < .05; r = 0.603, P < .001, respectively). Also, there was a negative correlation between the number of published articles and the population of the country (r = -0.083, P < .001). CONCLUSION: Although the top country focusing on the subject of BD was the United States in terms of bibliometrics, we found that there is a correlation between the indices measuring the welfare and development level of the country and publication productivity about BD, which means developed countries show more tendency about BD, which is the main component of the definitive treatment of end-organ failure.

Effect of partial oxygen supply on mitochondrial electron transport system during complete cardiac ischemia.

During complete ischemia we assessed myocardial utilization of the small amount of oxygen available. We also determined whether blood cardioplegia has any advantage over crystalloid cardioplegia in this setting. Patients with preserved left ventricular myocardial function and without anterolateral wall infarct or aneurysm were included to the study. Intermittent cold blood and crystalloid cardioplegia were used in 10 patients (group BC) and 9 patients (group CC), respectively. From myocardial biopsies, obtained before and after ischemia, complete electron transport system (ETS) enzyme activities (NDH, SDH, NCCR, SCCR, and COX) and lactate content were analyzed. Biochemical and hemodynamic analyses also were done. Myocardial and blood temperatures were monitored. Ischemic time was longer in group CC (p < 0.05). There were no important differences in biochemical and hemodynamic variables between the two groups. In addition, there was no difference in NDH and SDH activities as well as COX/SCCR and COX/RS-NCCR ratios between the two groups before and after ischemia. After Ischemia, RS-NCCR in group CC and SCCR and COX activities in both groups were lower than the control. For all enzymes, activity change ratios were not different between groups. Myocardial lactate content was increased in both groups after ischemia. However, the increase in group BC was less (p < 0.01). Based on our findings, we believe that the superiority of blood cardioplegia over crystalloid cardioplegia does not depend on oxygen content, but on other factors such as buffering and free oxygen radical scavenger effects among others. However, with the warm and continuous blood cardioplegia technique, oxygen content might be more important.