Online ISSN: 2515-8260

Comparison of intralipid with saline for ejection fraction, serum lactate and hemodynamic changes after coronary artery bypass graft

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Majid Razavi 1 , Shahram Amini 2*, Saeed Daghestani3 , Iman Kashani4 , Mehryar Taghavi Gilani5

Abstract

Background and Aims: One of the complications of coronary artery bypass graft is reperfusion injury and myocardial damage. In vitro, intralipid has been able to reduce the size of the infarct area. In this study, intralipid was compared to saline for ejection fraction, lactate, and hemodynamic parameters of patients. Materials and Methods: This study was conducted on 60 patients undergoing coronary artery bypass graft with age<70 years and with an ejection fraction > 35%. The induction of anesthesia was performed in a similar manner and by a same surgeon for all patients. After intensive care unit transfer and the extubation, saline and 20% intralipid solutions were injected into the subjects in the control and intervention groups, respectively, on three hours. Before and after the injection of solutions, ejection fraction and serum lactate level were assessed by a special cardiologist. Moreover, heart rate and mean blood pressure were measured every 30 min from the onset of infusion to the end of the study. Data was analyzed with SPSS software version 16. P-value less than 0.05 were considered statistically significant. Results: Sixty patients were divided into two same groups. Both groups were homogeneous for demographic characteristics and euroscore. Although, there was a significant increase in ejection fraction for two groups during the study (P=0.00 in both groups). But, no significant difference was observed between the two groups regarding EF (P=0.26). Lactate serum level decreased significantly in both groups; that was more in the intralipid group (P=0.001). In addition, mean arterial pressure significantly decreased in both groups (P=0.001 and P=0.00 in control and intralipid groups, respectively), that was higher in the intralipid group, compared with the control group (P=0.001). Also, the patients’ heart rate decreased in both groups, and it was more in the intralipid group (P=0.01) Conclusion: In our study, intralipid infusion improved the hemodynamic status of patients and was better than saline group. Also the level of serum lactate was lower in patients of the intralipid group. There was no significant difference between the two groups regarding the ejection fraction level. Given the low complications of intralipid administration and improved nutrition of patients, it is suggested that this method can be used for patients after CABG.

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