Does Preconditioning Affects Other Organs in Patients Undergoing Open Heart Surgery ?

Study Overview
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Brief Summary
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An association between white blood cell count (WBC), neutrophil-lymphocyte ratio , and inflammatory process is well known . Ischemic preconditioning reduces the inflammation

Detailed Description
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Preliminary evidence has suggested the role of inflammation in development and prognosis of cardiovascular diseases and cancers. Most of the prognostic studies failed to account for the effects of co-morbid conditions as these might have raised the systemic inflammation. We used neutrophil lymphocyte ratio (NLR) as a measure of systemic inflammation and investigated its association with cardiac preconditioning in open heart surgery .

Official Title
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Variable Types of Preconditioning,is There a Different Impact Upon Multiorgan Function After Open Heart Surgery ?

Conditions
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Neutrophil Lymphocyte Ratio, Serum Createnine, Mechanical Ventilation

Intervention / Treatment
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* Procedure: ischemic preconditioning
* Drug: Pharmacologic preconditionig


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-60 years old American Society of Anesthesiologists physical status II and III Patients scheduled for open heart surgery no active inflammatory process Exclusion Criteria:Exclusion Criteria: Emergency surgery Clinically significant kidney or liver disease Patients allergic to local anesthetic Patients with prolonged cardiopulmonary bypass time (>120 min) Patients required intra-aortic balloon pump Postoperative hemodynamic instability (including the occurrence of serious arrhythmia) or bleeding that required surgical re-exploration

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: intervention group well be pretreated with cardiac preconditioning
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Ischemic preconditioing<br>50 patients ischemic preconditioning will be done after induction and before cardiopulmonary bypass by inflation the cuff of blood pressure above 200mmhg in the lower limb every 5 min for 3cycles | Procedure: ischemic preconditioning<br>* ischemic preconditioning will be done after induction and before cardiopulmonary bypass by inflation the cuff of blood pressure above 200mmhg in the lower limb every 5 min for 3cycles<br>|
| Active Comparator: Pharmacologic preconditioing<br>by sevoflurane anesthesia | Drug: Pharmacologic preconditionig<br>* Pharmacologic preconditionig will be attained by sevoflurane anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change of Neutrophil lymphocyte ratio |  | during first two postoperative days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac preconditioning, open heart surgery, createnine, inflammation