The analysis of clinical data on the ability of heart rhythm self-restoration in patients undergoing on-pump CABG

Kiseleva D.G., Plyusnina T.Yu., Lishchuk A.N.1

Lomonosov Moscow State University, Faculty of Biology, Department of Biophysics, Russia, 119992, Moscow, Leninskie Gory

1Cardiac Surgery Center, Federal State Budgetary Institution "National Medical Research Center for High Medical Technologies named after A.A. Vishnevsky", Russia, 143400, Moscow region, Krasnogorsk, st. Svetlaya, 11

Coronary artery bypass grafting (CABG) in condition of complete cardiac arrest using cardiopulmonary bypass (on-pump) is one of the most common surgical interventions aimed at reducing the symptoms of coronary heart disease. When the graft suturing procedure is completed, the patient is prepared to be disconnected from cardiopulmonary bypass. However, cardiac activity does not always recover on its own. In such cases, additional resuscitation measures are required to restore cardiac activity and sinus rhythm of the heart and the risk of death increases sharply, as well as the risk of postoperative complications. The purpose of the analysis is to identify potential biomarkers signaling that patient is at risk for inability of heart rhythm self-restoration based on arterial blood parameters and to analyse the processes at the cellular level and the level of an individual organ that can potentially lead to the development of a pathological condition.

The authors processed and analyzed the data of 10 patients of the test group, whose cardiac activity during on-pump CABG was restored using several discharges of a defibrillator, and 11 patients of the control group. The information about patients whose blood test data were used in this study was held confidential, digital blood test data was processed anonymously. According to the results of statistical analysis using the nonparametric Mann-Whitney test, the null hypothesis about the absence of differences between the control and test samples was rejected for the following indicators: concentration of sodium and chloride, blood osmolality, glucose level.

All indicators with statistically significant differences for the two groups are closely interrelated, with sodium making the main contribution to the osmolality level. Thus, it is likely that hypoosmolality and hyponatremia can be potential markers of cell edema and cause the inability of self-restoration of cardiac activity.


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