Thiamine can decrease Lactate and Creatinine level after Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction

authors:

avatar Alireza Jahangirifard ORCID 1 , * , avatar Shirin Salajegheh 2 , avatar Sarvenaz Arab 3 , avatar Seyed Bashir Mirtajani ORCID 4 , avatar Golnar Radmand 5 , avatar Behrooz Farzanegan 6

Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology, Kerman University of Medical Sciences, Kerman, Iran
Anesthesiology Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences ,Tehran ,Iran.
Journal of Cellular & Molecular Anesthesia: Vol.3, issue 4; e149565
article type: Original Articles
DOI: https://doi.org/10.22037/jcma.v3i4.22603

how to cite: Jahangirifard A, Salajegheh S, Arab S, Mirtajani S B, Radmand G, et al. Thiamine can decrease Lactate and Creatinine level after Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction. J Cell Mol Anesth. 2018;3(4):e149565. https://doi.org/10.22037/jcma.v3i4.22603.

Abstract

Introduction: During cardiopulmonary bypass, oxidative stress happens in the patient's cells due to blood contact with various levels of synthetic materials. It can activate inflammatory process and release factors such as IL-6, CRP, and Neutrophils witch may hurt different organs. In recent years, many efforts have been made to prevent this type of damage, however, no single treatment has been proposed to reduce this risk. Antioxidant substances such as Thiamine is important in cell defense against free oxygen radicals. Regarding this issue, in this study, the effect of thiamine on lactate levels in patients undergoing coronary artery bypass graft surgery has been investigated.Materials and methods: In this study, 140 patients from 25 to 65 years old with mild systolic dysfunction (EF = 45-55%) who were candidates for elective CABG surgery in two groups: control and purpose (patients receiving Thiamine) were examined. All of these patients were anesthetized in an identical manner, and were subjected to a heart-lung pump. Serum lactate levels were measured before, during and 6, 12, 18, and 24 hours after surgery. All data collected in a questionnaire were recorded and evaluated using spss statistical software.Results: Study groups showed no significant differences regarding demographics and underlying diseases. Serum lactate was significantly lower in thiamine group during the first 24 hours after surgery (except before operation and 2 hours later) (p <0.05).Creatinine level in two groups before surgery was not significantly different ,However, it was significantly lower in case group 24 hours after surgery(1.54?0.14 vs. 1.24?0.19; p: 0.001).Also, dose of Inotropes in ?patients who received thiamine, was significantly lower than the control group (p= 0.001). Extubation was longer in control group (15.4?4.9 vs. 13.15?4.1; p=0.003) while ICU stay was not different.Conclusion: It seems that thiamine administration before cardiopulmonary bypass, in patient with decreased left ventricular function, can decrease serum lactate as tissue perfusion marker and also improve kidney function.