ABSTRACT
Surgical site infection is known as a common complication after cardiac surgery, and Cefazolin is the best prophylactic antibiotic to prevent this complication. The goal of this study was to evaluate the effect of continuous and intermittent Cefazolin for the prevention of superficial surgical site infection following off-pump coronary artery bypass [OPCAB]. This prospective randomized clinical trial study was conducted on 141 patients candidated for OPCAB and divided into two groups. This study was performed between February 2011 and February 2012 in the Iranian city of Yazd. Patients in both groups received 2 g of Cefazolin as a starting dose and at 30 minutes before incision. Definition of surgical site infections was according to the Centers for Disease Control and Prevention Criteria [CDC-criteria]. In the continuous infusion group [n = 74], 3 g of Cefazolin was infused over a 2 4-hour period after surgery. In the intermittent group [n = 67], 1 g of Cefazolin was administered at 3, 11, and 19 hours after the starting dose. Hyperlipidemia, diabetes, hypertension, smoking, history of heart disease, and incidences of superficial infection were compared between the two groups. Duration of follow- up was 4 weeks. The mean age of the patients was 60.49 +/- 10.63 years. The patients were 30.5% female and 69.5% male. There were no significant differences in age, body surface area, duration of operation, number of distal grafts, number of proximal grafts, and duration of hospital stay before heart surgery between two groups. The incidence of infection in intermittent group was [7.5%] and in continuous groups was [2.7%]. There was no significant difference in the incidence of infection between the two groups [p value = 0.26]. Our findings in this study showed no significant differences between continuous and intermittent Cefazolin for the prevention of superficial surgical site infections after OPCAB
ABSTRACT
Renal dysfunction is a risk marker in patients who candidate for coronary artery bypass graft [CABG]. Renal disorder is associated with prolonged stays in intensive care unit and hospital, morbidity and mortality. Aim of this study is specific evaluation of association between preoperative creatinine [Cr] with atrial fibrillation [AF] after elective off-pump CABG in non-diabetic male patients with normal ejection fraction. Two hundred non-diabetic male patients with normal ejection fraction undergoing elective off pump CABG surgery enrolled in this cross-sectional study and were stratified by present or absence of postoperative atrial fibrillation: patients with postoperative new-onset atrial fibrillation [n=100] as group 1 and patients without new-onset postoperative atrial fibrillation as group 2 [n=100]. Preoperative serological test of the participants, such as serum creatinine, were recorded in their medical dossiers. Data were analyzed in SPSS-16 software and tested for association between atrial fibrillation with creatinine level by using student t test, chi-square test or logistic regression. Cr level in patients with and without AF three days before surgery were 1.8 +/- 0.3 and 1.0 +/- 0.4 respectively [P value for Cr=0.00]. On surgical day, mean Cr level in patients with and without AF were 1.6 +/- 0.2 and 1.1 +/- 0.5 respectively [P value for Cr = 0.00]. Of the 100, male patients with postoperative AF, duration and frequency of recurrence of AF were not associated with Cr at three days before surgery and on surgical days [P>0.05]. Patients with postoperative AF had unsuitable status of renal function compare to patients without AF; however, preoperative serum creatinine cannot associate with duration and frequency of recurrence of AF