ABSTRACT
OBJECTIVE: Benefit of amiodarone in restoring sinus rhythm (SR) after cardiac surgery was concluded in previous studies that used different protocols for giving amiodarone. The purpose of this study was to assess the use of single parenteral intraoperative loading dose of amiodarone without maintenance as prophylaxis against atrial fibrillation (AF) after valvular heart surgery. MATERIALS AND METHODS: This was a prospective, randomized, double-blind controlled study on 94 patients listed for valvular heart surgery. The patients received either amiodarone, 3 mg/kg diluted in 100 ml of normal saline and started prior to making skin incision and administrated through venous line over a period of 30 minutes, or the same volume of normal saline infused in a similar fashion. The incidence of AF during the first 5 days after surgery was the main outcome measured. RESULTS: There was significant difference in favor of the amiodarone group regarding restoration of sinus rhythm after aortic cross-clamp removal, number of patients requiring cardioversion, incidence of AF and the time elapsed before incidence of it postoperatively (P values=0.02, 0.04, 0.02, 0.02, respectively). There was no difference in hospital mortality, major postoperative morbidity, intensive care unit (ICU) stay or hospital stay. CONCLUSIONS: Amiodarone prophylaxis in a single intraoperative dose was significantly effective in prevention of new-onset postoperative AF after valvular heart surgery. This amiodarone dose is well tolerated and not associated with postoperative complications.
ABSTRACT
INTRODUCTION: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. MATERIALS AND METHODS: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical conditions, complications, admission to intensive care unit (ICU), need for mechanical ventilation, length of ICU and hospital stay and mortality. RESULTS: For the study, 39 patients who were 60 years old or more and admitted to the hospital because of isolated rib fractures were enrolled. There were 28 males (71.7%) and 11 females (28.3%) with mean age of (66.84 +/- 4.7) years. No correlation was found between comorbidities and hospital outcomes except in those who were diabetic (P-value = 0.005) and those with chronic lung disease (P-value = 0.006). Pulmonary complications were the most frequent complications encountered in those patients. Pulmonary complications were: lung contusion in 8 patients (20.5%) and pulmonary infection in 6 patients (15.8%). CONCLUSION: Elderly patients sustaining blunt chest trauma had significant morbidity and potential for mortality.
