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All Journal Paediatrica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Pribadi Wiranda Busro
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Evaluation of myocardial injury from use of aortic cross-clamp and cardiopulmonary bypass duration in patients undergoing tetralogy of Fallot corrective surgery Wardoyo, Suprayitno; Djer, Mulyadi M.; Busro, Pribadi Wiranda
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.147-55

Abstract

Background Much remains unknown about the myocardial injury caused by aortic cross-clamp and cardiopulmonary bypass durations in children undergoing open-heart surgery, especially children with cyanotic congenital heart disease. To assess this injury, specific biomarkers can provide valuable insights. Troponin I (TnI) is known to be a specific marker of heart damage, while serum lactate serves as an indicator of tissue hypoperfusion and ischemic events. Additionally, malondialdehyde (MDA) is recognized as a marker of oxidative stress resulting from CPB machine usage. Objective To investigate the association of aortic cross clamp and CPB durations on myocardial injury and oxidative stress in children undergoing TOF corrective surgery. Methods We conducted this prospective study which included 29 patients diagnosed with TOF and who underwent corrective surgery. Troponin I and MDA levels were measured before surgery, 1 hour after surgery, and 8 hours after surgery. Lactate levels were measured in arterial blood specimens taken before surgery, as well as 1 hour, 6 hours, 12 hours, and 24 hours after surgery. Results Twenty-nine patients were included in this study and divided into groups based on aortic cross-clamp duration: shorter (<38 minutes) or longer (≥38 minutes), as well as based on CPB duration: shorter (<75 minutes) or longer (≥75 minutes), according to the median. Wilcoxon test indicated For the <38 min clamp duration group, there was only a significant increase in TnI at 1 hour compared to pre-op (P=0.048). However, there were no significant different in TnI, MDA, or lactate levels at any time point between the two CPB or cross-clamp groups.
Efektivitas Pemberian Deksametason dalam Memengaruhi Durasi Perawatan di Rumah Sakit Pada Operasi Bedah Pintas Arteri Koroner Off Pump Putra, Rally Galang Pratama; Hanafy, Dudy Arman; Wartono, Dicky Aligheri; Busro, Pribadi Wiranda; Herlambang, Bagus
Majalah Kedokteran Indonesia Vol 71 No 6 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.6-2021-746

Abstract

Introduction: The off pump coronary artery bypass surgery (OPCAB) technique is expected to be able to eliminate the side effects and complications caused by the use of a cardiopulmonary bypass (CPB) machine. However, this technique is not completely free from side effects or complications. One of the effects that can be caused is an increase in the systemic inflammatory response, so that the duration of hospitalization becomes longer. This is aim of this study to conduct a study of the administration of dexamethasone for reduced the length of hospital stay in patients undergoing OPCAB surgery. Methods: This was an analytic observational study with sixty patients who underwent OPCAB surgery and were randomized to either dexamethasone or placebo groups of 30 people each. Clinical results were analyzed. Results: The length of stay in the dexamethasone group compared to the placebo group was consecutive (5 (5-8) days vs 6.5 (5-30) days; p=0.04) so that there was a significant difference. Other clinical outcomes in the dexamethasone group were better than the placebo group, in terms of duration of mechanical ventilation (p=0.03) and intensive care unit stay (p=0.03). There were significant differences in inflammatory markers between the two groups: interleukin-6 (p=0.0001), procalcitonin (p=0.0001), and C-reactive protein (p=0.0001) were lower in the dexamethasone group. Conclusion: Preoperative dexamethasone in patients undergoing off-pump coronary artery bypass is effective in reducing the length of hospital stay and controlling postoperative inflammatory reactions.
Co-Authors Bagus Herlambang Hanafy, Dudy Arman Mulyadi M. Djer Putra, Rally Galang Pratama Wardoyo, Suprayitno Wartono, Dicky Aligheri