Abstract The identification of risk factors for major adverse events after coronary artery bypass surgery is of main importance as it allows outcome prediction, facilitates preoperative patient selection and improves the quality of care. In the present clinical studies we have evaluated the impact of preoperative angiographic severity of a coronary artery disease and preoperative C-reactive protein (CRP) on the immediate outcome after coronary artery bypass surgery. We have reviewed the results of off-pump (OPCAB) versus conventional on-pump coronary artery bypass surgery (CCAB) in high risk patients. We have evaluated the impact of postoperative pulmonary artery blood temperature on the immediate outcome as well. In addition, we have investigated the incidence, timing and outcome of an atrial fibrillation (AF) related stroke after surgery. The multivariate analysis showed that among 2233 patients, the overall coronary angiographic score was predictive of postoperative death (p = 0.03; OR 1.027, 95% CI: 1.003–1.052) and of a low cardiac output syndrome (p = 0.04; OR 1.172, 95% CI: 1.010–1.218). The poor status of the proximal segment of the left circumflex coronary artery, the diagonal branches and the left obtuse marginal artery were most closely associated with adverse postoperative outcome. Patients (114/764) with a preoperative serum concentration of CRP ≥ 1.0 mg/dL had a higher risk of overall postoperative death (5.3% vs. 1.1%, p = 0.001), cardiac death (4.4% vs. 0.8%, p = 0.002), a low cardiac output syndrome (8.8% vs. 3.7%, p = 0.01). Among 179 high risk patients with an additive EuroSCORE6, the 30-day postoperative death and stroke rates were 7.5% and 6.0% in the OPCAB group, and 5.4% (p = 0.75) and 8.0% (p = 0.77) in the CCAB group, respectively. No significant differences were observed in other major outcome end-points between these non-randomised groups either. High pulmonary artery blood temperature on admission to the ICU among 1639 patients was significantly associated with an increased risk of overall postoperative death (p = 0.002), cardiac death (p = 0.03), and a low cardiac output syndrome (p < 0.0001), and was significantly correlated with prolonged length of the ICU stay (r = 0.095; p < 0.0001), and postoperative bleeding (ρ = –0.091; p = 0.001). Among 2,630 patients who underwent coronary artery bypass grafting (CABG), 52 (2.0%) experienced a postoperative stroke. Twelve out of these 52 patients (23.1%) died postoperatively. The ischemic cerebral event occurred after a mean of 3.7 days (0–33). In 19 patients (36.5%), atrial fibrillation preceded the occurrence of neurological complication. The angiographic severity of the coronary artery disease and the preoperative serum concentration of CRP predict postoperative outcome after a CABG operation. OPCAB can be performed safely in high-risk patients with results as satisfactory as those achieved with CCAB. CABG patients with a high pulmonary artery blood temperature on admission to the ICU seem to have a higher risk of postoperative adverse events. Atrial fibrillation occurring after coronary artery bypass grafting is a major determinant of a postoperative stroke.

Roughly thirty percent of coronary artery bypass graft (CABG) patients develop atrial fibrillation (AF) in the five days following surgery, increasing the risk of stroke, prolonging hospital stay three to four days, and increasing the overall cost of the procedure. Current pharmacologic and nonpharmacologic means of AF prevention are suboptimal, and their side effects, expense, and inconvenience limit their widespread application. An accurate method for identifying patients at high risk for postoperative AF would allow these methods to be focused on the patients on which its utility would be highest. The main objective of this research was to develop a Bayesian network (BN) which could model/predict/assign risk of the occurrence of atrial fibrillation in CABG patients using retrospective data. A secondary objective was to develop an integrated framework for more advanced methods of feature selection and fusion for medical classification/prediction. We determined that the naïve Bayesian network classifier used with features selected by a genetic algorithm is a better classifier to use, given our cohort. The naïve BN allows for reasonable prediction despite being presented with patients with missing data points as might occur in the hospital. This classifier achieves a sensitivity of 0.63 and a specificity of 0.73 with an AUC of 0.74. Furthermore, this system is based on probabilities that are well understood and easily incorporated into a clinical environment. These probabilities can be altered based on the cardiologists prior knowledge through Bayesian statistics, allowing for online sensitivity analysis by doctors, to perceive the best treatment options. Contributions of this research include: - An accurate, physician-friendly, postoperative AF risk stratification system that performs even under missing data conditions, while outperforming the state of the art system, - A thorough analysis of previously examined and novel pre- and postoperative clinical and ECG features for postoperative AF risk stratification, - A new methodology for genetic algorithm-built traditional Bayesian network classifiers allowing dynamic structure through novel chromosome, operator, and fitness definitions, and - An integrated methodology for inclusion of doctor s expert knowledge into a probabilistic diagnosis support system.

Thesis (Ph.D. in Clinical Science) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 86-91). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

The purpose of this study was to compare patients who underwent on- vs. off-pump coronary artery bypass surgery managed with a fast-track protocol. Between September 2012 and December 2018, n = 3505 coronary artery bypass surgeries were managed with a fast-track protocol in our specialized post-anesthesia care unit. Propensity score matching was applied and resulted in two equal groups of n = 926. There was no significant difference in ventilation time (on-pump 75 (55–120) min vs. off-pump 80 (55–120) min, p = 0.973). We found no statistically significant difference in primary fast-track failure in on-pump (8.2% (76)) vs. off-pump (6% (56)) groups (p = 0.702). The secondary fast-track failure rate was comparable (on-pump 12.9% (110) vs. off-pump 12.3% (107), p = 0.702). There were no significant differences between groups in regard to the post-anesthesia care unit, the intermediate care unit, and the hospital length of stay. Postoperative outcome and complications were also comparable, except for a statistically significant difference in PACU postoperative blood loss in on-pump (234 mL) vs. off-pump (323 mL, p < 0.0001) and red blood cell transfusion (11%) and (5%, p < 0.001), respectively. Our results suggest that on- and off-pump coronary artery bypass surgery in fast-track settings are comparable in terms of ventilation time, fast-track failure rate, and postoperative complications rate.

Coronary artery bypass graft (CABG) surgery is a common treatment for patients with coronary artery disease. A potential complication of CABG is myocardial ischemia or infarction. In this thesis, a method - based on laser Doppler flowmetry (LDF) - for detection of intra- and postoperative ischemia by myocardial perfusion monitoring is evaluated. LDF is sensitive to motion artifacts. In previous studies, a method for reduction of motion artifacts when measuring on the beating heart has been developed. By using the ECG as a reference, the perfusion signal is measured in intervals during the cardiac cycle where the cardiac motion is at a minimum, thus minimizing the artifacts in the perfusion signal. The aim of this thesis was to investigate the possibilities to use the ECG-triggered laser Doppler system for continuous monitoring of myocardial perfusion in humans during and after CABG surgery. Two studies were performed. In the first study, changes in myocardial perfusion during CABG surgery were investigated (n = 13), while the second study focused on postoperative measurements (n = 13). In addition, an ECG-triggering method was implemented and evaluated. It was found that the large variations in myocardial perfusion during CABG surgery could be monitored with the ECG-triggered laser Doppler system. Furthermore, a perfusion signal of good quality could be registered postoperatively from the closed chest in ten out of thirteen patients. In eight out of ten patients, a proper signal was obtained also the following morning, i.e., about 20 hours after probe insertion. The results show that respiration and blood pressure can have an influence on the perfusion signal. In conclusion, the results indicate that the method is able to detect fluctuations in myocardial perfusion under favourable circumstances. However, high heart rate, abnormal cardiac motion, improper probe attachment and limitations in the ECG-triggering method may result in variations in the perfusion signal that are not related to tissue perfusion. / Varje år utförs omkring 4500 kranskärlsoperationer i Sverige. En allvarlig komplikation som kan uppstå efter operationen är otillräcklig blodförsörjning till hjärtmuskeln. Den här licentiatavhandlingen handlar om utveckling och utvärdering av en metod, baserad på laserdopplerteknik, för att kunna upptäcka nedsatt blodperfusion i hjärtmuskeln på ett tidigt stadium. Laserdopplertekniken är känslig för rörelsestörningar. I tidigare studier har en metod för reducering av rörelsestörningar vid mätning på slående hjärta tagits fram. Med EKG:t som referens mäts blodperfusionen i de faser under hjärtcykeln då hjärtats rörelse är som minst, vilket minskar bidraget av rörelsestörningar i blodperfusionssignalen. I den här avhandlingen undersöks om metoden kan användas för kontinuerlig övervakning av hjärtmuskelns blodperfusion på patienter under och efter hjärtoperationer. Två studier har genomförts: en där hjärtmuskelns perfusion mättes i olika faser under kranskärlsoperationer och en där mätproben lades in i hjärtmuskeln under operationen och mätningar gjordes under det första dygnet efter operationen. Det visade sig vara möjligt att följa förändringar i hjärtmuskelns blodperfusion under operation. Det var även möjligt att registrera en perfusionssignal av god kvalitet efter operationen då bröstkorgen var stängd. Hos åtta av tio patienter erhölls en bra signal även morgonen efter operationen, dvs. ca 20 timmar efter att proben lades in. Resultaten visar också att andning och blodtryck kan ha en påverkan på blodperfusionssignalen. Slutsatsen av arbetet är att det går att se variationer i hjärtmuskelns blodperfusion med EKG-triggad laserdoppler under vissa förutsättningar. Signalen är dock i många fall svårtolkad på grund av att t ex hög hjärtfrekvens, onormal hjärtväggsrörelse eller ändrad probposition sannolikt kan ge variationer i perfusionssignalen som inte är relaterade till blodflödesförändringar. / Report code: LIU-TEK-LIC-2007:35.

Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007. / Study Aim: To describe the profile and selected outcomes of CABG patients admitted in the Cape metropolitan area. Design: A prospective descriptive study design with a multicentre observational approach was followed. Method: All patients undergoing isolated CABG surgery, whether elective or emergency, during a three-month period (15 August–15 November 2005) were included in the study. Demographic data, pre-operative medical status, intra-operative, as well as post-operative information were collected using a self-designed structured initial assessment form (SIA). Means and standard deviations were calculated where applicable. Relationships between different variables were analyzed by means of: ANOVA, correlations, linear and logistic regressions. Where it appeared that the ANOVA assumptions were violated, non-parametric bootstrap techniques were employed. Results: Two hundred and forty five patients were admitted to the seven hospitals which provide CABG surgery in the Cape metropolitan area in the allotted period. The profile of patients admitted to private and state institutions were similar. The mean age of the sample was 60 (±10). The mean LOS of the total cohort was 12 (±5.5) days, with patients in the state hospitals staying longer 13.4 days (± 7.1). Patients who were older than 60 were twice as likely to have a LOS >12days (odds ratio = 2.49; 95% confidence interval = 1.33 to 4.65). The development of a pleural effusion or pneumothorax was associated with an increased LOS (p<0.01). At least one PPC was reported in 65% of the population. A mortality rate of only 3% was reported. Conclusion: Patients in this cohort were younger than in developed countries. An age greater than 60 years was a predictor of an LOS >12days in the current cohort. Patients were most likely to develop a PPC on day three after CABG surgery. Physiotherapeutic intervention, if any, would be well aimed at those patients older than 60 years of age. Screening of patients in the first three post-operative days for the development of PPCs is also advised.

Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Aim: The aim of this study is to determine if the addition of a pre-extubation recruitment manoeuvre to standard care is safe and will improve lung compliance and subsequent PaO2/FiO2 (PF ratio) after extubation in postoperative coronary artery bypass graft surgery patients. Design: Prospective, triple blind, randomised, controlled trial. Method: This study was conducted in a private hospital in the Northern suburbs of Cape Town, South Africa. All patients admitted between 03/10/2010 and 22/11/2011, for uncomplicated elective coronary artery bypass graft (CABG) surgery were eligible for inclusion into the study. Patients were randomly allocated into either the intervention group or the control group. The intervention group received a gradual build-up lung recruitment manoeuvre (RM). The primary outcome was PaO2/FiO2 (PF ratio). The secondary outcomes were safety and static lung compliance. ICU length of stay (LOS) and hospital LOS were also recorded. The pre-RM hemodynamic stability of the patient was checked before the intervention and repeated at 5 minutes after the intervention by the nursing sister. Data to calculate static lung compliance was captured at the same time. Criteria for safety and discontinuation of the RM were monitored during the intervention by the principle investigator only. Results: Of the 69 patients eligible for the study 47 were randomly allocated into the intervention group (n=22) and control group (n=25) respectively. Groups were the same at baseline with regards to sex, pulmonary risk, sedation and surgical procedures. The RM could be completed in all patients. The prior defined criteria for discontinuation of the RM were not reached in any of the patients. No adverse effects were noted. The PaO2/FiO2 (PF ratio) decreased significantly in both groups from pre-surgery measurements compared to when measured before the RM (p<0.001). There was a tendency noted for the intervention group to return to pre-surgery measurements of PF ratio within 12 hours after extubation when compared to the control group. There was no significant difference between the groups from extubation to 24 hours (p = 0.6). The static compliance improved at 5 minutes following the RM (p<0.001) and remained improved until extubation (p<0.001) for the intervention group. No difference was noted in the static compliance of the control group over the same time period. The mean hospital length of stay for the intervention group was 8.61 (95% confidence interval 7.26 to 9.96 days) and 10.08 (95% confidence interval 8.52 – 11.63 days) for the control group. Conclusion: A gradual recruitment manoeuvre at 30cmH2O 30minutes before extubation significantly improved static lung compliance within 5 minutes with no adverse hemodynamic side effects. There was noted maintained improved PF ratio at extubation or immediately afterwards for the intervention group and no difference in the PF ratio between the intervention group and control group. / AFRIKAANSE OPSOMMING: Doel: Die doel van hierdie studie is om te bepaal of die toevoeging van ’n pre-ekstubasie herwinningstegniek tot standaard sorg veilig is, en of dit longvervormbaarheid en gevolglike PaO2/FiO2 (PF-verhouding) na ekstubasie in post-operatiewe kroonaaromleidingchirurgiepasiënte sal verbeter. Ontwerp: Prospektiewe, trippel-blinde, ewekansige, gekontroleerde proefneming. Metode: Hierdie studie is uitgevoer in ’n privaat hospitaal in die noordelike voorstede van Kaapstad, Suid-Afrika. Alle pasiënte wat tussen 03/10/2010 en 22/11/2011 gehospitaliseer is vir ongekompliseerde elektiewe kroonaaromleidingchirurgie, kon in aanmerking kom vir die studie. Pasiënte is op ewekansige wyse ingedeel in die intervensie- en kontrolegroepe. ’n Geleidelike-opbou-van-druk-longherwinningstegniek (HT) is op die intervensiegroep toegepas. Die primêre uitkoms was die PaO2 /FiO2 (PF-verhouding). Die sekondêre uitkoms was veiligheid en statiese longvervormbaarheid. ISE-verblyf en hospitaalverblyf is ook genoteer. Die navorsingsassistent het data van bestaande eenheiddokumentasie geneem. Die pre-HT-hemodinamiese stabiliteit van die pasiënte is gemonitor voor en weer 5 minute na die intervensie. Inligting om die statiese longvervormbaarheid te bereken is terselfdertyd genoteer. Kriteria vir veiligheid en vir die staking van die HT is gemonitor tydens uitvoering deur die primêre ondersoeker en die verpleegkundige. Resultate: Van die 69 pasiënte wat in aanmerking kon kom vir die studie is 47 op ewekansige wyse ingedeel in die intervensiegroep (n=22) en die kontrolegroep (n=25). Die groepe was dieselfde by die basislyn. Die herwinningstegniek kon volledig op alle pasiënte uitgevoer word. Die vooraf gedefinieerde kriteria vir staking van die HT is met geen pasiënte bereik nie. Geen nadelige uitwerking is genoteer nie. Die PaO2 /FiO2 (PF-verhouding) het beduidend verminder in beide groepe van pre-operatiewe metings in vergelyking met meting voor die HT (p<0.001). ‘n Neiging is genoteer dat die intervensiegroep binne 12 uur na ekstubasie tot pre-chirurgie PF-metings teruggekeer het. Daar was geen merkbare verskil tussen die groepe vanaf ekstubasie tot 24 uur (p=0.6) nie. Die statiese vervormbaarheid het verbeter teen 5 minute na HT (p<0.001) en het verbeter gebly tot ekstubasie (p<0.001) vir die intervensiegroep. Daar was geen verskil in die statiese vervormbaarheid van die kontrolegroep nie. Die gemiddelde hospitaalverblyf vir die intervensiegroep was 8.61 (95% betroubaarheidsinterval 7.26 tot 9.96 dae) en 10.08 (95% betroubaarheidsinterval 8.52 – 11.63 dae) vir die kontrolegroep. Gevolgtrekking: ’n Geleidelike herwinningstegniek teen 30cmH2O 30 minute voor ekstubasie het statiese longvervormbaarheid beduidend verbeter binne 5 minute, met geen nadelige hemodinamiese newe-effekte nie. Daar was geen verskil in die oksigenasie-indeks tussen die intervensie- en kontrolegroep na ekstubasie nie.

Thesis (MA)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: It is well known that coronary bypass graft surgery influences the psycho-social adjustment of the patient, but little is known about the effect of bypass surgery on the family members of the patient. The primary aim of this study was to assess the effect of coronary bypass graft surgery on certain aspects of the marital relationship and family functioning of the patient. The secondary aim was to determine which coping strategies families used during the two months after the operation. An experimental pre-test and post-test research design was used. Data during the first measure was collected by means of Biographical, Enriching and Nurturing Relationship Issues, Communication and Happiness (ENRICH)- and Family Adaptability and Cohesion Evaluation Scale-II (FACES II)-questionnaires, which were completed by the patient, the spouse of the patient and the eldest child still living with the parents. ENRICH-, FACES 11-and Family Crisis Oriented Personal Evaluation Scales (F-COPES)-questionnaires were used during the second measure which was conducted two months after the operation. The results indicated that bypass surgery affected the patients' marital satisfaction and communication negatively and changed their attitudes toward the division of new roles in the marriage and family. Bypass surgery had a further negative influence on the emotional bonding of the patients and their spouses with other members of the family. The patients' adaptability regarding new challenges facing the family was also negatively affected. The patients in the experimental group who were still working also showed a greater decline than the retired patients with regards to some of the measured variables. The coping strategies most often used by the families were the seeking of spiritual support and the reframing of the problem. Correlation coefficients between changes in the marital and family variables of the patient and the coping strategies used indicated that if passive appraisal was used, the patients' marital satisfaction would decrease and if reframing of the problem was used, the patients' adaptability regarding new challenges facing the family would increase. / AFRIKAANSE OPSOMMING: Alhoewel kroonaarsiektes die psigo-sosiale aanpassing van die pasiënt beïnvloed, bestaan daar min inligting oor die invloed wat kroonaarhartomleidingchirurgie op die huweliksverhouding en gesinsfunksionering van die pasiënt het. Die doel van hierdie ondersoek is om te bepaal hoe kroonaarhartomleidingchirurgie sekere aspekte van die pasiënt se huweliks- en gesinslewe beïnvloed. Verder het die ondersoek ten doelom te bepaal watter coping-strategieë die gesin post-operatief gebruik. Daar is van 'n eksperimentele voor- en na-metingnavorsingsontwerp gebruik gemaak. Data is ingesamel met Biografiese, Enriching and Nurturing Relationship Issues, Communication and Happiness (ENRICH)- en Family Adaptability and Cohesion Evaluation Scale-II (FACES II)-vraelyste wat gedurende 'n voormetingsgeleentheid deur die pasiënt, huweliksmaat van die pasiënt en oudste kind wat nog in die huis bly, voltooi is. Die na-meting, wat bestaan het uit die voltooing van ENRICH-, FACES 11-en Family Crisis Oriented Personal Evaluation Scales (F-COPES)-vraelyste, het twee maande na die operasie plaasgevind. Die resultate toon dat kroonaarhartomleidingchirurgie die pasiënte se huwelikstevredenheid en -kommunikasie nadelige beïnvloed het en 'n veranderinge in hul houding oor die rolverdeling in die huwelik en gesin teweeg gebring het. Verder het die operasie 'n nadelige effek op die pasiënte en hul huweliksmaats se gevoel van emosionele binding met ander gesinslede gehad. Die pasiënte se vermoë om by nuwe eise en uitdagings wat aan die gesin gestel word aan te pas, is ook nadelig beïnvloed. Verder is bevind dat die werkende pasiënte 'n groter verandering as die afgetrede pasiënte ten opsigte van sekere van die gemete veranderlikes getoon het. Die coping-strategieë wat die meeste deur die gesinne gebruik is, is die soeke na geestelike ondersteuning en die herdefiniëring van die probleem. Die resultate het ook aangedui dat as passiewe waardering as coping-strategie gebruik word, die pasiënte se tevredenheid met hul huwelik sal afneem. Verder sal gesinne se vermoë om by nuwe eise en uitdagings wat aan die gesin gestel word aan te pas, toeneem indien herdefiniëring van die probleem as coping-strategie gebruik word.

<p>Coronary artery bypass graft (CABG) surgery is a common treatment for patients with coronary artery disease. A potential complication of CABG is myocardial ischemia or infarction. In this thesis, a method - based on laser Doppler flowmetry (LDF) - for detection of intra- and postoperative ischemia by myocardial perfusion monitoring is evaluated.</p><p>LDF is sensitive to motion artifacts. In previous studies, a method for reduction of motion artifacts when measuring on the beating heart has been developed. By using the ECG as a reference, the perfusion signal is measured in intervals during the cardiac cycle where the cardiac motion is at a minimum, thus minimizing the artifacts in the perfusion signal.</p><p>The aim of this thesis was to investigate the possibilities to use the ECG-triggered laser Doppler system for continuous monitoring of myocardial perfusion in humans during and after CABG surgery. Two studies were performed. In the first study, changes in myocardial perfusion during CABG surgery were investigated (n = 13), while the second study focused on postoperative measurements (n = 13). In addition, an ECG-triggering method was implemented and evaluated.</p><p>It was found that the large variations in myocardial perfusion during CABG surgery could be monitored with the ECG-triggered laser Doppler system. Furthermore, a perfusion signal of good quality could be registered postoperatively from the closed chest in ten out of thirteen patients. In eight out of ten patients, a proper signal was obtained also the following morning, i.e., about 20 hours after probe insertion. The results show that respiration and blood pressure can have an influence on the perfusion signal.</p><p>In conclusion, the results indicate that the method is able to detect fluctuations in myocardial perfusion under favourable circumstances. However, high heart rate, abnormal cardiac motion, improper probe attachment and limitations in the ECG-triggering method may result in variations in the perfusion signal that are not related to tissue perfusion.</p> / <p>Varje år utförs omkring 4500 kranskärlsoperationer i Sverige. En allvarlig komplikation som kan uppstå efter operationen är otillräcklig blodförsörjning till hjärtmuskeln. Den här licentiatavhandlingen handlar om utveckling och utvärdering av en metod, baserad på laserdopplerteknik, för att kunna upptäcka nedsatt blodperfusion i hjärtmuskeln på ett tidigt stadium.</p><p>Laserdopplertekniken är känslig för rörelsestörningar. I tidigare studier har en metod för reducering av rörelsestörningar vid mätning på slående hjärta tagits fram. Med EKG:t som referens mäts blodperfusionen i de faser under hjärtcykeln då hjärtats rörelse är som minst, vilket minskar bidraget av rörelsestörningar i blodperfusionssignalen.</p><p>I den här avhandlingen undersöks om metoden kan användas för kontinuerlig övervakning av hjärtmuskelns blodperfusion på patienter under och efter hjärtoperationer. Två studier har genomförts: en där hjärtmuskelns perfusion mättes i olika faser under kranskärlsoperationer och en där mätproben lades in i hjärtmuskeln under operationen och mätningar gjordes under det första dygnet efter operationen.</p><p>Det visade sig vara möjligt att följa förändringar i hjärtmuskelns blodperfusion under operation. Det var även möjligt att registrera en perfusionssignal av god kvalitet efter operationen då bröstkorgen var stängd. Hos åtta av tio patienter erhölls en bra signal även morgonen efter operationen, dvs. ca 20 timmar efter att proben lades in. Resultaten visar också att andning och blodtryck kan ha en påverkan på blodperfusionssignalen.</p><p>Slutsatsen av arbetet är att det går att se variationer i hjärtmuskelns blodperfusion med EKG-triggad laserdoppler under vissa förutsättningar. Signalen är dock i många fall svårtolkad på grund av att t ex hög hjärtfrekvens, onormal hjärtväggsrörelse eller ändrad probposition sannolikt kan ge variationer i perfusionssignalen som inte är relaterade till blodflödesförändringar.</p> / Report code: LIU-TEK-LIC-2007:35.

<p>The purpose of this study was to investigate the presence of arterial insufficiency in patients undergoing CABG surgery and whether arterial insufficiency is a risk factor for postoperative wound infections in the harvesting leg. Patients who had CABG surgery were enrolled consecutively. A total of 144 patients participated in the study. During their hospital stay demographic data was recorded, as well as pre-, intra-, and postoperative tests and risk factors. The patients answered a questionnaire regarding postoperative wound infections 30 days after surgery patients answered a questionnaire regarding infections. The known and potential risk factors that were recorded were BMI, HB, tobacco usage, diagnosed diabetes, hyperglycemia, duration of surgery, the lowest temperature during surgery and clinical or subclinical arterial insufficiency. The result showed that 34% had postoperative wound infections in the harvesting leg and 26 patients had an ABI (Ankel Brachial Index) indicating arterial insufficiency. There was no significant relationship between ABI and postoperative wound infections in the lower extremity in the total study group (p = 0.36) nor among men (p = 0.92). There was a significant correlation between ABI and postoperative wound infections in the lower extremity (p = 0.02) among women. The conclusion is that arterial insufficiency is more prevalent in women. The relationship between postoperative infections of the lower limbs and arterial insufficiency was significant for the participating women, but not in the total group nor among the men.</p>