patients randomized to this arm are given ringer's lactate solution for cardiopulmonary bypass prime, which is the standard practice

patients randomized to this arm are given Plasma Lyte - A solution for cardiopulmonary bypass prime

Cardiopulmonary Bypass

Plasma Lyte -A is administered intra operatively to maintain the hemodynamic status of patients

Plasmalyte A

Ringer's lactate is administered intra operatively to maintain the hemodynamic status of patients

Ringer Lactate

Comparative Analysis Between Ringer's Lactate vs Plasma Lyte-A as Cardiopulmonary Bypass Prime

Comparative Analysis Between Ringer's Lactate vs Acetate Containing Balanced Crystalloid Solution (Plasma Lyte-A) as Cardiopulmonary Bypass Prime

Arterial blood gas analysis at before induction, five minutes after CPB, at the end of the termination of CPB, half an hour stay in the ICU soon after the patient is shifted from completion of surgery, before the patient is extubated

Doniparthi Pradeep

Junior Resident, Department of General Surgery

Postgraduate Institute of Medical Education and Research

Solu - Medrol (methylprednisolone sodium succinate) 500mg IV once single administration

NaCl 0,9% 100ml IV once single administration

C.Surgical Procedure

Cardiac

patients will receive 500mg of methylprednisolone in 100ml NaCl 0,9% or placebo (100ml NaCl 0,9%) at anesthesia induction

Solu-medrol or placebo administration

Hôpital Erasme

Steroids and Microcirculation In Cardiac Surgery

Evaluation of High-dose Corticosteroids on Microcirculation Alterations in Cardiac Surgery, by FMD (Flow Mediated vasoDilation), Near Infrared Spectrophotometry (NIRS) and Biological Analysis (Syndecan-1)

Arterial diameter variation and Doppler flow are measured at brachial artery during vascular occlusion test - viariation of diameter and doppler flow befor and after cuff release will be assessed

Tissue oxygen saturation will be assessed by near - infrared spectroscopy (physiological parameter assesment based on spectrophotometry) during vascular occlusion test and after cuff release

C/ Syndecan - 1 concentration assessment: This molecule is closely linked to glycocalyx and is considered as the most predictive marker of its integrity.
Many factors might cause lesions of this structure (inflammation, hyperglycemia, CBP, etc). Its destruction causes further an impairement of endothelial function (vasoconstriction et vasodilation), mediated principally by endothelial factors.
Corticoids can be considered as the most effective molecule for glycocalyx protection.
Yet we will analyze the plasmatic concentration variation of syndecan - 1 as a glycocalyx marker.
Syndecan-1 analysis is performed on frozen plasma by ELISA technique, using specific antibodies (ELISA kit from Ray Biotech, Inc), this method has already been used in previous studies.

Erasme University Hospital

Jean Paul Van Vooren

Hemorrhagic Shock

1st loading : Upto 2 liters of Ringer's lactate, followed by Totilac which was given 5 mL/kgBW/15 minutes, followed by maintenance 2 mL/kgBW/hour for 3 hours

Hyperosmolar sodium lactate

1st loading : Upto 2 litres of Ringer's lactate, followed by 5 mL/kgBW/15 minutes,followed by maintenance : 2 mL/kgBW/hour for 3 hours

Ringer's lactate

Department of Surgery, Dr. Hasan Sadikin Hospital

Efficacy, Safety of Solution Containing Hyperosmolar Sodium Lactate Infusion for Resuscitation of Patients With Hemorrhagic Shock

The Clinical Efficacy and Safety of a Proprietary Solution Containing Hypertonic Sodium Lactate (Totilac®) Infusion for Resuscitation of Patients With Hemorrhagic Shock Due to Multiple Injuries

potassium chloride/hypoxia

Comparative Analysis Between Ringer's Lactate vs Plasma Lyte-A as Cardiopulmonary Bypass Prime

Steroids and Microcirculation In Cardiac Surgery

Efficacy, Safety of Solution Containing Hyperosmolar Sodium Lactate Infusion for Resuscitation of Patients With Hemorrhagic Shock

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