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Effect of spinal-epidural anesthesia on brain natriuretic peptide (BNP) in patients with ischemic dilated cardiomyopathy undergoing peripheral vascular surgery .

Research Authors
Emad Z. Kamel
Alaa M. Atia
Mustafa J. Hassan
Eman Mosad
Mahmoud A. M. Ashri
Nawal A. Gad Al Rab
Hassan I. M. Kotb
Research Journal
International Journal of Current Research
Research Publisher
International Journal of Current Research
Research Rank
1
Research Vol
Vol. 8, issue. 09
Research Website
NULL
Research Year
2016
Research_Pages
pp.39399-39402
Research Abstract

Background :Neuroaxial anesthesia for patients with cardiac disease is still a matter of debate . BNP has been added as a cardiac biomarker in response to stress. Spinal-epidural anesthesia seems to full fill some criteria of therapeutic intervention in cardiac patients. For this , in a group of patients with impaired left ventricular function , we test whether epidural –spinal anesthesia has an effect on BNP as well as testing the predictability of postoperative BNP for outcome.
Methods : the authors conducted this study on 24 lower extremity vascular surgery patients with ischemic dilated cardiomyopathy ( EF <40 % ) under CSE .the primary end point was the cardiac outcome over 6 months postoperatively, the secondary outcome was the effect of CSE on postoperative BNP and its predictability for the outcome .
Results : CSE offers perioperative hemodynamic stability ,and complication free early hospital stay period , but mortality and morbidity rates were 8% and 41.6 % respectively over the next 6 months . postoperative BNP ≥67.43pg/ml , provided the optimal BNP cutoff points for predicting major cardiac complications
In conclusion, CSE is a feasible technique of anesthesia in such patients with dilated cardiomyopathy undergoing vascular surgery in the lower half of the body . BNP study revealed that postoperative BNP levels are valuable bed side predictors of intermediate term post-operative cardiac death and major adverse cardiac events in