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Effect of mannitol on postoperative delirium in patients undergoing coronary artery bypass graft: a randomised

Masumeh Hemmati Maslakpak1, Sohrab Negargar2, Ali Farbod3

  • 1Maternal and Childhood Obesity Research Center, Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran (the Islamic Republic of).

Open Heart
|August 23, 2024
PubMed
Summary
This summary is machine-generated.

Adding mannitol to cardiopulmonary bypass prime solution significantly reduced postoperative delirium in cardiac surgery patients. This intervention offers a promising strategy for improving patient outcomes after coronary artery bypass surgery.

Keywords:
Cardiac Surgical ProceduresCoronary Artery BypassHeart, Artificial

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Area of Science:

  • Cardiology
  • Anesthesiology
  • Neurosurgery

Background:

  • Postoperative delirium (POD) is a common complication after cardiac surgery with cardiopulmonary bypass (CPB).
  • POD increases adverse effects, hospital stay, mortality, and healthcare costs.
  • Preventing POD is crucial for improving patient recovery and reducing healthcare burdens.

Purpose of the Study:

  • To evaluate the efficacy of mannitol in the CPB prime solution for preventing POD in patients undergoing coronary artery bypass surgery.
  • To assess the impact of mannitol on the incidence of POD.
  • To investigate secondary outcomes including ventilation duration, ICU stay, and mortality.

Main Methods:

  • A single-center, double-blinded, randomized controlled trial was conducted from December 2022 to May 2023.
  • Patients aged 18-70 undergoing elective coronary artery bypass surgery were included.
  • The intervention group (n=45) received 200 mL mannitol in the CPB prime solution, while the control group (n=45) received Ringer's lactate.

Main Results:

  • The incidence of POD was significantly lower in the mannitol group (22.25%) compared to the control group (42.2%) (p=0.035).
  • No significant differences were observed in demographic characteristics, CPB time, aortic cross-clamp time, mechanical ventilation duration, ICU length of stay, mortality, or return to the operating room.
  • Mannitol administration did not affect key surgical or perioperative parameters.

Conclusions:

  • Adding mannitol to the CPB prime solution is an effective strategy for reducing the incidence of POD after cardiac surgery.
  • This intervention shows potential for improving patient outcomes and reducing complications associated with cardiac procedures.
  • Further research may explore optimal mannitol dosage and its long-term effects.