EFFECT OF ESMOLOL CARDIOPLEGIA ON INOTROPIC SUPPORT AND INOTROPIC SCORE AFTER CORONARY ARTERY BYPASS SURGERY
Keywords:
Esmolol, coronary artery disease, cardiac surgery, cardioanesthesia, inotropic scoreAbstract
Coronary artery bypass surgery is associated with numerous complications as a result of perioperative myocardial ischemia. Administration of esmolol as an adjunct to cardioplegia is a pharmacological cardioprotective method to protect the myocardium in patients with coronary artery disease.
The aim of this study was to determine whether the application of esmolol as an adjunct to cardioplegia itself would provide additional myocardial protection, reduce the need for inotropic and vasopressor support, and decrease the inotropic score.
A total of 100 patients aged 40-80 years with coronary artery disease were included in this prospective, randomized, controlled study. Patients were grouped into two randomized groups according to whether they received esmolol in line with a well-defined protocol or placebo. In all patients, a vasoactive inotropic score was calculated by a formula.
The inotropic score in the operating room was statistically insignificant (p=0.141), and the highest inotropic score in the first 24 hours was statistically significantly lower (p= 0.002) in patients receiving esmolol compared to others. Inotropic support in intensive care unit with statistical significance (p=0.0001) and vasopressor support with borderline significance (p=0.06) was applied in a lower percentage after 24 hours in patients given esmolol.
A pharmacological cardioprotective method to protect the myocardium with esmolol in patients with coronary artery disease has a positive effect in reducing the inotropic score, respectively less use of inotropic and vasopressor support after coronary artery bypass surgery.
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