Rantanen Matias, Yousif Rizgar, Kallioinen Minna, Hynninen Ville-Veikko, Peltoniemi Marko, Söderholm Oki, Saarikoski Tuukka, Anttila Vesa, Aittokallio Jenni
Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
Department of Anesthesiology and Intensive Care, University of Turku, Turku, Finland.
Ann Med Surg (Lond). 2022 Nov 9;84:104812. doi: 10.1016/j.amsu.2022.104812. eCollection 2022 Dec.
To determine whether surgical technique has an effect on prognosis in coronary artery bypass grafting (CABG).
Retrospective observational.
Single center.
All the off-pump (OPCABG) and on-pump (ONCABG) patients at Turku University Central Hospital in 2018.
None.
After propensity score matching, perioperative, 1-year and 3-year mortality did not differ between the groups. The ONCABG patients received more allogenic red blood cells (1.3 vs. 0.6 units, p = 0.020), autologous red blood cells (564 vs. 285 ml, p < 0.001) and crystalloids (3388 vs. 2808 ml, p < 0.001), and had higher postoperative values of troponin T (581 vs. 222, p = 0.001) and lactate (1.69 vs. 1.23, p < 0.001) than the OPCABG patients.
The both techniques seem equally safe. However, there may be some benefits to avoiding using a heart-lung machine, such as lower infused fluid volumes. Myocardial damage may also be milder and postoperative hemodynamics more balanced in OPCABG patients, based on lower levels of troponin T and lactate.
确定手术技术对冠状动脉旁路移植术（CABG）预后是否有影响。
回顾性观察研究。
单中心。
2018年图尔库大学中心医院所有非体外循环（OPCABG）和体外循环（ONCABG）患者。
无。
倾向评分匹配后，两组围手术期、1年和3年死亡率无差异。ONCABG患者输注的异体红细胞更多（1.3单位对0.6单位，p = 0.020）、自体红细胞更多（564毫升对285毫升，p < 0.001）和晶体液更多（3388毫升对2808毫升，p < 0.001），且术后肌钙蛋白T值（581对222，p = 0.001）和乳酸值（1.69对1.23，p < 0.001）高于OPCABG患者。
两种技术似乎同样安全。然而，避免使用心肺机可能有一些益处，如较低的输液量。基于较低的肌钙蛋白T和乳酸水平，OPCABG患者的心肌损伤可能也较轻，术后血流动力学更平衡。
