José Valero

Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Catalonia, Spain

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Publications (2)2.35 Total impact

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    ABSTRACT: The purpose of this study was to determine the possible correlation between inflammatory activation after cardiac surgery with cardiopulmonary bypass, measured by postoperative C-reactive protein concentrations, and immediate intensive care unit outcome. A prospective, clinical cohort study. A 10-bed surgical intensive care unit at a tertiary university hospital. Two hundred sixteen consecutive patients undergoing nonemergency cardiac surgery with cardiopulmonary bypass. Parsonnet and Acute Physiology and Chronic Health Evaluation scores, characteristics of the surgical intervention, intensive care unit length of stay, and mortality were recorded along with the following variables: cardiac (hours requiring inotropic support and new atrial fibrillation), respiratory (oxygenation index and hours requiring intubation), renal (difference between serum creatinine at admission and maximum creatinine), and analytic (C-reactive protein at admission and 6, 24, and 48 hours later; troponin I; CK-MB; and lactate). Postoperative C-reactive protein concentrations did not correlate with variables such as time requiring inotropic support or intubation, oxygenation index, delta serum creatinine, and intensive care unit length of stay (with the exception of cardiopulmonary bypass time and the more frequent norepinephrine requirement in patients with higher C-reactive protein concentration at 48 hours); nor did C-reactive protein correlate with the analytic variables (with the exception of the lactate peak and C-reactive protein concentrations at 24 and 48 hours). There was no correlation between C-reactive protein and postoperative variables for coronary artery bypass graft surgery and valvular groups analyzed separately. Postoperative C-reactive protein does not seem to be a useful marker in predicting outcome after 48 hours in the intensive care unit.
    Journal of cardiothoracic and vascular anesthesia 03/2009; 23(2):166-9. DOI:10.1053/j.jvca.2008.11.014 · 1.46 Impact Factor
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    ABSTRACT: Cardiopulmonary bypass (CPB) is a relatively common procedure in cardiac surgery. At the end, the heart is electrically defibrillated if not already beating. External and internal cardioversion by specific catheters do not raise plasma troponin concentration, but the possible repercussion on troponin of the direct cardioversion of the heart has not been documented. Prospective comparative trial in a surgical intensive care unit in a university hospital was conducted. The study sample comprised 364 consecutive patients undergoing cardiac surgery with CPB and without perioperative myocardial infarction. The number of cardioversions applied was recorded and three groups were obtained: A/no cardioversion; B/one or two cardioversions; and C/more than two cardioversions. Serum troponin I and CK-MB were determined at admission and after 6, 12, 24, and 48 hours. Significant differences were found between group C and groups A and B for troponin I and creatine kinase (CK-MB) curves, being higher for both variables in group C. With more than two cardioversions post-CPB, both troponin I and CK-MB may present an additional increase.
    Journal of Cardiac Surgery 05/2007; 22(3):192-4. DOI:10.1111/j.1540-8191.2007.00383.x · 0.89 Impact Factor