Multidisciplinary Cardiovascular Annals

Published by: Kowsar

Association of Perioperative Serum Sodium Level Fluctuation and Postoperative Complications in Coronary Artery Bypass Graft Surgery

Rasoul Azarfarin 1 , Fahimeh Shekoohi 2 , Ziae Totonchi 3 , * , Azin Alizadehasl 4 and Zahrasadat Koleini 5
Authors Information
1 Professor of Anesthesiology, Fellowship of Cardiac Anesthesia, Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
2 MS in Extracorporeal Circulation Nursing, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
3 Associate Professor of Anesthesiology, Fellowship of Cardiac Anesthesia, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
4 Associate Professor of Cardiology, Fellowship of Echocardiography, Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
5 Department of Anesthesiology, Iran University of Medical Sciences, Tehran, IR Iran
Article information
  • Multidisciplinary Cardiovascular Annals: January 2018, 9 (1); e62857
  • Published Online: July 31, 2017
  • Article Type: Research Article
  • Received: April 17, 2017
  • Revised: May 14, 2017
  • Accepted: June 17, 2017
  • DOI: 10.5812/mcardia.62857

To Cite: Azarfarin R, Shekoohi F, Totonchi Z, Alizadehasl A, Koleini Z. Association of Perioperative Serum Sodium Level Fluctuation and Postoperative Complications in Coronary Artery Bypass Graft Surgery, Multidiscip Cardio Annal. 2018 ; 9(1):e62857. doi: 10.5812/mcardia.62857.

Copyright © 2017, Multidisciplinary Cardiovascular Annals. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Alexander JH, Smith PK. Coronary-Artery Bypass Grafting. N Engl J Med. 2016;374(20):1954-64. doi: 10.1056/NEJMra1406944. [PubMed: 27192673].
  • 2. Bagheri K, Safavi M, Honarmand A, Kashefi P, Ghasemi M, Mohammadinia L. Investigating the relationship between intra-operative electrolyte abnormalities (sodium and potassium) with post-operative complications of coronary artery bypass surgery. Adv Biomed Res. 2013;2.
  • 3. Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015;91(5):299-307. [PubMed: 25822386].
  • 4. Bueno-Orovio A, Sanchez C, Pueyo E, Rodriguez B. Na/K pump regulation of cardiac repolarization: insights from a systems biology approach. Pflugers Arch. 2014;466(2):183-93. doi: 10.1007/s00424-013-1293-1. [PubMed: 23674099].
  • 5. Cheung AT, Cruz-Shiavone GE, Meng QC, Pochettino A, Augoustides JA, Bavaria JE, et al. Cardiopulmonary bypass, hemolysis, and nitroprusside-induced cyanide production. Anesth Analg. 2007;105(1):29-33. doi: 10.1213/01.ane.0000264078.34514.32. [PubMed: 17578949].
  • 6. Crestanello JA, Phillips G, Firstenberg MS, Sai-Sudhakar C, Sirak J, Higgins R, et al. Postoperative hyponatremia predicts an increase in mortality and in-hospital complications after cardiac surgery. J Am Coll Surg. 2013;216(6):1135-43. 1143 e1. doi: 10.1016/j.jamcollsurg.2013.02.010. [PubMed: 23623219].
  • 7. Crestanello JA, Phillips G, Firstenberg MS, Sai-Sudhakar C, Sirak J, Higgins R, et al. Preoperative hyponatremia predicts outcomes after cardiac surgery. J Surg Res. 2013;181(1):60-6. doi: 10.1016/j.jss.2012.06.004. [PubMed: 22748596].
  • 8. Filipescu D. Early Profile and Clinical Significance of Hyperchloremic Acidosis in Patients Undergoing Cardiac Surgery. Acta Endocrinologica (Bucharest). 2006;2(3):295-306. doi: 10.4183/aeb.2006.295.
  • 9. Goto T, Maekawa K. Cerebral dysfunction after coronary artery bypass surgery. J Anesth. 2014;28(2):242-8. doi: 10.1007/s00540-013-1699-0. [PubMed: 23982856].
  • 10. Groeneveld AB, Jansen EK, Verheij J. Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study. J Cardiothorac Surg. 2007;2:11. doi: 10.1186/1749-8090-2-11. [PubMed: 17300720].
  • 11. Gunaydin S, Ayrancioglu K, Dikmen E, McCusker K, Vijay V, Sari T, et al. Clinical effects of leukofiltration and surface modification on post-cardiopulmonary bypass atrial fibrillation in different risk cohorts. Perfusion. 2007;22(4):279-88. doi: 10.1177/0267659107084146. [PubMed: 18181517].
  • 12. Halonen J, Halonen P, Jarvinen O, Taskinen P, Auvinen T, Tarkka M, et al. Corticosteroids for the prevention of atrial fibrillation after cardiac surgery: a randomized controlled trial. JAMA. 2007;297(14):1562-7. doi: 10.1001/jama.297.14.1562. [PubMed: 17426275].
  • 13. Homoky MA. Serum sodium levels and associated mortality rates and length of stay in surgical ICU patients. 2015.
  • 14. Hudcova J, Ruthazer R, Bonney I, Schumann R. Sodium homeostasis during liver transplantation and correlation with outcomes. Anesth Analg. 2014;119(6):1420-8. doi: 10.1213/ANE.0000000000000415. [PubMed: 25211389].
  • 15. Kim JT, Park YH, Chang YE, Byon HJ, Kim HS, Kim CS, et al. The effect of cardioplegic solution-induced sodium concentration fluctuation on postoperative seizure in pediatric cardiac patients. Ann Thorac Surg. 2011;91(6):1943-8. doi: 10.1016/j.athoracsur.2011.02.003. [PubMed: 21511247].
  • 16. Madan VD, Novak E, Rich MW. Impact of change in serum sodium concentration on mortality in patients hospitalized with heart failure and hyponatremia. Circ Heart Fail. 2011;4(5):637-43. doi: 10.1161/CIRCHEARTFAILURE.111.961011. [PubMed: 21673193].
  • 17. Mastoraki A, Karatzis E, Mastoraki S, Kriaras I, Sfirakis P, Geroulanos S. Postoperative jaundice after cardiac surgery. Hepatobiliary Pancreat Dis Int. 2007;6(4):383-7. [PubMed: 17690034].
  • 18. Mahmoud ABS, Burhani MS, Hannef AA, Jamjoom AA, Al-Githmi IS, Baslaim GM. Effect of modified ultrafiltration on pulmonary function after cardiopulmonary bypass. Chest. 2005;128(5):3447-53.
  • 19. Mazzeffi M, Paciullo C, Vega JD, Nguyen D, Connor M. Moderate-to-large increases in perioperative serum sodium concentration associated with adverse neurologic events after continuous flow left ventricular assist device implantation. J Cardiothorac Vasc Anesth. 2015;29(2):360-6. doi: 10.1053/j.jvca.2014.07.029. [PubMed: 25499669].
  • 20. Munoz E3, Briggs H, Tolpin DA, Lee VV, Crane T, Elayda MA, et al. Low serum sodium level during cardiopulmonary bypass predicts increased risk of postoperative stroke after coronary artery bypass graft surgery. J Thorac Cardiovasc Surg. 2014;147(4):1351-5. doi: 10.1016/j.jtcvs.2013.09.034. [PubMed: 24189318].
  • 21. Ono M, Brady K, Easley RB, Brown C, Kraut M, Gottesman RF, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg. 2014;147(1):483-9. doi: 10.1016/j.jtcvs.2013.07.069. [PubMed: 24075467].
  • 22. Ootaki Y, Ungerleider RM. Neuroprotection Strategies During Cardiopulmonary Bypass. Pediatr Congen Cardiol Cardiac Surg Intens Care. 2014:801-17. doi: 10.1007/978-1-4471-4619-3_76.
  • 23. Passaroni AC, Silva MA, Yoshida WB. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine. Rev Bras Cir Cardiovasc. 2015;30(2):235-45. doi: 10.5935/1678-9741.20150021. [PubMed: 26107456].
  • 24. Pekelharing J, Furck A, Banya W, Macrae D, Davidson SJ. Comparison between thromboelastography and conventional coagulation tests after cardiopulmonary bypass surgery in the paediatric intensive care unit. Int J Lab Hematol. 2014;36(4):465-71. doi: 10.1111/ijlh.12171. [PubMed: 24325756].
  • 25. Preeshagul I, Gharbaran R, Jeong KH, Abdel-Razek A, Lee LY, Elman E, et al. Potential biomarkers for predicting outcomes in CABG cardiothoracic surgeries. J Cardiothorac Surg. 2013;8:176. doi: 10.1186/1749-8090-8-176. [PubMed: 23866777].
  • 26. RezaMasoule S, Ahmadi N, Monfared A, Rezasefat A, Kazemnezhad Leili E, Ziaei T. Electrolyte disorders after coronary artery bypass grafting surgery. J Holistic Nurs Midwifery. 2015;25(4):81-90.
  • 27. Shen YM, Frenkel EP. Thrombosis and a hypercoagulable state in HIV-infected patients. Clin Appl Thromb Hemost. 2004;10(3):277-80. [PubMed: 15247986].
  • 28. Spatenkova V, Bradac O, Kazda A, Suchomel P. Central diabetes insipidus is not a common and prognostically worse type of hypernatremia in neurointensive care. Neuro Endocrinol Lett. 2011;32(6):879-84. [PubMed: 22286785].
  • 29. van der Linden J, Lindvall G, Sartipy U. Aprotinin decreases postoperative bleeding and number of transfusions in patients on clopidogrel undergoing coronary artery bypass graft surgery: a double-blind, placebo-controlled, randomized clinical trial. Circulation. 2005;112(9 Suppl):I276-80. doi: 10.1161/CIRCULATIONAHA.104.524611. [PubMed: 16159831].
  • 30. Wallmuller C, Sterz F, Testori C, Schober A, Stratil P, Horburger D, et al. Emergency cardio-pulmonary bypass in cardiac arrest: seventeen years of experience. Resuscitation. 2013;84(3):326-30. doi: 10.1016/j.resuscitation.2012.05.029. [PubMed: 22800860].
  • 31. Whitlock RP, Young E, Noora J, Farrokhyar F, Blackall M, Teoh KH. Pulse low dose steroids attenuate post-cardiopulmonary bypass SIRS; SIRS I. J Surg Res. 2006;132(2):188-94. doi: 10.1016/j.jss.2006.02.013. [PubMed: 16566943].

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