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<strong>Pl 1):P434 (doi: 10.1186/cc4781) Background Postoperative cardiac morbidity (PCM) continues to</strong><blockquote> </blockquote><blockquote>Pl 1):P434 (doi: 10.1186/cc4781) Background Postoperative cardiac morbidity (PCM) continues to pose considerable risks to surgical patients. High thoracic epidural analgesia (HTEA), with its selective blockade of cardiac sympathetic innervation, has been used for treatment of medically or surgically refractory angina pectoris. However, its use in patients with coronary artery disease (CAD) undergoing noncardiac surgery has not been adequately investigated. Objective To investigate the effect of HTEA on PCM in patients with established CAD undergoing major abdominal surgery as opposed to a comparable analgesic technique: low thoracic epidural analgesia (LTEA). Method After approval, 30 patients with CAD undergoing major abdominal surgery were included. Before general anesthesia, they were randomly allocated to receive HTEA or LTEA for both intraoperative and postoperative pain relief. In addition to haemodynamic measurements, PCM was investigated by comparing the preoperative ECG, echocardiography and troponin IConclusion The effectiveness of a post-ICU follow-up service may be less, the higher the risk of death pre-ICU discharge. References 1. Ball C, et al.: BMJ 2003, 327:1014. 2. Armitage P: Statistical Methods in Medical Research. Oxford: <a href="https://ourparenthood.nl/community/profile/ariannerobe8882/">Ridaifen-B</a> Blackwell; 2002.P433 Manganese and hepatic encephalopathy: a prospective studyI Cicinskaite, D Adukauskiene, V Pilvinis, J Pundzius, L Kupcinskas Kaunas Medicine University Hospital, Kaunas, Lithuania Critical Care 2006, 10(Suppl 1):P433 (doi: 10.1186/cc4780) Introduction We hypothesized that the manganese (Mn) concentration in the blood in cases of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) is associated with the Mn concentration in the liver tissue and cerebral globus pallidum and could be a marker of hepatic encephalopathy. Methods Mn blood tests were performed for 129 patients (54 patients of control group, 29 with ALF and 46 with ACLF) admitted to the ICU f<a href="https://www.ncbi.nlm.nih.gov/pubmed/21804710">PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/2878751</a><a href="https://www.ncbi.nlm.nih.gov/pubmed/2878751">PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/2878751</a> ID:https://www.ncbi.nlm.nih.gov/pubmed/21804710</a> gave their consent for this procedure (10 of control, 11 of ALF and 13 of ACLF). The Mn concentration in the vein blood and organs was analyzed by graphite furnace atomic absorption spectroscopy. Results The Mn concentration in the blood was significantly different (P < 0.04) in ALF (0.76 ?0.06) and ACLF (1.04 ?0.1)Table 1 (abstract P434) Group I = 15 Sex: male/female Age (years) Weight (kg) Goldman risk Operative time 10 (66)/5 (33) 56.6 (0.8) 73.5 (1.9) 5.7 (0.6) 3.8 (0.2) Group II = 15 9 (60)/6 (40) 56.7 (0.8) 76.5 (2.1) 6.3 (0.8) 3.5 (0.3) P value NS NS NS NS NSTable 2 (abstract P434) Group I = 15 Ischemia By echocardiography By ECG Infarction By echocardiography By ECG By tropinin I 0 (0 ) 0 (0 ) 0 (0 ) 2 (13.3 ) 1 (6.7 ) 2 (13.3 ) NS NS NS 2 (13.3 ) 0 (0 ) 8 (53.3 ) 5 (33.3 ) <0.05 <0.01 Group II = 15 P valueSCritical CareMarch 2006 Vol 10 Suppl26th International Symposium on Intensive Care and Emergency Medicinewith the postoperative ones done on the first, third and seventh days. Data are expressed as the mean (SE). Results Cardiac morbidity was only diagnosed in 13.3 of patients in the HTEA group (Group I). In the LTEA group (Group II), 53.3 were found to have new ischemic changes and 13.3 developed postoperative MI. There were no reported cases of cardiac mortality. The absolute risk reduction was 53.3 and the NNT was 2. Conclusion HTEA in patients with CAD undergoing non.</blockquote>
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