Патология кровообращения и кардиохирургия (Jan 2016)
Effect of topical vancomycin on organ functions after heart surgery
Abstract
Objective. Focus in the study was placed on topical administration of vancomycin on hepatic and renal functions of cardiac patients. Methods. A retrospective analysis of treatment of 184 patients who underwent cardiac surgery in the period from 2009 to 2013 was done. Antibiotics were applied locally for prevention of sternal wound infection. All patients underwent cardiac surgery via median longitudinal sternotomy. Before closing the chest, antibiotic of the glycopeptide group (vancomycin) was topically applied. The influence of topical vancomycin on the hepatic and renal functions was accessed. Results. Statistical analysis of data showed that the level of AST before surgery (M = 33.23; SD = 6.8) was above that of AST in the postoperative period (M = 32.18; SD = 7.6) by an average of 1.049 (t = 1.406; p = 0.161. [95% CI. –0.423; 2.521]). ALT level before surgery (M = 34.6; SD = 5.4) was higher comparing to that in the postoperative period (M = 34.5; SD = 4.5) by an average of 0.08 (t = 0.157; p = 0.875 [95% CI. –0.878; 1.03]). The differences were not statistically significant. This leads to the conclusion that there is no effect of topical application of vancomycin on the levels of AST and ALT in the postoperative period.The creatinine values in the postoperative period (M = 73.6; SD = 16.4) were higher than those before surgery (M = 71.3; SD = 17.05) by an average of 2.3 (t = –1.308; p = 0.192. [95% CI. –5.807; 1.177]). The differences were not statistically significant. It means that there is no influence of local topical vancomycin on serum creatinine level.Conclusion. Topical application of vancomycin in the postoperative period has no impact on the level of AST, ALT and creatinine in blood plasma. Also, when applied locally in cardiac patients, vancomycin does not lead to the dysfunction of kidneys and liver.
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