Siriraj Medical Journal

187-190

Authors: Wanchai Wongkornrat, M.D., Somchai Sriyoscharti, M.D., Pansak Laksanabunsong, M.D., Teeravit Phanchaipetch, M.D.,Thaworn Subtaweesin, M.D., Punnarerk Thongchareon, M.D., Pranya Sakiyalak, M.D., Worawong Slisatkorn, M.D.,Nisarat Opartkiattikul, M.D.

Background: Aspirin used after coronary artery bypass graft surgery (CABG) improved patient survival and reduced graft thrombosis. However, individual variations in the antiplatelet effect of aspirin have been reported among CABG patients. Objective: To compare the intensity of platelet aggregation between patients receiving low and high aspirin dosage in post CABG patients. Methods: We prospectively studied the effect of aspirin dosage on platelet aggregation in 100 CABG patients. Oral aspirin was discontinued prior to CABG and re-started within 12 hours after CABG. Blood samples were collected and transferred to a laboratory prior to surgery then again on postoperative days two and eight for platelet aggregation test and platelet count within three hours after venipuncture. Results: One hundred patients (sixty five male and thirty five female patients) post coronary artery bypass graft (CABG) were evaluated for eligibility to enter the trial. The percentage of platelet aggregation was compared between low dose (<100 mg/ day), and high dose (>100 mg/day) aspirin, at postoperative CABG days 2 and 8, which showed no significant difference for the platelet aggregation (p = 0.161 post CABG day 2 and p = 0.098 post CABG day 8). Conclusion: Low dosage aspirin should be used in post CABG patients because the intensity of platelet aggregation between patients post CABG receiving low and high aspirin dosage were not different, while the prophylactic effect of the low aspirin dosage in reducing the risk of cardiovascular events proved equally as effective as the high aspirin dosage.

196-199

Authors: Khemchat Wangtawesap, M.D., Arunotai Siriussawakul, M.D. Onuma Chaiwat, M.D., Tipa Chakorn, M.D.,Rapeepan Nuntabut, M.D., Daranee Kusakunniran, M.D., Sudta Parakkamodom, RN, Panisara Saengsung, RN,Thanawin Chawaruechai, RN, Wasinee Methapraphamorn, RN, Chulaluk Komoltri, DrPH (Biostatistics)

Objective: To survey the times to critical actions (defibrillator and doctor presence, initiation of chest compression) of inhospital simulated cardiopulmonary resuscitation (CPR). Methods: A 1-year retrospective simulated audit 2009 in a 2,400-bed university hospital in Thailand. Results: A total of 57 adult wards (around a third of all wards in the hospital), including intensive care units, critical wards, procedural units, general wards and out-patient units were audited. Overall, the median time of initiation of chest compression and defibrillator presence among CPR teams were 1.27 (0.35-7.19) and 1.16 (0.00-26.00) minutes, respectively. The median time of the first doctor presence was 3.45 (0.00-15.15) minutes. However, there were significant differences in time to defibrillator and doctor presence among wards. The longer time of these critical managements were recorded in non-monitored areas (general wards and out-patient units) (p = 0.004 and 0.007, respectively). Conclusion: In our CPR simulated survey, delayed initiation of critical managements commonly occurred in non-monitored areas. Better management should be concerned for favorable outcomes.

205-206

Authors: Adune Ratanawichitrasin, M.D., Somsri Ratanawichitrasin, M.D.

No abstract available.

210-214

Authors: Ananya Pongpaibul, M.D.

No abstract available.