Coronary artery disease has the highest mortality rate worldwide and coronary artery bypass grafting (CABG) is the most common cardiac surgery performed in patients with coronary artery disease to revascularize the heart. Despite of improvement in operation techniques, cardioplegia, cardiopulmonary bypass (CPB), myocardial injury related to on-pump CABG is still prominent. In patient with low ejection fraction undergone on-pump CABG, myocardial injury is related to worse outcome and prognosis during peri-operative and post-operative period. On-pump CABG patients with low ejection fraction has increased (up to four times higher) post-operative in hospital mortality rate compared to patient with normal ejection fraction. Administration of intravenous glutamine had been documented in reducing myocardial damage during cardiac surgery and previous studies indicated that glutamine can protect against myocardial injury by various mechanism during ischemia and reperfusion. The purpose of this study to determine whether intravenous glutamine could prevent the decline of plasma glutamine level, reduce myocardial damage, improve hemodynamic profile, and reduce morbidity of on-pump CABG in patients with low ejection fraction.
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Plasma Troponin I at Baseline
Timeframe: Before induction to anesthesia
Plasma Troponin I at 5 Minute After Cardiopulmonary Bypass
Timeframe: 5 minute after cardiopulmonary bypass
Plasma Troponin I at 6 Hour After Cardiopulmonary Bypass
Timeframe: 6 hour after cardiopulmonary bypass
Plasma Troponin I at 24 Hour After Cardiopulmonary Bypass
Timeframe: 24 hour after cardiopulmonary bypass
Plasma Troponin I at 48 Hour After Cardiopulmonary Bypass
Timeframe: 48 hour after cardiopulmonary bypass
Plasma Glutamine at Baseline
Timeframe: Before induction to anesthesia
Plasma Glutamine at 24 Hour After Cardiopulmonary Bypass
Timeframe: 24 hour after cardiopulmonary bypass