Objective: To determine the effectiveness of hypothermia on renal functions for patients undergoing
coronary artery bypass graft CABG surgery.
Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery
bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the
intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function
test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was
determined first week post operative and post operative renal function was classified on the base of peak of
the serum creatinine level and decline of glomeruler filteration rate(GFR) as following : normal renal function
serum creatinine concentration and decline in(GFR) less than 25% from preoperative, moderate renal
dysfunction increase serum creatinine concentration and decline in(GFR) 25%-50% from preoperative, sever
renal dysfunction increase serum creatinine concentration and decline in(GFR) more than 50% from
preoperative test.
Results: results of this study show that (78%) from the sample develop post operative renal dysfunction and
the highly percentage of them are male (50%), advance age 60-70 (60%), smoking (47.0%), diabetes mellitus
DM (68%), cardiopulmonary bypass 180 and more (57.20%), New York Heart Association calcification NYHA
class III(47.5%) and patient without Intra Aortic Balloon Pump IABP(50,0%) . We conclude from the study that
highly percentage of patient undergoing isolated CABG may develop postoperative renal dysfunction even
when using hypothermic strategy as a protective measure and the patients with DM, male, advance age,
smoker, prolong time of CPB (more than 180 minutes), NYHA class III and patient without IABP are considered
as patient at high risk to develop postoperative renal dysfunction.
Recommendations: The researcher recommended that to find addition strategy rather than hypothermia
to protect renal function especially with the high risk patients during isolated CABG surgery.
QA Sarhan, University of Anbar Sport and Physical Education Sciences, 2019
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Abstract
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The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private
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