Comparison of Inflammatory Response and Myocardial injury Between Normoxic and Hyperoxic Condition during.
- Author:
Ki Bong KIM
1
;
Seok Cheol CHOI
;
Kook Lyeol CHOI
;
Seok Mok JEONG
;
Kang Joo CHOI
;
Yang Weon KIM
;
Byung Hun KIM
;
Yang Haeng LEE
;
Kwang Hyun CHO
Author Information
1. Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University, Korea. ctslee@ijnc.inje.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Cardiopulmonary bypass;
Blood gas analgsis;
Myocardium, injuries;
Inflammatory response syndrome, systemic;
Vascular resistance
- MeSH:
Adenosine Monophosphate;
Adult;
Cardiopulmonary Bypass;
Coronary Sinus;
Free Radicals;
Humans;
Lactic Acid;
Leukocyte Count;
Leukocytes;
Lung;
Malondialdehyde;
Neutrophils;
Oxidative Stress;
Oxygen;
Peroxidase;
Systemic Inflammatory Response Syndrome;
Thoracic Surgery;
Trinitrotoluene;
Troponin T;
Vascular Resistance
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2001;34(7):524-533
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Hyperoxemic cardiopulmonary bypass (CPB) has been recognized as a safe technique and is widely used in cardiac surgery. However, hyperoxemic CPB may produce higher toxic oxygen species and cause more severe oxidative stress and ischemia/reperfusion injury than normoxemic CPB. This study was undertaken to compare inflammatory responses and myocardial injury between normoxemic and hyperoxemic CPB and to examine the beneficial effect of normoxemic CPB. MATERIAL AND METHOD: Thirty adult patients scheduled for elective cardiac surgery were randomly divided into normoxic group (n=15), who received normoxemic CPB (about PaO2 120 mmHg), and hyperoxic group (n=15), who received hyperoxemic CPB (about PaO2 400 mmHg). Myeloperoxidase (MPO), malondialdehyde (MDA), adenosine monophosphate (AMP), and troponin-T (TnT) concentrations in coronary sinus blood were determined at pre- and post-CPB. Total leukocyte and neutrophil counts in arterial blood were measured at the before, during, and after CPB. Lactate concentration in mixed venous blood was analyzed during CPB, and cardiac index (CI) and pulmonary vascular resistance (PVR) were evaluated pre- and post-CPB. All of the parameters were compared between the groups. RESULT: Normoxic group at post-CPB had lower MDA (4.79+/-0.7 vs 5.86+/-0.65 micromol/L, p=0.04) and MPO levels (5.38+/-1.01 vs 8.73+/-0.90 ng/mL, p=0.02), decreased total leukocyte counts (10,484+/-836 vs 13,572+/-1167/mm3, p=0.04) and higher AMP concentrations(1.23+/-0.07 vs 1.00+/-0.04 nmol/L, p=0.05), as well as a reduction in PVR (90.37+/-16.36 vs 118.12+/-12.21 dyne/sec/cm5, p=0.04) compared to hyperoxic group. There were no significant differences between the two groups with regard to TnT, lactate concentrations, and CI. CONCLUSION: Normoxic CPB provides less myocardial and lung damage related to oxygen free radicals and low inflammatory responses compared to hyperoxic CPB at post-CPB. Therefore, these results suggest that normoxemic CPB is a safe and salutary technique that could be applied in all cardiac surgery.
