Effect of different doses of aprotinin on perioperative inflammatory response in patients undergoing off-pump coronary artery bypass surgery
- VernacularTitle:不同剂量抑肽酶对非体外循环下冠状动脉搭桥术病人围术期炎性反应的影响
- Author:
Aixia HE
;
Jing YANG
;
Lihuan LI
- Publication Type:Journal Article
- Keywords:
Aprotinin;
Coronary artery bypass;
Cardiopulraonary bypass;
Inflammation
- From:
Chinese Journal of Anesthesiology
1996;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of full-dose and half-dose aprotinin on perioperative inflammatory response in patients undergoing off-pump coronary artery bypass grafting (CABG) .Methods Thirty-nine patients aged 50-65 yrs undergoing off-pump CABG were randomly divided into 3 groups (n = 13 each):Ⅰcontrol group (C);Ⅱfull-dose aprotinin group (A-full) andⅢhalf-dose aprotinin group (A-half) . In groupⅡ( A-full) aprotinin 2?106 KIU in 100 ml normal saline (NS) was infused over 30 min after induction of anesthesia followed by aprotinin infusion at 0.5?106 KIU?h-1 until the end of surgery. In group A-half, half the amount of aprotinin administered in group A-full was given. In control group only NS was administered. Blood samples were taken before operation (T1,baseline) , 0.5 h after completion of vascular anastomosis (T2) and 2, 6, 18 h after operation (T3-5), for determination of plasma concentrations of IL-10, IL-6 and troponin (TnI) .Results The 3 groups were comparable with respect to age, M/F ratio, duration of operation and the number of bypass grafts. Plasma concentrations of IL-10, IL-6 and TnI were significantly increased after operation as compared to the baseline values (T0) in all 3 groups. The plasma concentrations of IL-10, IL-6 and TnI were significantly lower and postoperative blood loss smaller in the 2 aprotinin groups than in the control group; but they were not significantly different between the two aprotinin groups. Conclusion Both full-dose and half-dose aprotinin can inhibit the inflammatory response to CABG, reduce myocardial injury and postoperative blood loss. Half-dose aprotinin is recommended in patients undergoing off-pump CABG.
