Influence of normothermic systemic perfusion temperature on cold myocardial protection during coronary artery bypass surgery.
Cardiovasc Surg
; 7(3): 369-74, 1999 Apr.
Article
em En
| MEDLINE
| ID: mdl-10386759
ABSTRACT
OBJECTIVE:
To determine the effect of normothermic systemic perfusion on myocardial injury when using cold cardioplegic techniques in patients undergoing coronary artery bypass surgery.METHOD:
Sixty six patients with stable angina pectoris were prospectively randomized into three groups according to cardiopulmonary bypass temperature hypothermia (28 degrees C, n = 22), moderate hypothermia (32 degrees C, n = 22) and normothermia (37 degrees C, n = 22). All patients received cold antegrade crystalloid cardioplegia and topical cooling with saline at 4 degrees C. Serum samples were collected for troponin T and I estimation preoperatively, 4 hours after removal of the aortic cross clamp, and 12, 24, 36 and 48 hours postoperatively. In addition, serial electrocardiographic studies were undertaken on days 1, 3 and 5.RESULTS:
Patients were similar with regard to preoperative and intraoperative characteristics Four patients showed ECG changes typical of perioperative myocardial infarction but remained clinically well (28 degrees C, one; 32 degrees C, one; 37 degrees C, two). In the remaining 62 patients, serum troponin T increased significantly from a mean baseline value of 0.02 ng/ml to 1.5+/-0.9 ng/ml 4 hours after removal of the aortic cross-clamp (P<0.0001). Similarly, troponin I increased from 0.06 ng/ml to 0.63+/-0.47 ng/ml 12 hours after reperfusion (P<0.0001). Serum concentrations of both markers subsequently declined with time but remained higher than preoperative values at 48 hours. There were no differences between the three groups with respect to peak and cumulative serum troponin release. Normothermic cardiopulmonary bypass did not compromise the efficacy of cold myocardial protection when assessed by serum troponin concentrations in low risk patients undergoing coronary revascularization.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ponte de Artéria Coronária
/
Hipotermia Induzida
/
Angina Pectoris
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Cardiovasc Surg
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
Reino Unido