| Cardioprotective effects of acute normovolemic hemodilution in patients undergoing coronary artery bypass surgery. | |
MedLine Citation:
|
PMID: 16100176 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY OBJECTIVES: We hypothesized that lowering blood viscosity with acute normovolemic hemodilution (ANH) would confer additional cardioprotection in patients undergoing coronary artery bypass surgery (CABG) with aortic cross-clamping. DESIGN: In a prospective, randomized controlled trial, we studied the efficacy of ANH in anesthetized patients prior to cardiopulmonary bypass for the prevention of myocardial injuries. SETTING: Cardiac surgical center in a university hospital. PATIENTS AND METHODS: Patients scheduled to undergo elective CABG entered the study protocol and were randomly allocated to one of two groups: ANH (n = 43 patients) or standard care management (n = 41 patients). In the ANH group, the whole-blood/colloid exchange was aimed to achieve a hematocrit value of 28%. All patients were managed with standard myocardial preservation techniques including cold-blood cardioplegia and anesthetic preconditioning. The outcome measures included the release of myocardial enzymes (plasma troponin I and creatinine phosphokinase), perioperative hemodynamic changes, need for pharmacologic cardiovascular support, and cardiac complications. RESULTS: In the hemodilution group, the postoperative release of troponin I (mean peak plasma concentration, 1.4 ng/mL; 95% confidence interval, 1.0 to 1.8) and myocardial fraction of creatine kinase (mean, 29 U/L; 95% confidence interval, 23 to 35) were significantly lower than in the control group (mean, 3.8 ng/mL; 95% confidence interval, 3.2 to 4.5; and 71 U/L; 95% confidence interval, 53 to 89). Requirement for inotropic support was significantly lower in the protocol patients (7 of 41 patients vs 15 of 39 patients), and fewer patients presented with either atrial fibrillation, atrioventricular conduction blockade, or combined disorders (12 of 41 patients vs 26 of 39 patients, p < 0.05). CONCLUSIONS: In addition to conventional myocardial preservation techniques, preoperative ANH achieved further cardiac protection in patients undergoing on-pump myocardial revascularization. |
Authors:
|
Marc Licker; Christoph Ellenberger; Jorge Sierra; Afksendiyos Kalangos; John Diaper; Denis Morel |
Related Documents
:
|
11074746 - Cardiac involvement in patients with acute neurologic disease: confirmation with cardia... 2917256 - Risk of aortic aneurysm surgery as assessed by preoperative gated heart pool scan. 11324376 - Different cut-off points of decreased heart rate variability for different groups of ca... 3352006 - Resuscitative thoracotomy: the effect of field time on outcome. 14616366 - Skin manifestations in acute arsenic poisoning from the wakayama curry-poisoning incident. 11120436 - The prevalence and stability of an executive processing deficit, response inhibition, i... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Chest Volume: 128 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 2005 Aug |
Date Detail:
|
Created Date: 2005-08-15 Completed Date: 2005-09-06 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
|
Languages: eng Pagination: 838-47 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesiology, Pharmacology, and Surgical Intensive Care, University Hospital of Geneva, Geneva, Switzerland. marc-joseph.licker@hcuge.ch |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Coronary Artery Bypass / adverse effects* Female Heart Diseases / etiology, prevention & control* Hemodilution* / methods Humans Male Middle Aged Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The relation between surgeon volume and outcome following off-pump vs on-pump coronary artery bypass...
Next Document: Stroke volume and pulse pressure variation for prediction of fluid responsiveness in patients underg...