Document Detail


Clinical benefit of cardiac ischemic postconditioning in corrections of tetralogy of Fallot.
MedLine Citation:
PMID:  18854339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The postoperative course of cyanotic patients is generally more complicated than in acyanotic patients. The ischemic postconditioning provides protection from myocardial injury. We conducted a randomized trial to evaluate the clinical benefits of postconditioning in patients undergoing repair of tetralogy of Fallot. Ninety-nine patients with tetralogy of Fallot were randomly assigned to ischemic postconditioning group (n=48) or control group (n=51). The postconditioning was performed by intermittent aortic clamping after reperfusion. The morbidity, mortality, ventilation time, length of ICU stay, inotropic score, release of troponin I and lactate were assayed. There was one death in postconditioned group and two in control. Major non-fatal morbidity was reduced in postconditioned patients (12.5%, 6/48) compared with control (33.3%, 17/51, P=0.016). The troponin I was significantly lower (P=0.026) with reduced inotrope score (P=0.001) and lactate release (P=0.019) in postconditioned patients. The ventilation time was significantly reduced in postconditioned patients compared with control (14+/-15 h vs. 25+/-28 h, P=0.024). There was a significant decrease in the ICU stay in the postconditioned patients (P=0.048). The study suggests that ischemic postconditioning may provide clinical benefits with respect to the morbidity, ventilation time, ICU stay, requirement of inotrope in patients undergoing repair for tetralogy of Fallot.
Authors:
Bei Li; Ri Chen; Rimao Huang; Wanjun Luo
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-10-14
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  8     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  17-21     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Xiang Ya Hospital, Central South University, Changsha, Hunan, PR China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aorta / surgery*
Cardiac Surgical Procedures* / adverse effects,  mortality
Cardiotonic Agents / therapeutic use
Child
Child, Preschool
Constriction
Female
Humans
Intensive Care Units
Lactic Acid / blood
Length of Stay
Male
Myocardial Contraction / drug effects
Myocardial Reperfusion Injury / etiology,  mortality,  physiopathology,  prevention & control*
Reperfusion / methods*
Respiration, Artificial
Tetralogy of Fallot / mortality,  physiopathology,  surgery*
Treatment Outcome
Troponin I / blood
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Troponin I; 50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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