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Effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing valvular heart surgery.
MedLine Citation:
PMID:  20498789     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Valvular heart surgery (VHS) utilizing cardiopulmonary bypass (CPB) is inevitably associated with ischemic-reperfusion injury, which is known to depend on oxygen tension during reperfusion. The aim of this study was to evaluate the effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing VHS.
METHODS: Fifty-six patients undergoing isolated VHS were randomly exposed to an oxygen fraction of 0.7 (hyperoxic group, n = 28) or 0.5 (normoxic group, n = 28) during reperfusion. All patients received an oxygen fraction of 0.7 during CPB. In the normoxic group, the oxygen fraction was lowered to 0.5 from the last warm cardioplegia administration to 1 minute after aortic unclamping, and was then raised back to 0.7. Hemodynamic data were measured after induction of anesthesia, weaning from CPB, and sternum closure. The frequency of cardiotonic medications used during and after weaning from CPB, and the short-term outcomes during the hospital stay were also assessed.
RESULTS: The frequency of vasopressin and milrinone use during weaning from CPB, but not norepinephrine, was significantly less in the normoxic group. The post-operative cardiac enzyme levels and short-term outcomes were not different between the groups.
CONCLUSIONS: Normoxic reperfusion from the last cardioplegia administration to 1 minute after aortic unclamping in patients undergoing VHS resulted in significantly less frequent use of vasopressin and inotropics during weaning from CPB than hyperoxic reperfusion, although it did not affect the post-operative myocardial enzyme release or short-term prognosis.
Authors:
Jeong-Soo Lee; Jong-Chan Kim; Joo-Young Chung; Seong-Wook Hong; Kil-Hwan Choi; Young-Lan Kwak
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Publication Detail:
Type:  Journal Article     Date:  2010-02-28
Journal Detail:
Title:  Korean journal of anesthesiology     Volume:  58     ISSN:  2005-7563     ISO Abbreviation:  Korean J Anesthesiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101502451     Medline TA:  Korean J Anesthesiol     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  122-8     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
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