Document Detail

Impact of preconditioning protocol on anesthetic-induced cardioprotection in patients having coronary artery bypass surgery.
MedLine Citation:
PMID:  19464461     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Anesthetic preconditioning may contribute to the cardioprotective effects of sevoflurane in patients having coronary artery bypass surgery. We investigated whether 2 different sevoflurane administration protocols can induce preconditioning in patients having coronary artery bypass. METHODS: Thirty patients were randomly allocated to 1 of 3 groups. All patients received a total intravenous anesthesia with sufentanil (0.3 microg(-1) x kg x h(-1)) and propofol as target controlled infusion (2.5 microg/mL). The control group had no further intervention; 10 minutes prior to establishing the extracorporeal circulation, patients of the sevoflurane-I group received 1 minimum alveolar concentration of sevoflurane for 5 minutes. Patients of the sevoflurane-II group received (2 times) 5 minutes of sevoflurane, interspersed by 5-minute washout 10 minutes prior to extracorporeal circulation. Troponin I was measured as marker of cardiac cellular damage. RESULTS: Peak levels of troponin I release were observed at 4 hours after cardiopulmonary bypass and were not affected by 1 cycle of sevoflurane administration (controls: 14 +/- 3 ng/mL vs sevoflurane-I group, 14 +/- 3 ng/mL). Two periods of sevoflurane preconditioning significantly reduced cellular damage compared with controls (peak troponin I level sevoflurane-II group, 7 +/- 2 ng/mL). CONCLUSION: These data show that sevoflurane-induced preconditioning is reproducible in patients having coronary artery bypass but depends on the preconditioning protocol used.
Jan Frässdorf; Andreas Borowski; Dirk Ebel; Peter Feindt; Manuel Hermes; Thomas Meemann; René Weber; Jost Müllenheim; Nina C Weber; Benedikt Preckel; Wolfgang Schlack
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-02-23
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  137     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1436-42, 1442.e1-2     Citation Subset:  AIM; IM    
Department of Anesthesiology, Academic Medical Center AMC, University of Amsterdam, Amsterdam, The Netherlands.
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MeSH Terms
Anesthesia, Intravenous
Anesthetics, Inhalation / administration & dosage*
Coronary Artery Bypass*
Ischemic Preconditioning, Myocardial* / methods
Methyl Ethers / administration & dosage*
Ventricular Function, Left
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane

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