| Influence of normothermic systemic perfusion temperature on cold myocardial protection during coronary artery bypass surgery. | |
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MedLine Citation:
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PMID: 10386759 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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I Birdi; M Caputo; M Underwood; G D Angelini; A J Bryan |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Cardiovascular surgery (London, England) Volume: 7 ISSN: 0967-2109 ISO Abbreviation: Cardiovasc Surg Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-08-27 Completed Date: 1999-08-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9308765 Medline TA: Cardiovasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 369-74 Citation Subset: IM |
Affiliation:
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Bristol Heart Institute, University of Bristol, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / surgery* Body Temperature Cardiopulmonary Bypass Coronary Artery Bypass* Female Humans Hypothermia, Induced* Male Middle Aged Postoperative Complications / blood Prospective Studies Treatment Outcome Troponin I / blood Troponin T / blood |
| Chemical | |
Reg. No./Substance:
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0/Troponin I; 0/Troponin T |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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