Document Detail


A prospective, randomized study of endothelin and postoperative recovery in off-pump versus conventional coronary artery bypass surgery.
MedLine Citation:
PMID:  14973794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objectives are 2-fold: (1). to serially determine endothelin (ET) levels in arterial vascular compartments in patients undergoing coronary artery bypass surgery using either cardiopulmonary bypass or off-pump techniques, and (2). to define potential relationships between endothelial levels and specific perioperative parameters of patient recovery. METHODS: In a prospective, randomized study, endothelin plasma content was measured from patients undergoing coronary artery bypass grafting using either off-pump techniques (OPCAB group, n = 25) or conventional cardiopulmonary bypass (CPB group, n = 25) before surgery, before and after coronary artery anastomosis, and 6 and 24 hours postoperatively. Specific indices of patient recovery including pulmonary artery pressures, ventilation requirement, and hospital stay were documented for patients in both study groups. RESULTS: Postoperative systemic arterial ET levels were significantly increased by 200% in the CPB group and 50% in the OPCAB group. ET levels remained significantly higher in the CPB group relative to the OPCAB group throughout the postoperative period of observation (p < 0.05). Pulmonary artery pressures, ventilation requirement, and hospital stay were significantly increased in patients in the CPB group. CONCLUSIONS: Postoperative ET levels were higher in patients who underwent CPB for coronary artery bypass surgery. Increased ET in the postoperative period may contribute to a more complex recovery from coronary artery bypass surgery in patients undergoing cardiopulmonary bypass.
Authors:
B Hugh Dorman; John M Kratz; Marlina M Multani; Ruth Baron; Emily Farrar; Scott Walton; Kim Payne; John Ikonomiois; Scott Reeves; Rupak Mukherjee; Francis G Spinale
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  18     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-19     Completed Date:  2004-06-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  25-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology
Cardiopulmonary Bypass / methods*
Coronary Artery Bypass / methods*
Electrolytes / blood
Endothelins / blood*
Female
Hematologic Tests
Humans
Length of Stay / statistics & numerical data
Male
Middle Aged
Postoperative Complications / blood*
Prospective Studies
Pulmonary Artery / physiology
Time Factors
Grant Support
ID/Acronym/Agency:
R01HC56603/HC/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Electrolytes; 0/Endothelins
Comments/Corrections
Comment In:
J Cardiothorac Vasc Anesth. 2004 Oct;18(5):680   [PMID:  15578491 ]

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


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