Nitric oxide provides myocardial protection when added to the cardiopulmonary bypass circuit during cardiac surgery: Randomized trial
Kamenshchikov N. O., Mandel` I. A., Podoksenov Y. K., Svirko Y. S., Lomivorotov V. V., Mikheev S. L., Kozlov B. N., Shipulin V. M., Nenakhova A. A., Anfinogenova Y. J.
The Journal of Thoracic and Cardiovascular Surgery
Vol.157, Issue6, P. 2328-2336.e1
Опубликовано: 2019
Тип ресурса: Статья
DOI:10.1016/j.jtcvs.2018.08.117
Аннотация:
Objectives: The aim of this pilot study was to elucidate the effects of exogenous nitric oxide (NO) supply to the extracorporeal circulation circuit for cardioprotection against ischemia–reperfusion injury during coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods: A total of 60 patients with coronary artery disease scheduled for CABG with CPB were enrolled in a prospective randomized study. Patients were allocated randomly to receive treatment according to standard or modified CPB protocol where 40-ppm NO was added to the CPB circuit during cardiac surgery. The primary endpoint was the measurement of cardiac troponin I (cTnI). The secondary end points consisted in the measurements of creatine kinase-muscle/brain fraction (CK-MB) and vasoactive inotropic score (VIS). Results: NO delivered into the CPB circuit had a cardioprotective effect. The level of cTnI was significantly lower in NO-treated group compared with the control group 6 hours after surgery: 1
Ключевые слова:
cardioprotection; cardiopulmonary bypass; coronary artery bypass grafting; ischemia–reperfusion injury; nitric oxide
antihistaminic agent; benzodiazepine; creatine kinase MB; dopamine; milrinone; nitric oxide; noradrenalin; phosphotransferase; troponin I; biological marker; cardiotonic agent; creatine kinase MB; nitric oxide; acute kidney failure; acute respiratory failure; adult; Article; artificial ventilation; cardiopulmonary bypass; cardiovascular parameters; controlled study; coronary artery bypass graft; coronary artery disease; delirium; EuroSCORE; extracorporeal circulation; female; heart function; heart protection; heart surgery; human; major clinical study; male; mean arterial pressure; middle aged; New York Heart Association class; pilot study; pneumonia; pneumothorax; positive end expiratory pressure; priority journal; prospective study; randomized controlled trial; reperfusion injury; vasoactive inotropic score; adverse event; blood; coronary artery disease; myocardial ischemia reperfusion injury; procedures; Biomarkers; Cardiopulmonary Bypass; Cardiotonic Agents; Coronary Artery Bypass
Язык текста: Английский
ISSN: 1097-685X
Kamenshchikov N. O.
Mandel` I. A. Irina Arkadyevna 1982-
Podoksenov Y. K.
Svirko Y. S.
Lomivorotov V. V.
Mikheev S. L.
Kozlov B. N.
Shipulin V. M.
Nenakhova A. A.
Anfinogenova Y. J.
Каменшчиков Н. О.
Мандель И. А. Ирина Аркадьевна 1982-
Подоксенов Y. К.
Свирко Y. С.
Ломиворотов В. В.
Михеев С. Л.
Козлов Б. Н.
Шипулин В. М.
Ненахова А. А.
Анфиногенова Y. Й.
Nitric oxide provides myocardial protection when added to the cardiopulmonary bypass circuit during cardiac surgery: Randomized trial
Текст визуальный непосредственный
The Journal of Thoracic and Cardiovascular Surgery
Mosby
Vol.157, Issue6 P. 2328-2336.e1
2019
Статья
cardioprotection cardiopulmonary bypass coronary artery bypass grafting ischemia–reperfusion injury nitric oxide
antihistaminic agent benzodiazepine creatine kinase MB dopamine milrinone nitric oxide noradrenalin phosphotransferase troponin I biological marker cardiotonic agent creatine kinase MB nitric oxide acute kidney failure acute respiratory failure adult Article artificial ventilation cardiopulmonary bypass cardiovascular parameters controlled study coronary artery bypass graft coronary artery disease delirium EuroSCORE extracorporeal circulation female heart function heart protection heart surgery human major clinical study male mean arterial pressure middle aged New York Heart Association class pilot study pneumonia pneumothorax positive end expiratory pressure priority journal prospective study randomized controlled trial reperfusion injury vasoactive inotropic score adverse event blood coronary artery disease myocardial ischemia reperfusion injury procedures Biomarkers Cardiopulmonary Bypass Cardiotonic Agents Coronary Artery Bypass
Objectives: The aim of this pilot study was to elucidate the effects of exogenous nitric oxide (NO) supply to the extracorporeal circulation circuit for cardioprotection against ischemia–reperfusion injury during coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Methods: A total of 60 patients with coronary artery disease scheduled for CABG with CPB were enrolled in a prospective randomized study. Patients were allocated randomly to receive treatment according to standard or modified CPB protocol where 40-ppm NO was added to the CPB circuit during cardiac surgery. The primary endpoint was the measurement of cardiac troponin I (cTnI). The secondary end points consisted in the measurements of creatine kinase-muscle/brain fraction (CK-MB) and vasoactive inotropic score (VIS). Results: NO delivered into the CPB circuit had a cardioprotective effect. The level of cTnI was significantly lower in NO-treated group compared with the control group 6 hours after surgery: 1