Methylprednisolone use is associated with endothelial cell activation following cardiac surgery.

Autor: Lomivorotov VV; Research Institute of Circulation Pathology, Rechkunovskaya Street 15, Novosibirsk 630055, Russia., Efremov SM, Kalinichenko AP, Kornilov IA, Knazkova LG, Chernyavskiy AM, Lomivorotov VN, Karaskov AM
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2013 Jan; Vol. 22 (1), pp. 25-30. Date of Electronic Publication: 2012 Aug 28.
DOI: 10.1016/j.hlc.2012.08.001
Abstrakt: Background: The objective of this study was to investigate the effect of the perioperative use of methylprednisolone in medium doses on markers of endothelial cell activation in patients with coronary artery disease undergoing cardiopulmonary bypass.
Methods: In this prospective, double-blinded, placebo-controlled, randomised study, 44 patients, undergoing a coronary artery bypass graft surgery received either methylprednisolone 20 mg/kg or a placebo intraoperatively after anaesthesia induction. The primary endpoint was endothelin-1, and secondary endpoints were E-selectin, interleukin (IL)-6 and IL-10, PaO(2)/FiO(2) coefficient, and microalbuminuria.
Results: Endothelin-1 was higher in the study group postoperatively at 10 min (p=0.0008), 2 h (p=0.02), 4 h (p=0.005), and 24 h (p=0.004). IL-6 was lower in the study group postoperatively at 2 h (p=0.03), 4 h (p=0.04), and 24 h (p<0.0001). IL-10 was higher in the study group postoperatively at 10 min (p<0.0001), 2 h (p=0.009), and 4 h (p=0.001). PaO(2)/FiO(2) was lower in the study group at 24 h after surgery (p=0.03). Microalbuminuria was similar in both groups.
Conclusion: Despite an obvious anti-inflammatory effect, methylprednisolone causes endothelial cell activation in patients undergoing cardiopulmonary bypass.
(Copyright © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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