Endothelial Function and Hypoxic-Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial.

Autor: Mandel IA; Department of Anesthesiology and Intensive Care, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia.; Department of Anesthesiology and Intensive Care, Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, 115682 Moscow, Russia., Podoksenov YK; Department of Anesthesiology and Intensive Care, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, Russia.; Department of Hospital Surgery with a Cardiovascular Surgery Course, Siberian State Medical University, 634050 Tomsk, Russia., Mikheev SL; Department of Cardiovascular Surgery, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, Russia.; Department of Internal Medicine Department, Clinical Hospital 'MEDSI' in Otradnoe, 123056 Moscow, Russia., Suhodolo IV; Department of Morphology and General Pathology, Siberian State Medical University, 634050 Tomsk, Russia., Svirko YS; Biochemical Laboratory, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, Russia., Shipulin VM; Department of Hospital Surgery with a Cardiovascular Surgery Course, Siberian State Medical University, 634050 Tomsk, Russia.; Department of Cardiovascular Surgery, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, Russia., Ivanova AV; General Medicine Faculty, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia., Yavorovskiy AG; Department of Anesthesiology and Intensive Care, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia., Yaroshetskiy AI; Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia.
Jazyk: angličtina
Zdroj: Biomedicines [Biomedicines] 2023 Mar 28; Vol. 11 (4). Date of Electronic Publication: 2023 Mar 28.
DOI: 10.3390/biomedicines11041044
Abstrakt: A hypoxic-hyperoxic preconditioning (HHP) may be associated with cardioprotection by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients ( n = 120) were randomly assigned to an HHP and a control group. A safe, inhaled oxygen fraction for the hypoxic preconditioning phase (10-14% oxygen for 10 min) was determined by measuring the anaerobic threshold. At the hyperoxic phase, a 75-80% oxygen fraction was used for 30 min. The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs. 23 (41.1%), p = 0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low for more than 24 h in the control group. The endothelial damage markers appeared to be predictors of postoperative complications. The HHP with individual parameters based on the anaerobic threshold is a safe procedure, and it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications.
Databáze: MEDLINE