Glucocorticoids reduce cardiac dysfunction after cardiopulmonary bypass and circulatory arrest in neonatal piglets
| Autor: | Jeffrey M. Pearl, Jefferson M. Lyons, Steven M. Bauer, Jerri L McNamara, Connie J. Wagner, Steven M. Schwartz, David P. Nelson, Jodie Y. Duffy |
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| Rok vydání: | 2004 |
| Předmět: |
Cardiac function curve
Swine medicine.medical_treatment Myocardial Reperfusion Injury Critical Care and Intensive Care Medicine law.invention Random Allocation law Preoperative Care medicine Cardiopulmonary bypass Animals Glucocorticoids Saline Analysis of Variance Cardiopulmonary Bypass Intraoperative Care business.industry medicine.anatomical_structure Methylprednisolone Ventricle Anesthesia Heart Function Tests Pediatrics Perinatology and Child Health Circulatory system Deep hypothermic circulatory arrest Cytokines business Glucocorticoid medicine.drug |
| Zdroj: | Pediatric Critical Care Medicine. 5:28-34 |
| ISSN: | 1529-7535 |
| DOI: | 10.1097/01.pcc.0000102382.92024.04 |
| Popis: | OBJECTIVE The hypotheses were that glucocorticoid administration could improve ventricular recovery by reducing cardiopulmonary bypass (CPB)-induced inflammatory response and that presurgical administration might be more effective than intraoperative dosing. DESIGN Animal case study. SUBJECTS Crossbred piglets (5-7 kg). INTERVENTIONS Piglets were cooled with CPB, followed by 120 mins of deep hypothermic circulatory arrest (DHCA). Animals were rewarmed to 38 degrees C, removed from CPB, and maintained for 120 mins. Methylprednisolone (60 mg/kg) was administered in the CPB pump prime (intraoperative glucocorticoid [intraop GC]) or 6 hrs before CPB (30 mg/kg) in addition to the intraoperative dose (30 mg/kg; pre- and intraop GC). Controls (no GC) received saline. MEASUREMENTS AND MAIN RESULTS In no GC, left ventricle (LV) positive change in pressure in time (+dP/dt) (mm Hg/sec) had a mean +/- SD of 1555 +/- 194 at baseline vs. 958 +/- 463 at 120 mins after CPB, p=.01). LV +dP/dt was maintained in glucocorticoid-treated animals (1262 +/- 229 at baseline vs. 1212 +/- 386 in intraop GC and 1471 +/- 118 vs. 1393 +/- 374 in pre-intraop GC). Glucocorticoids reduced myocardial interleukin-6 messenger RNA expression, measured by ribonuclease protection assay, at 120 mins after CPB compared with animals receiving saline (p |
| Databáze: | OpenAIRE |
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