Propofol versus insulin cardioplegia in valvular heart surgeries assessed by myocardial histopathology and troponin I
| Autor: | Omyma Shehata Mohamed, Shady Eid Al-Elwany, Mina Maher Raouf, Heba Mohamed Tawfik, Ibrahim Abbas Youssef |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Egyptian Journal of Anaesthesia, Vol 38, Iss 1, Pp 587-596 (2022) |
| Druh dokumentu: | article |
| ISSN: | 11101849 1110-1849 |
| DOI: | 10.1080/11101849.2022.2133760 |
| Popis: | Background and Aims Despite of the effectiveness of on pump cardiac surgeries in valvular diseases, cardioplegic arrest and myocardial reperfusion injury are still an obstacle. Many cardioprotective additives are tried but the obtained laboratory results are mixed. Our objective was to compare the effects of supplementing the cardioplegia solution with propofol or insulin evaluated not only by laboratory biomarkers but also with papillary muscle biopsy in patients undergoing on pump valvular surgeries.Methods Sixty adult patients were randomly assigned into three equal groups to receive: cold blood cadioplegia (control (C) group), supplemented with either 9 mg/L propofol 10% (P group), or 10 IU/L regular insulin (I group)Results Propofol induced significant higher myocardial protection presented by better histopathological grading of the obtained muscle biopsies when compared to either group C (P = 0.0460) or group I (P = 0.014), lower postoperative dysrhythmia (P = 0.004), lower troponin I release (40.57 ± 8.5 vs 47.7 ± 6.22-fold increase), and more eukalemic state with lower need for K supplementation than insulin.Conclusion Propofol was superior to insulin in providing higher grade of myocardial protection with lower troponin I release, more steady K level and lower postoperative complications. |
| Databáze: | Directory of Open Access Journals |
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