Yogaratnam JZ, Laden G, Guvendik L, Cowen M, Cale A, Griffin S, et al.
The Journal of surgical research. Date of publication 2008 Sep 1;volume 149(1):155-64.
1. J Surg Res. 2008 Sep;149(1):155-64. Epub 2007 Oct 11.
Pharmacological preconditioning with hyperbaric oxygen: can this therapy
attenuate myocardial ischemic reperfusion injury and induce myocardial protection
via nitric oxide?
Yogaratnam JZ(1), Laden G, Guvendik L, Cowen M, Cale A, Griffin S.
Author information:
(1)Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, United
Kingdom. jeysenzy@msn.com
Ischemic reperfusion injury (IRI) is an inevitable part cardiac surgery such as
coronary artery bypass graft (CABG). While ischemic hypoxia and the ensuing
normoxic or hyperoxic reperfusion are critical to the initiation and propagation
of IRI, conditioning myocardial cells to an oxidative stress prior to IRI may
limit the consequences of this injury. Hyperbaric oxygen (HBO2) is a modality of
treatment that is known to generate an oxidative stress. Studies have shown that
treatment with HBO2 postischemia and reperfusion is useful in ameliorating
myocardial IRI. Moreover, preconditioning the myocardium with HBO2 before
reperfusion has demonstrated a myocardial protective effect by limiting the
infarct size post ischemia and reperfusion. Current evidence suggests that HBO2
preconditioning may partly attenuate IRI by stimulating the endogenous production
of nitric oxide (NO). As NO has the capacity to reduce neutrophil sequestration,
adhesion and associated injury, and improve vascular flow, HBO2 preconditioning
induced NO may play a role in providing myocardial protection during
interventions that involve an inevitable episode of IRI. This current opinion
review article attempts to suggest that HBO2 may be used to pharmacologically
precondition and protect the myocardium from the effects of IRI that is known to
occur during cardiac surgery.
DOI: 10.1016/j.jss.2007.09.003
PMID: 17996900 [Indexed for MEDLINE]
