Li Y, Dong H, Chen M, Liu J, Yang L, Chen S, Xiong L, et al.
Journal of cardiothoracic and vascular anesthesia. Date of publication 2011 Dec 1;volume 25(6):908-16.
1. J Cardiothorac Vasc Anesth. 2011 Dec;25(6):908-16. doi:
10.1053/j.jvca.2011.06.017. Epub 2011 Aug 25.
Preconditioning with repeated hyperbaric oxygen induces myocardial and cerebral
protection in patients undergoing coronary artery bypass graft surgery: a
prospective, randomized, controlled clinical trial.
Li Y(1), Dong H, Chen M, Liu J, Yang L, Chen S, Xiong L.
Author information:
(1)Department of Anesthesiology, Xijing Hospital, Fourth Military Medical
University, Xi'an, China.
OBJECTIVES: To evaluate the cerebral and myocardial protective effects of
hyperbaric oxygen preconditioning in both on-pump and off-pump coronary artery
bypass graft surgery.
DESIGN: A prospective, randomized, single-blinded study including patients
scheduled for elective on-pump or off-pump surgery between December 2007 and
February 2009.
SETTING: A tertiary care university teaching hospital.
PARTICIPANTS: Forty-nine elective on-pump or off-pump coronary artery bypass
graft surgery patients.
INTERVENTIONS: Patients were randomized to either the control (15 patients with
on-pump procedure and 10 patients with off-pump procedure, respectively) or
hyperbaric oxygen (HBO; 14 patients with on-pump procedure and 10 patients with
off-pump procedure, respectively) groups. Patients in the HBO groups underwent
preconditioning for 5 days before surgery.
MEASUREMENTS AND MAIN RESULTS: On-pump coronary artery bypass graft surgery
patients preconditioned with HBO had significant decreases in S100B protein,
neuron-specific enolase, and troponin I perioperative serum levels compared with
the on-pump control group. Postsurgically, patients in the on-pump HBO group had
a reduced length of stay in the intensive care unit and a decreased use of
inotropic drugs. Serum catalase activity 24 hours postoperatively was
significantly increased compared with the on-pump control group. In the off-pump
groups, there was no difference in any of the same parameters.
CONCLUSIONS: Preconditioning with HBO resulted in both cerebral and cardiac
protective effects as determined by biochemical markers of neuronal and
myocardial injury and clinical outcomes in patients undergoing on-pump coronary
artery bypass graft surgery. No protective effects were noted in off-pump
coronary artery bypass graft surgery.
Copyright © 2011 Elsevier Inc. All rights reserved.
DOI: 10.1053/j.jvca.2011.06.017
PMID: 21868252 [Indexed for MEDLINE]
