Title: The myocardial preservation of aprotinin on normothermic-CPB heart surgery
Abstract: Objective:To evaluate the myocardial protective effect of aprotinin on normothermic cardiopulmonary bypass(CPB )heart surgery.Methods:Sixty patients with congenital heart disease undergoing normothermic CPB were randomly divided into group Ⅰ(unused aprotinin), groupⅡand group Ⅲ.GroupⅡpatients received aprotinin 5×104KIU·kg -1 in hyper k+ cardioplegia.Group Ⅲ patients received 2.5×104KIU·kg -1 and also added to CPB priming solution.Serum samples were collected for measurement of cardiac troponinI(cTnI),creatine kinase MB(CK-MB),superoxide dismutase(SOD) and lipid peroxidation(LPO) at various times during operation.The changes of hemodynamics indices were recorded. Results :After CPB plasma concentration of cTnI increased in all groups,but the increase values in group Ⅱ and group Ⅲ were lower than that in group Ⅰ( P 0.01). CK-MB apparently increased,and returned to the value before CPB at 72h after opening the ascending aorta.SOD descedned continuously until 12h after opening the ascending aorta,then ascended gradually. LPO significantly increased after opening the ascending aorta, apparently descended at 12h after opening the ascending aorta.The changes of CK-MB,SOD and LPO in groupⅡandⅢwere significantly lower than those in groupⅠ( P 0.01),but there was no differnce between groupⅡandⅢ.In groupⅡand groupⅢ, the rate of heart spontaneous re-beating and sinus rhythm recovery were higher,rate of defibrillation and arrhythmia as well as the kind and dose of cardiac inotropic agents used and its duration were lower than those of group Ⅰ.In three groups,cardiac output(CO),cardiac index(CI),stroke volume(SV)were increased,mean pulmonary arterial pressure(PAP),pulmonary capillary wedge pressure(PCWP),pulmonary vascular resistance(PVR),systemic vascular resistance(SVR) were decreased,but the degree of change in groupⅡand group Ⅲ was more than that in group Ⅰ( P 0.05).Heart rate (HR) and mean arterial pressure (MAP)were not changed after induction and CPB 5min( P 0.05). Conclusion :Aprotinin possesses the myocardial preservation on normothermic CPB vision cardiac surgery
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: article
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