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Impact of preconditioning protocol on anesthetic-induced cardioprotection in patients having coronary artery bypass surgery. J Thorac Cardiovasc Surg 2009 Jun;137(6):1436-42, 1442.e1-2

Date

05/26/2009

Pubmed ID

19464461

DOI

10.1016/j.jtcvs.2008.04.034

Scopus ID

2-s2.0-67349200811 (requires institutional sign-in at Scopus site)   71 Citations

Abstract

OBJECTIVE: Anesthetic preconditioning may contribute to the cardioprotective effects of sevoflurane in patients having coronary artery bypass surgery. We investigated whether 2 different sevoflurane administration protocols can induce preconditioning in patients having coronary artery bypass.

METHODS: Thirty patients were randomly allocated to 1 of 3 groups. All patients received a total intravenous anesthesia with sufentanil (0.3 microg(-1) x kg x h(-1)) and propofol as target controlled infusion (2.5 microg/mL). The control group had no further intervention; 10 minutes prior to establishing the extracorporeal circulation, patients of the sevoflurane-I group received 1 minimum alveolar concentration of sevoflurane for 5 minutes. Patients of the sevoflurane-II group received (2 times) 5 minutes of sevoflurane, interspersed by 5-minute washout 10 minutes prior to extracorporeal circulation. Troponin I was measured as marker of cardiac cellular damage.

RESULTS: Peak levels of troponin I release were observed at 4 hours after cardiopulmonary bypass and were not affected by 1 cycle of sevoflurane administration (controls: 14 +/- 3 ng/mL vs sevoflurane-I group, 14 +/- 3 ng/mL). Two periods of sevoflurane preconditioning significantly reduced cellular damage compared with controls (peak troponin I level sevoflurane-II group, 7 +/- 2 ng/mL).

CONCLUSION: These data show that sevoflurane-induced preconditioning is reproducible in patients having coronary artery bypass but depends on the preconditioning protocol used.

Author List

Frässdorf J, Borowski A, Ebel D, Feindt P, Hermes M, Meemann T, Weber R, Müllenheim J, Weber NC, Preckel B, Schlack W

Author

Jan Fraessdorf MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Anesthesia, Intravenous
Anesthetics, Inhalation
Coronary Artery Bypass
Female
Hemodynamics
Humans
Ischemic Preconditioning, Myocardial
Male
Methyl Ethers
Ventricular Function, Left