Abstract | OBJECTIVE: DESIGN: A prospective, randomized controlled trial. SETTING: A university hospital (single center). PARTICIPANTS: METHODS: Blood samples were obtained at 6 different time points before, during, and after surgery. Nuclear factor-kB (NF-κB) was evaluated before surgery and 2 and 24 hours after surgery. Myocardial damage was evaluated measuring cardiac troponin I. MEASUREMENTS AND MAIN RESULTS:
Interleukin (IL)-6 (a marker of inflammation), prothrombin fragment 1-2 (PF-1.2, a marker of thrombin generation), plasmin- antiplasmin complex (PAP, a marker of fibrinolysis), and platelet factor 4 (PF4, a marker of platelet activation) were measured. The DNA binding activity of proinflammatory transcription factor NF-κB was quantified in the isolated lymphomonocyte cells. Surgery caused changes of all plasma biomarkers. This reaction was attenuated strongly in the Physio group; PF-1.2, PAP, and PF4 all were decreased significantly. In the Physio group, a significantly lower cardiac troponin I release was observed postoperatively. After surgery, NF-κB activity was reduced in the Physio group although this difference was not statistically significant. CONCLUSIONS: A multimodal strategy using a closed and phosphorylcholine-coated CPB circuit together with the avoidance of cardiotomy suction reduced activation of the coagulation and fibrinolytic systems intraoperatively, although these changes did not persist postoperatively. However, no difference in clinical outcome was appreciated on a larger scale.
|
Authors | Domenico Paparella, Giuseppe Scrascia, Crescenzia Rotunno, Nicola Marraudino, Pietro Guida, Micaela De Palo, Giovanni Rubino, Giangiuseppe Cappabianca |
Journal | Journal of cardiothoracic and vascular anesthesia
(J Cardiothorac Vasc Anesth)
Vol. 26
Issue 4
Pg. 557-62
(Aug 2012)
ISSN: 1532-8422 [Electronic] United States |
PMID | 22658688
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Chemical References |
- NF-kappa B
- Troponin I
- Phosphorylcholine
|
Topics |
- Aged
- Cardiopulmonary Bypass
(methods)
- Coronary Artery Bypass
- Female
- Hemostasis
- Humans
- Inflammation
(prevention & control)
- Male
- Middle Aged
- NF-kappa B
(metabolism)
- Phosphorylcholine
- Prospective Studies
- Troponin I
(blood)
|