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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2002 December;43(6):803-9

CARDIAC SECTION 

    ORIGINAL ARTICLES

Inhibition of systemic inflammatory response with sodium nitroprusside in open heart surgery

Göl M. K., Nisanoglu V., Iscan Z., Balci M., Kandemir Ö., Tasdemir O.

Car­di­o­vas­cular Sur­gery ­Clinic Türkiye ­Yüksek ­I˚htisas Hos­pital Ankara, ­Turkey

Back­ground. A ­nitric ­oxide ­donor, ­sodium nitro­prus­side has ­been ­reported to ­reduce the inflam­ma­tory ­response ­during car­di­o­pul­mo­nary ­bypass (CPB). To inves­ti­gate ­this, a ­double-­blind and pros­pec­tive ­study was con­ducted.
­Methods. ­Twenty ­patients ­with ­multi ­vessel cor­o­nary dis­ease ­were ran­domly ­chosen to ­form ­study (SNP) and con­trol ­groups. In the SNP ­group, 0.5 μg/kg/­min ­sodium nitro­prus­side ­were admin­is­tered for 20 min­ ­right ­after the ­release of the ­aortic cross­clamp. Mac-1 (CD11b/CD18) leu­ko­cyte adhe­sion mole­cule expres­sions, inter­leukin-6 ­levels ­were meas­ured ­from ­radial ­artery ­blood as ­well as leu­ko­cyte and ­platelet ­counts in ­both ­groups at 6 dif­ferent ­time ­points: a) ­before anes­thesia, b) ­after hep­arin admin­is­tra­tion, c) ­after ­aortic cross­clamp ­release, d) ­after pro­ta­mine admin­is­tra­tion, e) 3 ­hours ­after the ter­mi­na­tion of CPB, f) 24 ­hours ­after the ter­mi­na­tion of CPB.
­Results. The ­increase in Mac-1 expres­sions ­were not dif­ferent ­between the two ­groups at any ­time ­point ­except the meas­ure­ments ­after the admin­is­tra­tion of pro­ta­mine. At ­this ­time ­point, Mac-1 expres­sions ­were not dif­ferent ­between the ­groups (99.8±30.7 vs 134.6±95.1%, p=0.076), but ­higher ­when com­pared ­with the pre­in­duc­tion ­levels. IL-6 ­levels for SNP and con­trol ­groups was 89±43 and 215±131 pg/dL, respec­tively (p=0.016) 3 ­hours ­after the ter­mi­na­tion of CPB. ­Twenty-­four ­hours ­after the ter­mi­na­tion of CPB, IL-6 ­levels ­were ­still sig­nif­i­cantly ­higher in the con­trol ­group (47±27 vs 111±68 pg/dL, p=0.039). Leu­ko­cyte and ­platelet ­counts ­were not dif­ferent at any ­time ­point ­between the ­groups.
Con­clu­sions. ­Systemic inflam­ma­tory ­response in ­patients under­going CPB can be ­reduced to a cer­tain ­level ­with ­sodium nitro­prus­side, espe­cially the acti­va­tion of vas­cular endo­the­lial ­cells can be inhib­ited, but acti­va­tion of lekoc­ytes ­still ­takes ­place.

language: English


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