Cardioprotective Effects of Lowering Oxygen Tension After Aortic Unclamping on Cardiopulmonary Bypass During Coronary Artery Bypass Grafting
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概要
- 論文の詳細を見る
The effect on myocardial reperfusion injury of reducing oxygen tension during reperfusion on cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) was examined at the same time as the influence of diltiazem during CPB was evaluated. A prospective, randomized trial evaluated the hemodynamic and myocardial metabolic recovery in 3 groups of patients undergoing elective CABG; subjects were randomly allocated on the basis of oxygen tension during reperfusion after aortic unclamping: group 1 (n=10) hyperoxic reperfusion (oxygen tension [PO_2]=450-550mmHg); group 2 (n=10): hyperoxic reperfusion and subsequent continuous infusion of diltiazem (0.5μg/kg); group 3 (n=10): lowering reperfusate PO_2 (PO_2=200-250mmHg). Hemodynamic and myocardial metabolic measurements were taken at 6 preset times: before starting the surgical procedure and at 30min and 3, 9, 21, and 45h after discontinuation of CPB. The cardiac index in the lowering reperfusate PO_2 group was higher than that of the hyperoxic reperfusion groups at 30min and 3h after CPB, and malondialdehyde and troponin-T were significantly lower at 30min and 3h, respectively. In comparison with the hyperoxic + diltiazem group, the hemodynamic and myocardial recovery in the lowering reperfusate PO_2 group was improved for about 3h after CPB. Reduced oxygen tension during reperfusion after aortic unclamping on CPB is more effective against myocardial injury than a calcium antagonist in the short term. It is a convenient and safe management technique that can reduce morbidity and mortality, especially in the severely compromised heart.
- 社団法人日本循環器学会の論文
- 2002-07-20
著者
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INOUE Takehiro
Department of Radiation Oncology, Osaka University Graduate School of Medicine
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KU Kwansong
Department of Gastroenterology, Kobe Asahi Hospital
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KANEDA Toshio
Department of Pathophysiology, Faculty of Pharmaceutical Sciences, Hoshi University
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Zhang Zhi-wei
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Inoue Takehiro
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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OKU HIDETAKA
Department of Cardiovascular Surgery, Kinki University School of Medicine
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Zang Zhiwei
Department of Cardiovascular Surgery, Kinki University School of Medicine
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Otaki Masaki
Department of Cardiovascular Surgery, Kinki University School of Medicine
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Zhang Zhiwei
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Inoue Takehiro
Department Of Cardiac Surgery Kinki University Of Medicine
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Inoue T
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Ku Kwansong
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Oku Hidetaka
Department Of Cardiac Surgery
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Oku Hidetaka
Hyogo Kenritsu Amagasaki Hospital Division Of Cardiovascular Surgery
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Oku Hidetaka
The Department Of Cardiovascular Surger Kinki University School Of Medicine
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Otaki Masaki
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Otaki Masaki
Department Of Cardiac Surgery
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Kaneda Toshio
Department Of Cardiovascular Surgery Kinki University School Of Medicine
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Kaneda Toshio
Department Of Cardiovascular Medicine Hanwa Senboku Hospital
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