Impaired Endothelial Responses in Patients with Deep Hypothermic Cardiopulmonary Bypass

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概要

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• We examined whether vascular endothelial function is impaired with deep hypothermia during cardiopulmonary bypass. Such impairment may cause the prolonged hypoperfusion of tissues or organs. Thirty adult patients were classified into three groups according to the degree of hypothermia during cardiopulmonary bypass; deep (DH: 18-20°C, n=10), moderate (MDH: 25-30°C, n=10) and mild (MLH: 32-34°C, n=10) hypothermia. A bolus dose of 100 mg acetylcholine was injected, followed by 1 mg nitroglycerine 20 min later under hypothermic cardiopulmonary bypass. Plasma concentrations of nitric oxide metabolites (NOx) and endothelin-1 were determined until the 7<SUP>th</SUP> post-operative day (POD). The reduction of arterial pressure after acetylcholine was the smallest in the DH group (-9±6 mmHg, p<0.01). The time to reach the maximum reduction of arterial pressure was the longest in the DH group (acetylcholine: 47.7±23.6 sec, nitroglycerine: 53.4±21.4 sec, p<0.01). NOx production was reduced until the 1<SUP>st</SUP> POD and then recoverd. The recovery was more rapid in the MLH group than the other two groups (p<0.01). The plasma endothelin-1 did not differ among the three groups. These results suggest that endothelial function is impaired during cardiopulmonary bypass with deep hypothermia.

• 久留米大学医学部 The Kurume Medical Journal 編集部の論文

著者

• YAMADA SHINICHI

  Department of Anesthesiology, Kurume University School of Medicine

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• Impaired Endothelial Responses in Patients with Deep Hypothermic Cardiopulmonary Bypass

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