Background: Phosphodiesterase inhibitors (PDI) are used in cardiac surgery to improve and stabilize cardiac function after surgery. The aim of this study is to evaluate changes in hemodynamics and early outcomes when ...Background: Phosphodiesterase inhibitors (PDI) are used in cardiac surgery to improve and stabilize cardiac function after surgery. The aim of this study is to evaluate changes in hemodynamics and early outcomes when PDI (Inocor/inamrinone) is given in terminal warm blood cardioplegia to on-pump CABG only patients and compare results with patients who did not receive the drug. Material and methods: From April 2003 through September 2004 241 pts underwent elective on-pump CABG only surgery. 141 pts received Inocor in the terminal warm blood cardioplegia (Group 1) and 100 pts did not (Group 2). Results: Demographic data, preoperative EuroSCORE risk scores and operative details were similar. Of pts preoperatively in sinus rhythm (SR) 80.15% in Group 1 and 69.79% in Group 2 regained spontaneous SR (p = 0.07) after release of crossclamp. Inotropic support was needed in 5 pts in Group 1 and in 12 pts in Group 2, p = 0.02. Post cardiopulmonary by-pass (CPB) IABP support was needed for 4 pts in Group 2 and none for Group 1 pts, p = 0.01. There was no operative mortality in either Group and hospital/30 day mortality was similar (3/2.13% vs 3/3.00%, p = 0.69). There were no statistical difference in stay in postoperative intensive care unit (p = 0.15), total hospital stay (p = 0.07), appearance of postoperative atrial fibrillation (p = 0.23) or appearance of postoperative kidney injury (p = 0.27). Post CPB cardiac index improved 16.90% in Group1but decreased 1.49% in Group 2, p < 0.0001. Mean arterial pressure decreased 7.46%in Group 1 pts and 5.08% in Group 2 pts, p = 0.002, but no pts in either Group needed medication for too low blood pressure. Systemic vascular resistance decreased 28.40% in Group 1 and 9.02% in Group 2, p < 0.0001. Conclusions: Inamrinone in terminal warm blood cardioplegia (hot shot) is safe and effective way to improve and stabilize cardiac function after on-pump CABG surgery but does not affect short-term outcomes.展开更多
目的 观察体外循环冠状动脉 (冠脉 )旁路移植术中吸烟患者血浆 15 F2 t isoprostane(15 F2 t Iso P)的变化及其与术后心功能恢复的关系。方法 选择 30例吸烟冠心病患者及 30例非吸烟冠心病患者 ,均在异丙酚、芬太尼复合麻醉及体外循...目的 观察体外循环冠状动脉 (冠脉 )旁路移植术中吸烟患者血浆 15 F2 t isoprostane(15 F2 t Iso P)的变化及其与术后心功能恢复的关系。方法 选择 30例吸烟冠心病患者及 30例非吸烟冠心病患者 ,均在异丙酚、芬太尼复合麻醉及体外循环下行冠脉旁路移植术。分别于麻醉诱导后手术前 (T0 )、主动脉阻断后 30 m in(T1)、主动脉开放后 10 min(T2 )及 30 m in(T3)经中心静脉抽血 ,测血浆游离 15 F2 t Iso P浓度。结果 T0时吸烟及非吸烟组血浆 15 F2 t Iso P浓度差异无显著性。T1时两组血浆 15 F2 t Iso P显著升高 (与 T0比较 ,P均 <0 .0 1) ,此时吸烟组 15 F2 t Iso P的升高幅度显著高于非吸烟组 (P<0 .0 5 )。再灌注期 (T2、T3)吸烟组血浆 15 F2 t Iso P浓度下降速度较非吸烟组为慢 ,术后更多患者需血管活性药物支持。结论 吸烟者体内抗氧化能力降低 ,增加了心脏手术后心功能障碍的发生率。展开更多
文摘Background: Phosphodiesterase inhibitors (PDI) are used in cardiac surgery to improve and stabilize cardiac function after surgery. The aim of this study is to evaluate changes in hemodynamics and early outcomes when PDI (Inocor/inamrinone) is given in terminal warm blood cardioplegia to on-pump CABG only patients and compare results with patients who did not receive the drug. Material and methods: From April 2003 through September 2004 241 pts underwent elective on-pump CABG only surgery. 141 pts received Inocor in the terminal warm blood cardioplegia (Group 1) and 100 pts did not (Group 2). Results: Demographic data, preoperative EuroSCORE risk scores and operative details were similar. Of pts preoperatively in sinus rhythm (SR) 80.15% in Group 1 and 69.79% in Group 2 regained spontaneous SR (p = 0.07) after release of crossclamp. Inotropic support was needed in 5 pts in Group 1 and in 12 pts in Group 2, p = 0.02. Post cardiopulmonary by-pass (CPB) IABP support was needed for 4 pts in Group 2 and none for Group 1 pts, p = 0.01. There was no operative mortality in either Group and hospital/30 day mortality was similar (3/2.13% vs 3/3.00%, p = 0.69). There were no statistical difference in stay in postoperative intensive care unit (p = 0.15), total hospital stay (p = 0.07), appearance of postoperative atrial fibrillation (p = 0.23) or appearance of postoperative kidney injury (p = 0.27). Post CPB cardiac index improved 16.90% in Group1but decreased 1.49% in Group 2, p < 0.0001. Mean arterial pressure decreased 7.46%in Group 1 pts and 5.08% in Group 2 pts, p = 0.002, but no pts in either Group needed medication for too low blood pressure. Systemic vascular resistance decreased 28.40% in Group 1 and 9.02% in Group 2, p < 0.0001. Conclusions: Inamrinone in terminal warm blood cardioplegia (hot shot) is safe and effective way to improve and stabilize cardiac function after on-pump CABG surgery but does not affect short-term outcomes.
文摘目的 观察体外循环冠状动脉 (冠脉 )旁路移植术中吸烟患者血浆 15 F2 t isoprostane(15 F2 t Iso P)的变化及其与术后心功能恢复的关系。方法 选择 30例吸烟冠心病患者及 30例非吸烟冠心病患者 ,均在异丙酚、芬太尼复合麻醉及体外循环下行冠脉旁路移植术。分别于麻醉诱导后手术前 (T0 )、主动脉阻断后 30 m in(T1)、主动脉开放后 10 min(T2 )及 30 m in(T3)经中心静脉抽血 ,测血浆游离 15 F2 t Iso P浓度。结果 T0时吸烟及非吸烟组血浆 15 F2 t Iso P浓度差异无显著性。T1时两组血浆 15 F2 t Iso P显著升高 (与 T0比较 ,P均 <0 .0 1) ,此时吸烟组 15 F2 t Iso P的升高幅度显著高于非吸烟组 (P<0 .0 5 )。再灌注期 (T2、T3)吸烟组血浆 15 F2 t Iso P浓度下降速度较非吸烟组为慢 ,术后更多患者需血管活性药物支持。结论 吸烟者体内抗氧化能力降低 ,增加了心脏手术后心功能障碍的发生率。
