Effect of preoperative inhaled budesonide on pulmonary injury after cardiopulmonary bypass: A randomized pilot study Wei Gao, MD, Na Li, MS, Zhe-hao.

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Presentation transcript:

Effect of preoperative inhaled budesonide on pulmonary injury after cardiopulmonary bypass: A randomized pilot study Wei Gao, MD, Na Li, MS, Zhe-hao Jin, MS, Xiang-qi Lv, MD, Xiao-guang Cui, MD The Journal of Thoracic and Cardiovascular Surgery Volume 157, Issue 1, Pages 272-284 (January 2019) DOI: 10.1016/j.jtcvs.2018.09.017 Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Flow diagram of patient enrollment. BALF, Bronchoalveolar lavage fluid; CPB, cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Dynamic changes of the Pao2/Fio2 ratio in the 2 groups (n = 30). Data are expressed as the mean ± standard deviation (SD) for each group (n = 30). () and () represent the saline and budesonide groups, respectively. The positive error bar represents the SD, and the negative error bar represents the 95% confidence interval. *P < .05 compared with the saline group. CPB, Cardiopulmonary bypass; Pao2/Fio2, partial pressure of arterial oxygen to the fraction of inspired oxygen. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Dynamic changes ventilation parameters in the 2 groups. Data are expressed as the mean ± SD for each group (n = 30). () and () represent the saline and budesonide groups, respectively. *P < .05 compared with the saline group. CPB, Cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 The cytokine concentrations in the BALF in the 2 groups (n = 30). Levels of TNF-α, C3a, C5a, CRP, and IL-10 in the BALF from individual patients. Data are expressed as box-plots of the median, interquartile range, and range for each group (n = 30). The black dots indicate the outliers in each group. () and () represent the saline and budesonide groups, respectively. *P < .05 compared with the saline group. BALF, Bronchoalveolar lavage fluid; CPB, cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 The cell infiltration and protein contents in the BALF in the 2 groups. Numbers of macrophages and neutrophils, and the concentrations of total protein and elastase in the BALF. Data are expressed as box-plots of the median, interquartile range, and range for each group (n = 30). The black dots indicate the outliers in each group. () and () represent the saline and budesonide groups, respectively. *P < .05 compared with the saline group (n = 30). BALF, Bronchoalveolar lavage fluid; CPB, cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Serum cytokine concentrations in the 2 groups (n = 30). Serum concentrations of TNF-α, C3a, C5a, CRP, and IL-10 in individual patients were determined. Data are expressed as the mean ± SD for each group (n = 30). () and () represent the saline and budesonide groups, respectively. *P < .05 compared with the saline group. TNF, Tumor necrosis factor; CPB, cardiopulmonary bypass; IL, interleukin; CRP, C-reactive protein. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Preoperative budesonide improved the Pao2/Fio2 after CPB. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Thoracotomy procedure. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32518-2/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 2 Cannulation of the aorta and vena cava. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32518-2/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 3 CPB procedure. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32518-2/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 4 Procedure for sternal closure. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32518-2/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 5 Treatment of patients in the ICU. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32518-2/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 272-284DOI: (10.1016/j.jtcvs.2018.09.017) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions