Profound haemodilution during normothermic cardiopulmonary bypass influences neither gastrointestinal permeability nor cytokine release in coronary artery.

Slides:

Advertisements

Similar presentations

Reply from the authors British Journal of Anaesthesia

Advertisements

Impact of xenon anaesthesia in isolated cardiopulmonary bypass on very early leucocyte and platelet activation and clearance: a randomized, controlled.

Functional walking capacity as an outcome measure of laparoscopic prostatectomy: the effect of lidocaine infusion S. Lauwick, D.J. Kim, G. Mistraletti,

Reduced clearance of rocuronium and sugammadex in patients with severe to end- stage renal failure: a pharmacokinetic study† L.M. Staals, M.M.J. Snoeck,

M. Daunderer, M. S. Feuerecker, B. Scheller, N. B. Pape, D

Melatonin and structurally similar compounds have differing effects on inflammation and mitochondrial function in endothelial cells under conditions mimicking.

Coronary artery bypass grafting in the awake patient combining high thoracic epidural and femoral nerve block: first series of 15 patients N. Noiseux,

High concentrations of N-BNP are related to non-infectious severe SIRS associated with cardiovascular dysfunction occurring after off-pump coronary artery.

Comparison of alfentanil, fentanyl and sufentanil for total intravenous anaesthesia with propofol in patients undergoing coronary artery bypass surgery†

Changes in the effect of propofol in response to altered plasma protein binding during normothermic cardiopulmonary bypass E Takizawa, H Hiraoka, D Takizawa,

Changes in glomerular filtration rate after cardiac surgery with cardiopulmonary bypass in patients with mild preoperative renal dysfunction B.G. Loef,

Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state P.S.

M. Boutonnet, V. Faitot, A. Katz, L. Salomon, H. Keita

Ventilatory ratio: a simple bedside measure of ventilation

Effects of dexamethasone on clinical course, C-reactive protein, S100B protein and von Willebrand factor antigen after paediatric cardiac surgery L Lindberg,

R.S. Bondok, A.M. Abd El-Hady British Journal of Anaesthesia

J.-Y. Hwang, H.-S. Na, Y.-T. Jeon, Y.-J. Ro, C.-S. Kim, S.-H. Do

Effect of low-dose ketamine on inflammatory response in off-pump coronary artery bypass graft surgery J.E. Cho, J.K. Shim, Y.S. Choi, D.H. Kim, S.W.

Relationship Between Antiinflammatory Cytokine Interleukin-10 and Lactate Concentrations in Neonates Undergoing the Arterial Switch Operation Kyrylo.

T. Ledowski, J. Burke, J. Hruby British Journal of Anaesthesia

A. Duma, C. Wagner, M. Titz, M. Maleczek, M. Hüpfl, V. B. Weihs, E

Reduced cerebral oxygen saturation measured by absolute cerebral oximetry during thoracic surgery correlates with postoperative complications R. Kazan,

Effects of cardiopulmonary bypass on neurocognitive performance and cytokine release in old and diabetic rats F. de Lange, J.M. Dieleman, B. Jungwirth,

Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials M.T. Giglio,

Measuring quality of recovery-15 after day case surgery

Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery† O. Ahlers, I.

A. Dyson, N. Ekbal, M. Stotz, S. Barnes, J. Carré, S. Tully, S

D.H.J. Davis, M. Oliver, A.J. Byrne British Journal of Anaesthesia

W. Ruppen, L. A. Steiner, J. Drewe, L. Hauenstein, S. Brugger, M. D

Xenon has no effect on cytokine balance and adhesion molecule expression within an isolated cardiopulmonary bypass system†‡ A. Bedi, W.T. McBride, M.A.

Premedication with controlled-release oxycodone does not improve management of postoperative pain after day-case gynaecological laparoscopic surgery

K.J. Chin British Journal of Anaesthesia

Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol–remifentanil anaesthesia M. Gruenewald, C. Ilies, J. Herz,

A. Abdelnasser, B. Abdelhamid, A. Elsonbaty, A. Hasanin, A. Rady

D. Jee, D. Lee, S. Yun, C. Lee British Journal of Anaesthesia

Saliva cyclic GMP increases during anaesthesia

Diastolic dysfunction, cardiopulmonary bypass, and atrial fibrillation after coronary artery bypass graft surgery C.M. Ashes, M. Yu, M. Meineri, R. Katznelson,

Changes in serum albumin concentration and volume expanding effects following a bolus of albumin 20% in septic patients Margarson M.P. , Soni N.C.

Defining oliguria during cardiopulmonary bypass and its relationship with cardiac surgery–associated acute kidney injury D. Hori, N.M. Katz, D.M. Fine,

V. Uppal, G. Fletcher, J. Kinsella British Journal of Anaesthesia

Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery S.R. El Azab, P.M.J. Rosseel, J.J. de Lange, A.B.J. Groeneveld,

The output of two sevoflurane vaporizers in the presence of helium

J.E. Heavner, A.D. Kaye, B.-K. Lin, T. King

Β2 Adrenergic antagonist inhibits cerebral cortical oxygen delivery after severe haemodilution in rats G.M.T. Hare, J.M.A. Worrall, A.J. Baker, E. Liu,

Differential modulation of interleukin‐6 and interleukin‐10 by diclofenac in patients undergoing major surgery A.M. Mahdy, H.F. Galley, M.A. Abdel‐Wahed,

Mudassir I Dar, Timothy Gillott, Franco Ciulli, MD, Graham J Cooper

Recovery of fibrinogen after administration of fibrinogen concentrate to patients with severe bleeding after cardiopulmonary bypass surgery C. Solomon,

Optimizing cerebral oxygenation in anaesthetized patients with carotid artery stenosis: the influence of inspired oxygen fraction P. Picton, S.K. Ramachandran,

Effect of anaesthesia and cardiopulmonary bypass on blood endocannabinoid concentrations during cardiac surgery F Weis, A Beiras-Fernandez, D Hauer,

E. -H. Lee, H. -M. Lee, C. -H. Chung, J. -H. Chin, D. -K. Choi, H. -J

Stress response during weaning after cardiac surgery

Jon B. Meddings, Ian Gibbons Gastroenterology

M. D. Bould, M. A. Hayter, D. M. Campbell, D. B. Chandra, H. S. Joo, V

Significant decrease of cerebral oxygen saturation during single-lung ventilation measured using absolute oximetry T.M. Hemmerling, M.C. Bluteau, R.

Comparison of ropivacaine 0. 5% (in glucose 5%) with bupivacaine 0

Rocuronium plasma concentrations during three phases of liver transplantation: relationship with early postoperative graft liver function†‡ L. Gao, I.

Relationship of the functional recovery after hip arthroplasty to the neuroendocrine and inflammatory responses† G.M. Hall, D. Peerbhoy, A. Shenkin,

Use of a high-fidelity simulator to develop testing of the technical performance of novice anaesthetists† F.C. Forrest, M.A. Taylor, K. Postlethwaite,

B.H. Cuthbertson, S.A. Stott, N.R. Webster

Fibrinogen plasma concentration before delivery is not associated with postpartum haemorrhage: a prospective observational study O. Karlsson, A. Jeppsson,

The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients.

Adding lactate to the prime solution during hypothermic cardiopulmonary bypass: a quantitative acid–base analysis D. Himpe, H. Neels, S. De Hert, P.

Rocuronium dose-dependently suppresses the spectral entropy response to tracheal intubation during propofol anaesthesia M. Kawaguchi, I. Takamatsu, T.

Controlled hypotension for middle ear surgery: a comparison between remifentanil and magnesium sulphate† J.-H. Ryu, I.-S. Sohn, S.-H. Do British Journal.

Hypothermic responses to infection are inhibited by α2-adrenoceptor agonists with possible clinical implications S. Tolchard, P.A. Burns, D.J. Nutt,

S.J. Olday, R. Walpole, J.Y.Y. Wang British Journal of Anaesthesia

Levosimendan pre-treatment improves outcomes in patients undergoing coronary artery bypass graft surgery† L. Tritapepe, V. De Santis, D. Vitale, F. Guarracino,

Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter after radical retropubic prostatectomy† P. Tauzin-Fin, M. Sesay,

Monitoring level of sedation with bispectral EEG analysis: comparison between hypothermic and normothermic cardiopulmonary bypass† D. Schmidlin, P. Hager,

Plasma lidocaine concentrations following insertion of 2% lidocaine gel into the uterine cavity after uterine balloon thermal ablation G.F. Rousseau,

Presentation transcript:

Profound haemodilution during normothermic cardiopulmonary bypass influences neither gastrointestinal permeability nor cytokine release in coronary artery bypass graft surgery K. Berger, M. Sander, C.D. Spies, L. Weymann, S. Bühner, H. Lochs, K.-D. Wernecke, C. von Heymann British Journal of Anaesthesia Volume 103, Issue 4, Pages 511-517 (October 2009) DOI: 10.1093/bja/aep201 Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 1 Triple-sugar test: urine excretion, before and after surgery. Results are given as box and whisker plots showing the median, IQR, and range. (a) Mannitol: the concentration was always within normal limits (<27%) and median values did not differ between the groups before surgery (P=0.439). After surgery, mannitol excretion was significantly reduced in both groups (§P<0.05), without significant differences between study groups: 20% haematocrit group 5.4% (2.7−6.7%) and 25% haematocrit group 2.9% (1.5−7.0%). (b) Lactulose: the urine excretion was within normal limits (<0.44%). After surgery, lactulose excretion was significantly increased in the 20% group (§P<0.05). There were no differences of lactulose excretion between the groups either before (P=0.940) or after surgery: 20% haematocrit group 1.2% (0.5−3.0%) and 25% haematocrit group 0.8% (0.3−1.4%). (c) Sucrose: after surgery, sucrose excretion was significantly increased in both groups (§P<0.05). The groups did not differ before surgery or after surgery: 20% haematocrit group 1.23% (0.4−3.2%) and 25% haematocrit group 0.65% (0.3−1.4%). British Journal of Anaesthesia 2009 103, 511-517DOI: (10.1093/bja/aep201) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 2 PI before and after surgery. The PI was calculated by dividing urinary lactulose excretion by mannitol excretion (reference range: lactulose %/mannitol %: <0.03%). The postoperative PI was not different between the groups either before surgery or after surgery. British Journal of Anaesthesia 2009 103, 511-517DOI: (10.1093/bja/aep201) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 3 IL-6/IL-10 plasma concentrations. Results are given as median and range. Measurements took place before and 30 min during surgery and at ICU after 1, 6, and 18 h. (a) IL-6 (pg ml−1) showed low levels before surgery, reached the peak 1 h after surgery at the ICU and declined within the first 6 h after surgery. There was no difference between the study groups (P=0.78). (b) IL-10 (pg ml−1) showed highest plasma concentration 1 h after surgery and declined continuously afterwards, but never reached the initial values. There was no difference between the study groups. British Journal of Anaesthesia 2009 103, 511-517DOI: (10.1093/bja/aep201) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions

Fig 4 Baseline values of TNFα plasma concentration. Results are given as median and range. TNFα plasma concentration was measured at five measure points, before surgery, and 30 min during, after 1, 6, and 18 h at ICU. Over the study period, TNFα reached the highest levels in both groups 30 min after start of CPB [haematocrit 20% group: 8.20 pg ml−1 (25th−75th quartiles: 6.27–9.08 pg ml−1); haematocrit 25% group: 8.29 pg ml−1 (25th−75th quartiles: 7.53–9.27 pg ml−1)]. Only at 30 min after start of CPB, TNFα plasma levels were significantly increased (§20% P=0.03 and §25% P=0.008) compared with baseline. Between the groups, there were no differences over the study period (P=0.67). British Journal of Anaesthesia 2009 103, 511-517DOI: (10.1093/bja/aep201) Copyright © 2009 British Journal of Anaesthesia Terms and Conditions