A prospective, randomized study of endothelin and postoperative recovery in off-pump versus conventional coronary artery bypass surgery

Dorman, B. Hugh; Kratz, John M.; Multani, T. Marlina M.; Baron, Thoracotomy; Farrar, E; Walton, Ted; Payne, Kim; Ikonomiois, John; Reeves, Thomas; Mukherjee, Rupak; Spinale, Francis G.

doi:10.1053/j.jvca.2003.10.005

Cited by 34 publications

(14 citation statements)

References 29 publications

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“…Using the well-established severity indicators, duration of CPB, duration of mechanical ventilation, length of stay at the PICU and IS [13], we found negative correlations between the duration of CPB and adiponectin levels at the end of surgery and at 6 hours after arrival to the PICU ( r = −0.438, P = 0.037 and r = −0.488, P = 0.021, resp.). There was also a negative correlation between adiponectin levels and log of length of stay in the PICU, starting from the time of arrival to the PICU ( r = −0.457, P = 0.025) (Figure 4) and up to 12 hours afterwards ( r = −0.495, P = 0.016).…”

Section: Resultsmentioning

confidence: 95%

Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

Thaler

Kanety

Avni

et al. 2013

BioMed Research International

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Background. Adipose tissue is an important endocrine organ that secretes cytokines, including adiponectin, levels of which are negatively correlated with the severity of the inflammatory process. Aim. To assess the time course of adiponectin levels following open heart surgery with cardiopulmonary bypass and its correlation with early postoperative outcomes. Materials and Methods. Blood samples were obtained from 24 children undergoing cardiac surgery and analyzed for adiponectin, C-reactive protein, and other inflammatory markers. Results. Baseline adiponectin levels were negatively correlated with patients' preoperative weight and age. Postoperative adiponectin levels decreased compared to baseline (P = 0.01) and correlated negatively with duration of cardiopulmonary bypass (r = −0.438, P = 0.037), length of stay in the pediatric intensive care unit (r = −0.457, P = 0.025), and the inotropic score (r = −0.471, P = 0.02). Adiponectin levels were positively correlated with sVCAM 1 levels; however, there was no correlation between adiponectin levels and sP selectin, tPA, MCP1, and sCD40. Conclusions. The inflammatory response after open heart surgery with cardiopulmonary bypass is associated with a reduction in adiponectin levels. Prolonged or more complicated surgery induced a more substantial inflammatory process characterized by a significant reduction in adiponectin levels over time and a delayed return to baseline levels.

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Section: Resultsmentioning

confidence: 95%

Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

Thaler

Kanety

Avni

et al. 2013

BioMed Research International

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“…The reported incidence of conversion from off-pump technique to CPB in the literature may be underestimated not only in case series but also in randomized controlled studies [6]: sometimes, patients who required conversion from off-pump to CPB are only briefly mentioned and either excluded from the analysis [15][16][17][18] or included in the CPB group [19,20], not following the intention to treat analysis. The incidence of conversions is variable, ranging from 1.6% to 13.3% in reports focusing on this aspect [7][8][9][10][11][12][13][14], with a high mortality rate (8.3-18%).…”

Section: Discussionmentioning

confidence: 99%

The outcome of patients requiring emergency conversion from off-pump to on-pump coronary artery bypass grafting

Landoni

Pappalardo

Crescenzi

et al. 2007

European Journal of Anaesthesiology

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“…26 Lastly, IL-1β and TNF-α stimulate endothelial cell production of proinflammatory cytokines, IL-1, IL-6, IL-8, MCP-1, and PAF. 25 In a prospective, randomized study, Dorman et al 27 measured endothelin plasma content from patients undergoing coronary artery bypass grafting using either OPCAB (n = 25) or conventional cardiopulmonary bypass (CPB group, n = 25) before surgery, before and after coronary artery anastomosis, and 6 and 24 hours postoperatively. They also documented specific indices of patient recovery including pulmonary artery pressures, ventilation requirement, and hospital stay.…”

Section: Opcab and Endothelial Cellsmentioning

confidence: 99%

Impact of Off-Pump Coronary Artery Bypass Surgery on Systemic Inflammation: Current Best Available Evidence

2007

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The systemic inflammatory response after coronary artery bypass grafting using cardiopulmonary bypass (CPB) contributes substantially to postoperative organ dysfunction and coagulation disorders. Important features of this inflammatory reaction include the activation of complement and leukocytes, the release of proinflammatory cytokines, alterations in the metabolism of nitric oxide, and an increase in the production of oxygen-free radicals, which in some cases may lead to oxidant stress injury. Several strategies including the use of steroids, use of aprotinin, heparin-coated CPB circuits, and hemofiltration have been reported to reduce the inflammatory reaction induced by CPB and its consequences. A more radical and effective way of counteracting the effects of the inflammatory reaction and oxidative stress may be the omission of CPB itself. The development and application of off-pump coronary artery bypass (OPCAB) technology has largely been driven by this theme of avoiding systemic inflammatory reaction to decrease the incidence and/or severity of adverse outcomes. This review article discusses the influence of cardiopulmonary bypass on systemic inflammation and attempts to evaluate the current best available evidence on the impact of OPCAB on systemic inflammation.

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A prospective, randomized study of endothelin and postoperative recovery in off-pump versus conventional coronary artery bypass surgery

Cited by 34 publications

References 29 publications

Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

Postoperative Adiponectin Levels in Pediatric Patients Undergoing Open Heart Surgery

The outcome of patients requiring emergency conversion from off-pump to on-pump coronary artery bypass grafting

Impact of Off-Pump Coronary Artery Bypass Surgery on Systemic Inflammation: Current Best Available Evidence

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