Effect of Staged Preconditioning on Biochemical Markers in the Patients Undergoing Coronary Artery Bypass Grafting

Abstract

The present study has investigated the effectiveness of staged-preconditioning, in both remote and target organs. After IP the myocardial release of the biochemical markers including, creatine phosphokinase (CPK), cardiac creatine kinase (CK-MB), cardiac troponin T (cTnT) and lactate dehydrogenase (LDH) were evaluated in patients who underwent CABG, with and without staged-preconditioning. Sixty-one patients entered the study; there were 32 patients in the staged-preconditioning group and 29 patients in the control group. All patients underwent on-pump CABG using cardiopulmonary bypass (CPB) techniques. In the staged-preconditioning group, patients underwent two stages of IP on remote (upper limb) and target organs. Each stage of preconditioning was carried out by 3 cycles of ischemia and then reperfusion. Serum levels of biochemical markers were immediately measured postoperatively at 24, 48 and 72 h. Serum CK-MB, CPK and LDH levels were significantly lower in the staged-preconditioning group than in the control group. The CK-MB release in the staged-preconditioning patients reduced by 51% in comparison with controls over 72 h after CABG. These results suggest that myocardial injury was attenuated by the effect of three rounds of both remote and target organ IP.

Pulsatile versus non-pulsatile perfusion in coronary artery bypass operation: The comparison of laboratory and clinical outcomes

“…A previous study with not well-described pulsatile perfusion method showed that the LDH levels at 48 and 72 h after operation were significantly higher in the non-pulsatile perfusion, which needs further considerations. 25 Although controversial, the degree of organ injuries, mainly liver and kidney, seem similar in our investigated patients. Therefore, we suppose that nonpulsatile flow could be applied confidently in selected patient populations.…”

“…A previous study with not well-described pulsatile perfusion method showed that the LDH levels at 48 and 72 h after operation were significantly higher in the non-pulsatile perfusion, which needs further considerations. 25…”

Sleep Quality after Coronary Artery Bypass Graft Surgery: Comparing Pulsatile and Nonpulsatile Pump Flow

“…CPB can cause body organ malperfusion and dysfunction (17)(18)(19). Loss of pulsatility of pump flow is one of the items which may be responsible for organ malperfusion (20,21) and worse blood microcirculation (11,22). It is still controversial whether maintaining pulsatile flow is associated with less end-organ damage or not (23,24).…”