New therapy in cardioprotection

Chow, Ka Ying; Liu, Sophie E.; Irwin, Michael G.

doi:10.1097/aco.0000000000000211

Cited by 5 publications

(3 citation statements)

References 57 publications

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“…Second, the anesthesia regimen adopted in this study, the sufentanil and midazolam infusion, is not common. The reason was that we would like to avoid the possible interaction between EI and inhaled anesthetics or propofol, both of which were proved to be cardioprotective as summarized in a very recent review 20 . But in clinical practice, the best anesthesia regimen should be explored to produce maximal cardioprotection in CPB patients.…”

Section: Discussionmentioning

confidence: 99%

Adding Emulsified Isoflurane to Cardioplegia Solution Produces Cardiac Protection in a Dog Cardiopulmonary Bypass Model

Huang

Zhou

Liu

et al. 2016

Sci Rep

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This study investigated whether caridoplegia solution with Emulsified Isoflurane (EI) could improve cardiaoprotection in a dog CPB model of great similarity to clinical settings. Adult dogs were randomly assigned to receive one of the following cardioplegia solutions: St. Thomas with EI (group ST+EI), St. Thomas with 30% Intralipid (group ST+EL) and St. Thomas alone (group ST). The aorta was cross-clamped for two hours followed by reperfusion for another two hours, during which cardiac output was measured and dosages of positive inotropic agent to maintain normal hemodynamics were recorded. Serum level of cardiac troponin I (cTnI) and CK-MB were measured. Deletion of cardiac mitochondrial DNA was examined at the end of reperfusion. Compared with ST, ST+EI decreased the requirement of dopamine support while animals receiving ST+EI had a significantly larger cardiac output. ST+EI reduced post-CPB release of cTnI and CK-MB. Mitochondrial DNA loss was observed in only one of the tested animals from group ST+EI while it was seen in all the tested animals from group ST+EL and ST. Addition of emulsified isoflurane into cardioplegia solution protects against myocardial ischemia reperfusion injury. This protective effect might be mediated by preserving mitochondrial ultrastructure and DNA integrity.

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Section: Discussionmentioning

confidence: 99%

Adding Emulsified Isoflurane to Cardioplegia Solution Produces Cardiac Protection in a Dog Cardiopulmonary Bypass Model

Huang

Zhou

Liu

et al. 2016

Sci Rep

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“…[646566] Recent study shows favorable effects on target and another organ system too. [6768] RIPC was first described by Przyntenk in 1993. He had classified the favorable outcomes as clinical, biochemical, and investigative.…”

Section: Gold Standard Concepts: Ischemic Preconditioning and Reperfumentioning

confidence: 99%

Preconditioning in cardiac anesthesia…… where are we?

Annachhatre

2019

Ann Card Anaesth

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Preconditioning, a milestone concept in the cardiovascular sciences introduced 32 years back by Murry. This concept opened a new era in the field of organ protection. To start with extensive studies done on ischemic preconditioning for myocardial protection, ischemic preconditioning is an endogenous science of cellular kinetics. Several components in signal transduction cascade have been identified but still some mechanisms not yet revealed. Anesthetic preconditioning also contributed a lot for myocardial protection and concreted the concept of preconditioning. We, with an inquisitive brain meticulously persuing newer methods of cardioprotection. Remote ischemic preconditioning (RIPC) is a brilliant example of it. RIPC can be future of cardioprotection, clinical trials and studies proved the benefits but yet to conclude the superiority of RIPC over myocardial ischemic cardioprotection. This review is an attempt to reveal this extraordinary concept with its basic cellular kinetics, methods, and recent trends.

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“…Current knowledge is insufficient to state whether there is any increased risk or possibly a protective effect [34]. There are two recent reviews around protection commenting that much of preclinical work is jet not confirmed in the clinical setting, it seems however reassuring to continue beta-blocking as well as statin therapy, possibly also to use halogenated inhaled anaesthetics although their animal effects has still not been conformed [35,36]. For non-cardiac surgery the choice of main anaesthetic halogenated inhaled agent or propofol seems not to have major impact [37].…”

Section: Not Only Anaesthesia But Potential Protection?mentioning

confidence: 99%

Safe Perioperative Practice, How Can We Further Improve Clinical Every Day Work?

Brattwall¹,

MW²

2015

J Perioper Crit Intensive Care Nurs

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Anaesthesia has become reassuringly safe. All modern anaesthetic agents are effective and associated to only minor side effects, anaesthetic machines and monitors helps delivery and closely in real time observation of vital signs. Anaesthesia practice has expanded and includes today perioperative care, preoperative assessment and optimisation, anaesthesia and postoperative care. Following the postoperative course up to day 30 after surgery is today of increasing interest and importance to document value based perioperative. Interprofessional care where the perioperative nurse has a major commitment will help to further improve the perioperative process.

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New therapy in cardioprotection

Cited by 5 publications

References 57 publications

Adding Emulsified Isoflurane to Cardioplegia Solution Produces Cardiac Protection in a Dog Cardiopulmonary Bypass Model

Adding Emulsified Isoflurane to Cardioplegia Solution Produces Cardiac Protection in a Dog Cardiopulmonary Bypass Model

Preconditioning in cardiac anesthesia…… where are we?

Safe Perioperative Practice, How Can We Further Improve Clinical Every Day Work?

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