The Role of Protein C as an Inhibitor of Blood Clotting During Extracorporeal Circulation

Feindt, P.; Volkmer, I; Ut, Seyfert; Haack, Horst

doi:10.1055/s-2007-1019995

Cited by 27 publications

(3 citation statements)

References 8 publications

(9 reference statements)

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“…The values were corrected for hemodilution using the hematocrit. 5 Plasma creatine kinase MB-isoenzyme (CK-MB) activity was measured 3 times in every patient: 6 hours after CPB and on the 1st and 2nd postoperative days. ( p = 0.78), and significantly increased further at 20 h to 287.9 ± 62.9 ng•mL -1 ( p < 0.01) as shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Wei

Laurikka²,

Kuukasjärvi³

et al. 2003

Asian Cardiovasc Thorac Ann

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Plasma levels of sE-selectin, sP-selectin, and sICAM-1 were measured before anesthesia and at 0.5, 4, and 20 hours after cardiopulmonary bypass in 37 men undergoing coronary artery bypass surgery. Plasma sE-selectin remained close to the preoperative levels. The levels of sP-selectin increased significantly from 46.5 +/- 15.3 ng x mL(-1) to 69.3 +/- 39.6 ng x mL(-1) at 0.5 hours, 84.1 +/- 45.5 ng x mL(-1) at 4 hours, and 79.6 +/- 35.5 ng x mL(-1) at 20 hours. Plasma sICAM-1 levels decreased 0.5 hours after cardiopulmonary bypass, recovered at 4 hours, and showed a significant increase at 20 hours. The changes in plasma levels of adhesion molecules did not correlate with the duration of bypass or aortic crossclamping, hemodynamics, or creatine kinase-MB levels. However, sE-selectin and sICAM-1 levels increased considerably more in patients who needed norepinephrine in the intensive care unit. These results indicate that the transient changes in plasma levels of soluble adhesion molecules are not associated with postoperative myocardial injury in low-risk coronary grafting, although they correlate with the need for a vasopressor.

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Section: Methodsmentioning

confidence: 99%

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Wei

Laurikka²,

Kuukasjärvi³

et al. 2003

Asian Cardiovasc Thorac Ann

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“…The final two paired samples (35 and 45 minutes) were taken after weaning from cardiopulmonary bypass. The values of troponin T and CK-MB taken while on cardiopulmonary bypass were corrected for haemodilution by multiplying the measured component with a correction factor (CF) as described by Feindt et al 9:

CF = \frac{{PCV}_{o}}{{pPCV}_{o}} - \frac{{pPCV}_{1}}{{PCV}_{1}}

where PCV is packed cell volume (%), pPCV is plasma packed cell volume (100% − PCV%), 0 is the value before cardiopulmonary bypass, and 1 the value at the time of sampling.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative release of troponin T in coronary venous and arterial blood and its relation to recovery of left ventricular function and oxidative metabolism following coronary artery surgery

Koh¹,

Hooper²,

Kemp³

et al. 1998

Heart

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Objective-To investigate the intraoperative release of troponin T during uncomplicated coronary artery surgery and to determine its relation to ischaemic time and to recovery of left ventricular function and oxidative metabolism. Design-A prospective observational study. Setting-Cardiac surgical unit in a tertiary referral centre. Methods-Troponin T, creatine kinase, and lactate were analysed from arterial and coronary sinus samples taken before operation, and 1, 4, 6, 10, 20, 35, and 45 minutes after cross clamp release. Net myocardial troponin T release and lactate extraction were derived from their respective arteriovenous diVerences. Haemodynamic measurements were made using a thermodilution pulmonary artery catheter. Patients-45 patients, mean (SD) age 62 (9) years, with two or three vessel coronary artery disease and chronic stable angina undergoing routine coronary artery surgery. Results-Before operation, troponin T concentrations were not raised, but within one minute of cross clamp release they increased progressively in both coronary sinus and arterial blood for the entire 45 minutes of reperfusion studied. Coronary sinus troponin T concentrations were consistently higher than arterial concentrations at all time points (p < 0. Conclusions-Troponin T concentrations increased in every patient after cross clamp release, and were consistently higher in coronary sinus blood than in arterial blood, indicating net myocardial release of troponin T during the period of reperfusion. Intraoperative net troponin T release has functional significance, as it is closely related to ischaemic time and reflects delayed recovery of left ventricular function and oxidative metabolism; therefore, its measurement may contribute to the perioperative assessment of myocardial injury sustained during coronary artery surgery. (Heart 1998;80:341-348)

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“…The detection levels were 0.1, 0.5, 0.35 ng/ml for sE-selectin, sP-selectin, and sICAM-1, respectively. The values were corrected by hemodilution using the hematocrit [9]. Creatine kinase cardiac isoenzymemuscle-bound (CK-MB) release was analyzed three times in every patient: 6 hours after CPB and on the first and second postoperative days.…”

Section: Sample Collection and Analysismentioning

confidence: 99%

Soluble Adhesion Molecules and Myocardial Injury during Coronary Artery Bypass Grafting

et al. 2003

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Cardiopulmonary bypass is acknowledged to be one of the major causes of a complex systemic inflammatory response after cardiac surgery. Leukocyte‐endothelial binding followed by neutrophil migration appears to play a central role. These interactions are mediated by adhesion molecules on the surface of activated cells. The present study compared the perioperative levels of soluble adhesion molecules after coronary artery bypass grafting (CABG) in patients with or without cardiopulmonary bypass (CPB). Altogether, 9 patients underwent off‐pump revascularization and 11 did so with CPB. Plasma levels of soluble adhesion molecules sE‐selectin and sP‐selectin and soluble intercellular adhesion molecule‐1 (sICAM‐1) were measured before anesthesia induction and 1, 4, and 20 hours after reperfusion to the myocardium. The baseline plasma levels of the adhesion molecules were similar in the two groups. Perioperative levels of sE‐selectin remained the same and did not differ between groups. Plasma sP‐selectin increased in both groups, the change being significantly greater in the CPB group than that in the off‐pump group (p = 0.001). Plasma sICAM‐1 decreased during an early stage after CABG with CPB, recovering at 4 hours after reperfusion; and a significant increase in ICAM‐1 was observed 20 hours later. In the off‐pump group, sICAM‐1 levels did not change at 1 and 4 hours after reperfusion but increased 20 hours later. Postoperative creatine kinase–muscle bound (CK‐MB) levels were significantly higher in the CPB group than in the off‐pump group (p = 0.001). The change in sP‐selectin levels also showed a correlation with CK‐MB values (r = 0.676, p = 0.001). The results indicated that off‐pump revascularization is associated with reduced endothelial activation and myocardial injury.

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The Role of Protein C as an Inhibitor of Blood Clotting During Extracorporeal Circulation

Cited by 27 publications

References 8 publications

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Soluble Adhesion Molecules in Coronary Artery Bypass Surgery

Intraoperative release of troponin T in coronary venous and arterial blood and its relation to recovery of left ventricular function and oxidative metabolism following coronary artery surgery

Soluble Adhesion Molecules and Myocardial Injury during Coronary Artery Bypass Grafting

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