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J Cardiothorac Vasc Anesth. 2011 Dec;25(6):908-16. doi: 10.1053/j.jvca.2011.06.017. Epub 2011 Aug 25.

Preconditioning with repeated hyperbaric oxygen induces myocardial and cerebral protection in patients undergoing coronary artery bypass graft surgery: a prospective, randomized, controlled clinical trial.

Author information

1
Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

Abstract

OBJECTIVES:

To evaluate the cerebral and myocardial protective effects of hyperbaric oxygen preconditioning in both on-pump and off-pump coronary artery bypass graft surgery.

DESIGN:

A prospective, randomized, single-blinded study including patients scheduled for elective on-pump or off-pump surgery between December 2007 and February 2009.

SETTING:

A tertiary care university teaching hospital.

PARTICIPANTS:

Forty-nine elective on-pump or off-pump coronary artery bypass graft surgery patients.

INTERVENTIONS:

Patients were randomized to either the control (15 patients with on-pump procedure and 10 patients with off-pump procedure, respectively) or hyperbaric oxygen (HBO; 14 patients with on-pump procedure and 10 patients with off-pump procedure, respectively) groups. Patients in the HBO groups underwent preconditioning for 5 days before surgery.

MEASUREMENTS AND MAIN RESULTS:

On-pump coronary artery bypass graft surgery patients preconditioned with HBO had significant decreases in S100B protein, neuron-specific enolase, and troponin I perioperative serum levels compared with the on-pump control group. Postsurgically, patients in the on-pump HBO group had a reduced length of stay in the intensive care unit and a decreased use of inotropic drugs. Serum catalase activity 24 hours postoperatively was significantly increased compared with the on-pump control group. In the off-pump groups, there was no difference in any of the same parameters.

CONCLUSIONS:

Preconditioning with HBO resulted in both cerebral and cardiac protective effects as determined by biochemical markers of neuronal and myocardial injury and clinical outcomes in patients undergoing on-pump coronary artery bypass graft surgery. No protective effects were noted in off-pump coronary artery bypass graft surgery.

PMID:
21868252
DOI:
10.1053/j.jvca.2011.06.017
[Indexed for MEDLINE]

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