Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass.

Binglin Yuan, Xiqiang Huang, Junlin Wen, Mengzhe Peng
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Abstract

Purpose: The study aims to assess the effects of dexmedetomidine (Dex) pretreatment on patients during cardiac valve replacement under cardiopulmonary bypass.

Methods: For patients in the Dex group (n = 52), 0.5 μg/kg Dex was given before anesthesia induction, followed by 0.5 μg/kg/h pumping injection before aortic occlusion. For patients in the control group (n = 52), 0.125 ml/kg normal saline was given instead of Dex.

Results: The patients in the Dex group had longer time to first dose of rescue propofol than the control group (P = 0.003). The Dex group required less total dosage of propofol than the control group (P = 0.0001). The levels of cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), malondialdehyde (MDA), and tumor necrosis factor-α (TNF-α) were lower in the Dex group than the control group at T4, 8 h after the operation (T5), and 24 h after the operation (T6) (P <0.01). The Dex group required less time for mechanical ventilation than the control group (P = 0.003).

Conclusion: The study suggests that 0.50 µg/kg Dex pretreatment could reduce propofol use and the duration of mechanical ventilation, and confer myocardial protection without increased adverse events during cardiac valve replacement.

右美托咪定预处理为心肺旁路下接受心脏瓣膜置换术的患者提供心肌保护并缩短机械通气时间
目的:本研究旨在评估右美托咪定(Dex)预处理对心肺旁路下心脏瓣膜置换术患者的影响:方法:对于右美托咪定组患者(n = 52),在麻醉诱导前给予 0.5 μg/kg 右美托咪定,然后在主动脉闭塞前进行 0.5 μg/kg/h 泵注。对照组患者(n = 52)使用 0.125 ml/kg 生理盐水代替地塞米松:结果:与对照组相比,地塞米松组患者首次使用抢救性异丙酚的时间更长(P = 0.003)。地塞米松组所需的异丙酚总剂量少于对照组(P = 0.0001)。在T4、术后8小时(T5)和术后24小时(T6),Dex组的心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、丙二醛(MDA)和肿瘤坏死因子-α(TNF-α)的水平均低于对照组(P 结论:该研究表明,0.50微克的Dex能显著降低心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、丙二醛(MDA)和肿瘤坏死因子-α(TNF-α)的水平:该研究表明,0.50 µg/kg Dex 预处理可减少异丙酚的使用和机械通气的持续时间,并在不增加心脏瓣膜置换术不良事件的情况下提供心肌保护。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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