Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial
A hypoxic–hyperoxic preconditioning (HHP) may be associated with cardioprotection by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients (<i>n</i> = 120) were randomly assigned to...
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MDPI AG
2023-03-01
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| Online Access: | https://www.mdpi.com/2227-9059/11/4/1044 |
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| author | Irina A. Mandel Yuriy K. Podoksenov Sergey L. Mikheev Irina V. Suhodolo Yulia S. Svirko Vladimir M. Shipulin Anastasia V. Ivanova Andrey G. Yavorovskiy Andrey I. Yaroshetskiy |
| author_facet | Irina A. Mandel Yuriy K. Podoksenov Sergey L. Mikheev Irina V. Suhodolo Yulia S. Svirko Vladimir M. Shipulin Anastasia V. Ivanova Andrey G. Yavorovskiy Andrey I. Yaroshetskiy |
| author_sort | Irina A. Mandel |
| collection | DOAJ |
| description | A hypoxic–hyperoxic preconditioning (HHP) may be associated with cardioprotection by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients (<i>n</i> = 120) were randomly assigned to an HHP and a control group. A safe, inhaled oxygen fraction for the hypoxic preconditioning phase (10–14% oxygen for 10 min) was determined by measuring the anaerobic threshold. At the hyperoxic phase, a 75–80% oxygen fraction was used for 30 min. The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs. 23 (41.1%), <i>p</i> = 0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low for more than 24 h in the control group. The endothelial damage markers appeared to be predictors of postoperative complications. The HHP with individual parameters based on the anaerobic threshold is a safe procedure, and it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications. |
| first_indexed | 2024-03-11T05:13:07Z |
| format | Article |
| id | doaj.art-7ab4489e6fe94b2fa6cd47527b57ae93 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T05:13:07Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-7ab4489e6fe94b2fa6cd47527b57ae932023-11-17T18:25:45ZengMDPI AGBiomedicines2227-90592023-03-01114104410.3390/biomedicines11041044Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical TrialIrina A. Mandel0Yuriy K. Podoksenov1Sergey L. Mikheev2Irina V. Suhodolo3Yulia S. Svirko4Vladimir M. Shipulin5Anastasia V. Ivanova6Andrey G. Yavorovskiy7Andrey I. Yaroshetskiy8Department of Anesthesiology and Intensive Care, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, RussiaDepartment of Anesthesiology and Intensive Care, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, RussiaDepartment of Cardiovascular Surgery, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, RussiaDepartment of Morphology and General Pathology, Siberian State Medical University, 634050 Tomsk, RussiaBiochemical Laboratory, Tomsk National Research Medical Center of the Russian Academy of Sciences, Cardiology Research Institute, 634012 Tomsk, RussiaDepartment of Hospital Surgery with a Cardiovascular Surgery Course, Siberian State Medical University, 634050 Tomsk, RussiaGeneral Medicine Faculty, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, RussiaDepartment of Anesthesiology and Intensive Care, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, RussiaDepartment of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, RussiaA hypoxic–hyperoxic preconditioning (HHP) may be associated with cardioprotection by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Patients (<i>n</i> = 120) were randomly assigned to an HHP and a control group. A safe, inhaled oxygen fraction for the hypoxic preconditioning phase (10–14% oxygen for 10 min) was determined by measuring the anaerobic threshold. At the hyperoxic phase, a 75–80% oxygen fraction was used for 30 min. The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs. 23 (41.1%), <i>p</i> = 0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low for more than 24 h in the control group. The endothelial damage markers appeared to be predictors of postoperative complications. The HHP with individual parameters based on the anaerobic threshold is a safe procedure, and it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications.https://www.mdpi.com/2227-9059/11/4/1044oxygen transportcardioprotectionhypoxic–hyperoxic preconditioningischemia-reperfusion injurycardiopulmonary bypassendothelial damage markers |
| spellingShingle | Irina A. Mandel Yuriy K. Podoksenov Sergey L. Mikheev Irina V. Suhodolo Yulia S. Svirko Vladimir M. Shipulin Anastasia V. Ivanova Andrey G. Yavorovskiy Andrey I. Yaroshetskiy Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial Biomedicines oxygen transport cardioprotection hypoxic–hyperoxic preconditioning ischemia-reperfusion injury cardiopulmonary bypass endothelial damage markers |
| title | Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial |
| title_full | Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial |
| title_fullStr | Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial |
| title_full_unstemmed | Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial |
| title_short | Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial |
| title_sort | endothelial function and hypoxic hyperoxic preconditioning in coronary surgery with a cardiopulmonary bypass randomized clinical trial |
| topic | oxygen transport cardioprotection hypoxic–hyperoxic preconditioning ischemia-reperfusion injury cardiopulmonary bypass endothelial damage markers |
| url | https://www.mdpi.com/2227-9059/11/4/1044 |
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