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Mass intraoperative endothelial glycocalyx shedding affects postoperative systemic inflammation response.
- Source :
-
BMC Anesthesiology . 2/26/2024, Vol. 24 Issue 1, p1-10. 10p. - Publication Year :
- 2024
-
Abstract
- Bacground: Off-pump coronary artery bypass graft (OPCABG) has a high incidence of postoperative systemic inflammation response syndrome (SIRS), and perioperative endothelial glycocalyx layer (EGL) disruption can be one of the predisposing factors. We hypothesized that EGL shedding happened earlier in OPCABG which can influence on postoperative SIRS, and sevoflurane might preserve EGL better than propofol. Methods: We randomly allocated 50 patients undergoing OPCABG to receive either sevoflurane-sufentanil or propofol-sufentanil anesthesia. Plasma syndecan-1, heparan sulfate (HS), atrial natriuretic peptide (ANP), IL-6, and cardiac troponin I (cTnI) were measured. Blood samples were collected at 6 timepoints: induction (T1), before grafting (T2), after grafting(T3), surgery done (T4), postoperative day1 (POD1,T5) and POD2 (T6). SIRS criteria and sequential organ failure assessment (SOFA) score were examined. Results: There were neither differences of syndecan-1, HS, IL-6 nor of SIRS criteria or SOFA score between the sevoflurane and propofol groups. All patients were pooled as a single group for further statistical analyses, plasma syndecan-1 (P < 0.001) and IL-6 (P < 0.001) increased significantly as a function of time; syndecan-1 increasing correlated significantly with the duration of coronary graft anastomosis (r = 0.329, P = 0.026). Syndecan-1(T3) correlated significantly with ANP(T3) (r = 0.0.354, P = 0.016) and IL-6 (T5) (r = 0.570, P < 0.001). The maximum value of IL-6 correlated significantly with SIRS (r = 0.378, P = 0.010), the maximum value of SOFA score (r = 0.399, P = 0.006) and ICU days (r = 0.306, P = 0.039). The maximum value of SOFA score correlated significantly with the occurrence of SIRS (r = 0.568, P < 0.001) and ICU days (r = 0.338, P = 0.022). Conclusions: OPCABG intraoperative early EGL shedding caused of grafts anastomosis greatly affected postoperative SIRS and SOFA score, sevoflurane did not clinically preserve EGL better. Trial registration: ChiCTR-IOR-17012535. Registered on 01/09/2017. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PROPOFOL
*INTERLEUKINS
*TROPONIN
*INTENSIVE care units
*LENGTH of stay in hospitals
*ENDOTHELIUM
*CORONARY artery bypass
*COMBINATION drug therapy
*SURGICAL anastomosis
*CELL membranes
*INTRAOPERATIVE care
*SYSTEMIC inflammatory response syndrome
*SUFENTANIL
*TREATMENT duration
*RANDOMIZED controlled trials
*GLYCOSAMINOGLYCANS
*ATRIAL natriuretic peptides
*SEVOFLURANE
*GLYCOPROTEINS
*DESCRIPTIVE statistics
*RESEARCH funding
*STATISTICAL sampling
*PHARMACODYNAMICS
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 24
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 175675469
- Full Text :
- https://doi.org/10.1186/s12871-024-02459-z