Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
J Cardiothorac Vasc Anesth. 2011 Dec;25(6):908-16. doi: 10.1053/j.jvca.2011.06.017. Epub 2011 Aug 25.
To evaluate the cerebral and myocardial protective effects of hyperbaric oxygen preconditioning in both on-pump and off-pump coronary artery bypass graft surgery.
A prospective, randomized, single-blinded study including patients scheduled for elective on-pump or off-pump surgery between December 2007 and February 2009.
A tertiary care university teaching hospital.
Forty-nine elective on-pump or off-pump coronary artery bypass graft surgery patients.
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.
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.
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.
评估高压氧预处理对体外循环和非体外循环冠状动脉旁路移植术的脑和心肌保护作用。
这是一项前瞻性、随机、单盲研究，纳入了 2007 年 12 月至 2009 年 2 月间择期行体外循环或非体外循环冠状动脉旁路移植术的患者。
一家三级护理大学教学医院。
49 例择期行体外循环或非体外循环冠状动脉旁路移植术的患者。
患者随机分为对照组（体外循环组各 15 例，非体外循环组各 10 例）或高压氧（HBO）组（体外循环组各 14 例，非体外循环组各 10 例）。HBO 组患者在术前 5 天进行预处理。
与体外循环对照组相比，HBO 预处理的体外循环冠状动脉旁路移植术患者围手术期 S100B 蛋白、神经元特异性烯醇化酶和肌钙蛋白 I 血清水平显著降低。术后，体外循环 HBO 组患者 ICU 住院时间缩短，正性肌力药物使用减少。术后 24 小时血清过氧化氢酶活性显著升高，与体外循环对照组相比差异有统计学意义。非体外循环组中，相同参数无差异。
体外循环冠状动脉旁路移植术患者采用 HBO 预处理，通过神经元和心肌损伤的生化标志物和临床结果确定具有脑和心肌保护作用。非体外循环冠状动脉旁路移植术无保护作用。
