Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Stockholm Center for Spine Surgery (RKC), Stockholm, Sweden.
Br J Anaesth. 2021 Oct;127(4):547-555. doi: 10.1016/j.bja.2021.06.046. Epub 2021 Aug 14.
Nitric oxide (NO) is an important signalling molecule in the cardiovascular system with protective properties in ischaemia-reperfusion injury. Inorganic nitrate, an oxidation product of endogenous NO production and a constituent in our diet, can be recycled back to bioactive NO. We investigated if preoperative administration of inorganic nitrate could reduce troponin T release and other plasma markers of injury to the heart, liver, kidney, and brain in patients undergoing cardiac surgery.
This single-centre, randomised, double-blind, placebo-controlled trial included 82 patients undergoing coronary artery bypass surgery with cardiopulmonary bypass. Oral sodium nitrate (700 mg×2) or placebo (NaCl) were administered before surgery. Biomarkers of ischaemia-reperfusion injury and plasma nitrate and nitrite were collected before and up to 72 h after surgery. Troponin T release was our predefined primary endpoint and biomarkers of renal, liver, and brain injury were secondary endpoints.
Plasma concentrations of nitrate and nitrite were elevated in nitrate-treated patients compared with placebo. The 72-h release of troponin T did not differ between groups. Other plasma biomarkers of organ injury were also similar between groups. Blood loss was not a predefined outcome parameter, but perioperative bleeding was 18% less in nitrate-treated patients compared with controls.
Preoperative administration of inorganic nitrate did not influence troponin T release or other plasma biomarkers of organ injury in cardiac surgery.
NCT01348971.
一氧化氮（NO）是心血管系统中的一种重要信号分子，具有缺血再灌注损伤的保护作用。无机硝酸盐是内源性 NO 产生的氧化产物，也是我们饮食的一部分，可以被重新循环回具有生物活性的 NO。我们研究了术前给予无机硝酸盐是否可以减少心脏手术患者肌钙蛋白 T 释放和其他血浆标志物的损伤，包括心脏、肝脏、肾脏和大脑。
这是一项单中心、随机、双盲、安慰剂对照试验，纳入了 82 例行体外循环冠状动脉旁路移植术的患者。术前给予口服硝酸钠（700mg×2）或安慰剂（NaCl）。收集手术前和手术后 72 小时内的缺血再灌注损伤的生物标志物以及血浆硝酸盐和亚硝酸盐。肌钙蛋白 T 释放是我们预先设定的主要终点，其他肾脏、肝脏和大脑损伤的生物标志物是次要终点。
与安慰剂组相比，硝酸盐治疗组的血浆硝酸盐和亚硝酸盐浓度升高。两组间 72 小时肌钙蛋白 T 释放无差异。其他器官损伤的血浆生物标志物也相似。术中出血量不是预先设定的结果参数，但与对照组相比，硝酸盐治疗组的围手术期出血量减少了 18%。
术前给予无机硝酸盐不会影响心脏手术中的肌钙蛋白 T 释放或其他血浆标志物的器官损伤。
NCT01348971。
Zotero 插件
