Effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing valvular heart surgery

Jeong Soo Lee, Jong Chan Kim, Joo Young Chung, Seong Wook Hong, Kil Hwan Choi, Young Lan Kwak

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Valvular heart surgery (VHS) utilizing cardiopulmonary bypass (CPB) is inevitably associated with ischemic-perfusion injury, which is known to depend on oxygen tension during reperfusion. The aim of this study was to evaluate the effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing VHS. Methods: Fifty-six patients undergoing isolated VHS were randomly exposed to an oxygen fraction of 0.7 (hyperoxic group, n = 28) or 0.5 (normoxic group, n = 28) during reperfusion. All patients received an oxygen fraction of 0.7 during CPB. In the normoxic group, the oxygen fraction was lowered to 0.5 from the last warm cardioplegia administration to 1 minute after aortic unclamping, and was then raised back to 0.7. Hemodynamic data were measured after induction of anesthesia, weaning from CPB, and sternum closure. The frequency of cardiotonic medications used during and after weaning from CPB, and the short-term outcomes during the hospital stay were also assessed. Results: The frequency of vasopressin and milrinone use during weaning from CPB, but not norepinephrine, was significantly less in the normoxic group. The post-operative cardiac enzyme levels and short-term outcomes were not different between the groups. Conclusions: Normoxic reperfusion from the last cardioplegia administration to 1 minute after aortic unclamping in patients undergoing VHS resulted in significantly less frequent use of vasopressin and inotropics during weaning from CPB than hyperoxic reperfusion, although it did not affect the post-operative myocardial enzyme release or short-term prognosis.

Original languageEnglish
Pages (from-to)122-128
Number of pages7
JournalKorean Journal of Anesthesiology
Volume58
Issue number2
DOIs
Publication statusPublished - 2010 Feb 1

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Myocardial Reperfusion
Cardiopulmonary Bypass
Thoracic Surgery
Arterial Pressure
Oxygen
Weaning
Reperfusion
Induced Heart Arrest
Vasopressins
Milrinone
Cardiotonic Agents
Sternum
Enzymes
Length of Stay
Norepinephrine
Anesthesia
Perfusion
Hemodynamics
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Lee, Jeong Soo ; Kim, Jong Chan ; Chung, Joo Young ; Hong, Seong Wook ; Choi, Kil Hwan ; Kwak, Young Lan. / Effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing valvular heart surgery. In: Korean Journal of Anesthesiology. 2010 ; Vol. 58, No. 2. pp. 122-128.
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Effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing valvular heart surgery. / Lee, Jeong Soo; Kim, Jong Chan; Chung, Joo Young; Hong, Seong Wook; Choi, Kil Hwan; Kwak, Young Lan.

In: Korean Journal of Anesthesiology, Vol. 58, No. 2, 01.02.2010, p. 122-128.

Research output: Contribution to journalArticle

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T1 - Effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing valvular heart surgery

AU - Lee, Jeong Soo

AU - Kim, Jong Chan

AU - Chung, Joo Young

AU - Hong, Seong Wook

AU - Choi, Kil Hwan

AU - Kwak, Young Lan

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N2 - Background: Valvular heart surgery (VHS) utilizing cardiopulmonary bypass (CPB) is inevitably associated with ischemic-perfusion injury, which is known to depend on oxygen tension during reperfusion. The aim of this study was to evaluate the effect of arterial oxygen tension during reperfusion on myocardial recovery in patients undergoing VHS. Methods: Fifty-six patients undergoing isolated VHS were randomly exposed to an oxygen fraction of 0.7 (hyperoxic group, n = 28) or 0.5 (normoxic group, n = 28) during reperfusion. All patients received an oxygen fraction of 0.7 during CPB. In the normoxic group, the oxygen fraction was lowered to 0.5 from the last warm cardioplegia administration to 1 minute after aortic unclamping, and was then raised back to 0.7. Hemodynamic data were measured after induction of anesthesia, weaning from CPB, and sternum closure. The frequency of cardiotonic medications used during and after weaning from CPB, and the short-term outcomes during the hospital stay were also assessed. Results: The frequency of vasopressin and milrinone use during weaning from CPB, but not norepinephrine, was significantly less in the normoxic group. The post-operative cardiac enzyme levels and short-term outcomes were not different between the groups. Conclusions: Normoxic reperfusion from the last cardioplegia administration to 1 minute after aortic unclamping in patients undergoing VHS resulted in significantly less frequent use of vasopressin and inotropics during weaning from CPB than hyperoxic reperfusion, although it did not affect the post-operative myocardial enzyme release or short-term prognosis.

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