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Objective To evaluate the effect of dexmedetomidine on oxidative stress and pulmonary function in children with congenital heart disease after cardiopulmonary bypass. Methods From June 2016 to June 2018, fifty-five children who underwent ventricular septal or atrial defect repair under cardiopulmonary bypass in the First Affiliated Hospital of Zunyi Medical University were recruited and randomly divided into two groups: control group (group C) and dexmedetomidine group (group D). After tracheal intubation, patients of group D were received dexmedetomidine 0.5 ug/kg/h by intravenous pump until the end of operation. Patients of group C were received 0.9% physiological saline with the same volume. Heart rate, mean arterial pressure, oxygen saturation, bypass time, and computation of respiratory index (RI) and oxygenation index (OI) based on blood gas analysis, measured SOD, MDA and GSH in plasma, recording the time from the end of operation to the extubation of tracheal tube, the duration of stay in extracardiac ICU after operation, and pulmonary complications were followed up before infusion of dexmedetomidine (T0), sternal sawing (T1), CPB stopping (T2), and 24 hours after operation (T3). Results The changes of heart rate and mean arterial pressure in the two groups were within the normal range. There was no significant difference in plasma SOD, MDA and GSH between the two groups (P>0.05）. There was no difference in OI and RI at T0 and T1 time points (P>0.05). Compared with group C, OI was increased and RI was decreased in group D at T2 and T3 time points (P< 0.05). Compared with group C, group D had shorter ICU support time and extubation time, and fewer pulmonary complications after operation (P<0.05). Conclusion The treatment of 0.5 μg/kg/h dexmedetomidine can improve the respiratory function, reduce the pulmonary complications, and is conducive to the rehabilitation of children after CPB. But, this concentration cannot alleviate the oxidative stress reaction of children with CPB.
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Objective To study the influence of sivelestat sodium on platelets activity,injury and count during cardiopulmonary bypass (CPB)in dogs.Methods Twelve adult health dogs were randomly divided into control group (group C,n=6)and sivelestat sodium group (group S,n=6). Sivelestat sodium at 15 mg/kg was administrated intravenously before the establishment of CPB and then was maintained intravenously at 10 mg·kg-1·h-1 to the end of CPB in the group S,and the same volume of saline was used in the group S.The levels of neutrophil elastase (NE),malondialdehyde (MDA),granular membrane protein-140 (GMP-140),thromboxaneB2 (TXB2 ),the count of plate-lets and the hematocrit (Hct)were measured before CPB,15 and 45 min after cross-clamping and 30, and 60 min after aortic unclamping in both groups.Results The levels of NE,GMP-140,TXB2 at T2-T5 and MDA at T3-T5 were significantly higher than those at T1 in both groups;moreover the lev-els were significantly lower in group S than group C (P<0.05).The levels of Plt at T2-T5 were sig-nificantly lower than those at T1 in both groups;moreover the levels were significantly higher in group S than group C (P <0.05).Conclusion Sivelestat sodium reduced the levels of plasma NE, MDA,GMP-140,TXB2 inhibited the activation of Plt,and decreased the injury and consumption of Plt,which presents the protective effects for Plt during CPB.
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<p><b>OBJECTIVE</b>To observe the effect of Shenfu Injection (SFI) on erythrocyte immunity function of patients undergoing cardiopulmonary bypass (CPB).</p><p><b>METHODS</b>Twenty patients scheduled for valve replacement were randomly assigned to two groups, i.e. , the SFI group and the control group, 10 in each. SFI 1 mL/kg was intravenously dripped before induction of anesthesia and SFI 1 mL/kg administered in priming solution in the SFI group, while only normal saline was given to those in the control group. Venous blood samples (5 mL) were collected before induction of anesthesia (T1), 30 min CPB (T2), immediate by the end of CPB (T3), and postoperative 24 h (T4) respectively in all groups. The levels of the rosette rate of RBC-C3b receptor (RBC-C3bRR), the rosette rate of RBC-immune complex (RBC-ICR), plasma malondialdehyde (MDA), free hemoglobin (FHB), and interleukin-6 (IL-6) were detected.</p><p><b>RESULTS</b>There was no significant difference in the levels of RBC-C3bRR, RBC-ICR, plasma MDA, FHB, and IL-6 at T1 in both groups (P > 0.05). RBC-C3bRR at the rest time points was lower in the two groups than before induction of anesthesia. There was no statistical difference in FHB or IL-6 between T4 and T1 in the SFI group. The levels of RBC-ICR, MDA, FHB, and IL-6 increased in the two groups more than before induction of anesthesia at T2-4 ( P < 0.05). Besides, the RBC-C3b RR was lower, and levels of RBC-ICR, MDA, FHB, and IL-6 higher in the control group than in the SFI group, showing significant difference (P <0.05).</p><p><b>CONCLUSION</b>SFI could decrease the generation of inflammatory mediators during CPB, improve the erythrocyte immune function of patients during CPB, and reduce the risk of postoperative infection.</p>