The mechanism of erythrocyte injury during cardiopulmonary bypass in children and the protective effect of propofol / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the relationship between erythrocyte injury and intracellular calcium ion overload and the protective effect of propoful on erythrocytes during cardiopulmonary bypass(CPB) Methods Thirty children (male 21,female 9) with congential heart disease scheduled for elective open heart surgery with CPB were randomly divided into two groups control group (C) and propoful group (P) The congential heart disease included ventricular septal defect (17 patients) and atrial septal defect (13 patients) The age ranged from 2 10 yr and body weight 10 35kg Anesthesia was induced with fentanyl 20 ?g/kg and vecuronime 0 1mg/kg in both groups and maintained with low concentration of isoflurane inhalation in group C and propofol intravenous infusion at a rate of 6mg?kg -1 ?h -1 in group P Blood samples were taken before and 20 min after CPB was began, at the end of CPB and 2 and 4h after CPB for determination of intracellular calcium ion content (E Ca 2+ ), Ca 2+ ,Mg 2+ ATPase and Na +, K + ATPase activities, erythrocyte filtration index(IF), mean corpuscular volume (MCV) and plasma free hemoglobin concentration (F Hb) Results In control group E Ca 2+ ,IF,MCV and F Hb gradually increased and Ca 2+ ,Mg 2+ ATPase and Na +,K + ATPase activities decreased during CPB The increase in E Ca 2+ was linearly paralleled to IF,MCV and F Hb There was no significant change in all the above mentioned parameters The difference in these parameters was significant between the two groups Conclusions The study suggests that erythrocyte injury is related to the increase in intracellular calcium ion during CPB and propoful has a protective effect on erythrocyte against injury due to its abilities to scavenge free radical and inhibit calcium channel