Effects of dexmedetomidine on oxidative stress and pulmonary function in children with cardiopulmonary bypass / 医学研究生学报

ABSTRACT

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.