Effect of Dexmedetomidine Preconditioning on Myocardial Ischemia-reperfusion Injury in Patients Undergoing Open Heart Surgery With Cardiopulmonary Bypass
Study Details
Study Description
Brief Summary
About 200000 cardiac operations are performed in China every year. Cardiopulmonary bypass is the basic strategy of open-heart surgery, which may lead to myocardial ischemia-reperfusion injury and low cardiac output syndrome. It will inevitably affect the patient's postoperative recovery. A number of studies have shown that dexmedetomidine, as an auxiliary sedative, has the effects of inhibiting stress response, antiarrhythmia and cardiac protection.Dexmedetomidine has been widely used in anesthesia in cardiac surgery. However, at present, few clinical studies pay attention to its mechanism. In this study, dexmedetomidine will be used in cardiac surgery with cardiopulmonary bypass to explore the mechanism of cardiac ischemia-reperfusion injury and the protective effect of dexmedetomidine.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 4 |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Group D The participant will be infused with dexmedetomidine during anesthesia to protect the myocardium. |
Drug: dexmedetomidine
The participant will pump dexmedetomidine at the rate of 1μg/(Kg·h) for 10 minutes at the beginning of anesthesia induction, and then maintain the pump at a rate of 0.5μg/(Kg·h) during the operation.
|
| Placebo Comparator: Group R The participant will use saline of the same volume as dexmedetomidine as a placebo during anesthesia. |
Drug: Placebo
The participant will pump saline without dexmedetomidine at the same speed as group D.
|
Outcome Measures
Primary Outcome Measures
- troponin T level [before operation]
the level of troponin in the participant's serum
- troponin T level [the end of operation]
the level of troponin in the participant's serum
- troponin T level [when the participant returned to the ward after the operation]
the level of troponin in the participant's serum
- troponin T level [24 hours after operation]
the level of troponin in the participant's serum
- troponin T level [72 hours after operation]
the level of troponin in the participant's serum
Secondary Outcome Measures
- AQP4、iNOS andTNF-α level [before operation]
the level of AQP4、iNOS andTNF-α in the participant's serum
- AQP4、iNOS andTNF-α level [when blocking the ascending aorta]
the level of AQP4、iNOS andTNF-α in the participant's serum
- AQP4、iNOS andTNF-α level [when developing the ascending aorta]
the level of AQP4、iNOS andTNF-α in the participant's serum
- AQP4、iNOS andTNF-α level [when cardiopulmonary bypass is stopped]
the level of AQP4、iNOS andTNF-α in the participant's serum
- AQP4、iNOS andTNF-α level [the end of the operation]
the level of AQP4、iNOS andTNF-α in the participant's serum
Eligibility Criteria
Criteria
Inclusion Criteria:
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Aged 18-70 years
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American Society of Anesthesiologists(ASA) physical status of I-Ⅳ
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BMI: 18.5-28 kg/m2
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Type of operation: elective open-heart surgery with cardiopulmonary bypass
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The patient and/or family members have signed the informed consent.
Exclusion Criteria:
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Preoperative diagnosis of heart failure 、gradeⅡ-Ⅲ heart block and diabetes
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LEVF<40%
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Severe coagulation dysfunction
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Severe heart, lung, liver and kidney insufficiency
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Used to have immunosuppressive therapies such as radiotherapy, chemotherapy and glucocorticoid, or have immune system diseases
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Perioperative allogeneic blood transfusion
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Affiliated Hospital Nantong University | Nantong | Jiangsu | China | 226000 |
Sponsors and Collaborators
- Affiliated Hospital of Nantong University
Investigators
- Study Director: Yibin Qin, Affiliated Hospital of Nantong University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2022-K125