The effects of dexmedetomidine on inflammatory mediators after cardiopulmonary bypass
The effects of dexmedetomidine on inflammatory mediators after cardiopulmonary bypass
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DOI：
10.1111/anae.12636
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发表时间：
2014-07-01
期刊：
影响因子：
10.7
通讯作者：
Sata, T.
中科院分区：
文献类型：
--
作者：
Ueki, M.;Kawasaki, T.;Sata, T.
体外循环心脏手术与全身炎症反应的发生有关，这种反应通常会导致主要器官功能障碍。我们假设高度选择性的 2-肾上腺素能激动剂右美托咪定可减弱全身炎症反应。 42 名患者在主动脉阻断后被随机分配接受右美托咪定或生理盐水治疗。生理盐水组体外循环期间（16.6（7.3）ng.ml-1）和体外循环后（14.3（8.2）ng.ml-1）核蛋白血浆高迁移率组框1的平均（SD）水平从5.1（2.2）ng.ml-1显着增加。在右美托咪定组中，该水平仅在体外循环期间显着增加（4.0（1.9）ng.ml-1基线与10.8（2.7）ng.ml-1），但在（7.4（3.8）ng.ml-1）之后没有显着增加。右美托咪定输注还抑制了体外循环后平均 (SD) 白细胞介素 6 水平的升高（升高 124.5 (72.0)pg.ml-1 vs 65.3 (30.9)pg.ml-1）。右美托咪定的这些抑制作用可能是由于抑制核因子 kappa B 激活，表明术中右美托咪定可能有益地抑制体外循环期间与缺血再灌注损伤相关的炎症反应。
Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. We hypothesised that the highly selective 2-adrenergic agonist, dexmedetomidine, attenuates the systemic inflammatory response. Forty-two patients were randomly assigned to receive dexmedetomidine or saline after aortic cross-clamping). The mean (SD) levels of the nuclear protein plasma high-mobility group box 1 increased significantly from 5.1 (2.2)ng.ml-1 during (16.6 (7.3)ng.ml-1) and after (14.3 (8.2)ng.ml-1) cardiopulmonary bypass in the saline group. In the dexmedetomidine group, the levels increased significantly only during cardiopulmonary bypass (4.0 (1.9)ng.ml-1 baseline vs 10.8 (2.7)ng.ml-1) but not after (7.4 (3.8)ng.ml-1). Dexmedetomidine infusion also suppressed the rise in mean (SD) interleukin-6 levels after cardiopulmonary bypass (a rise of 124.5 (72.0)pg.ml-1 vs 65.3 (30.9)pg.ml-1). These suppressive effects of dexmedetomidine might be due to the inhibition of nuclear factor kappa B activation and suggest that intra-operative dexmedetomidine may beneficially inhibit inflammatory responses associated with ischaemia-reperfusion injury during cardiopulmonary bypass.