Dexmedetomidine Attenuates Myocardial Injury in Off-Pump Coronary Artery Bypass Graft Surgery

Chi, Xiaohui; Liao, Ming‐Feng; Chen, Xin; Zhao, Yilin; Liu, Yang; Luo, Ai-lun; Yang, Hui

doi:10.1053/j.jvca.2015.06.026

Cited by 37 publications

(43 citation statements)

References 30 publications

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“…All the authors of this meta-analysis participated in deciding on the studies to be included the present meta-analysis. In accordance with the selection criteria, a total of 18 studies (13,15–31) published between 2003 and 2015 were selected. A total of 19,225 patients were included in these studies and formed part of the present meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Myocardial protective effects of dexmedetomidine in patients undergoing cardiac surgery: A meta-analysis and systematic review

Gong

Zhong

et al. 2017

Experimental and Therapeutic Medicine

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Arrhythmias are the common complications following cardiac surgery and contribute to hemodynamic instability, cognitive impairment, thromboembolic events, and congestive heart failure. Prevention of atrial fibrillation following cardiac surgery reduces morbidity and among the many available preventive approaches dexmedetomidine shows many positive effects on cardiovascular stability. Even though many studies indicated the beneficial effects of dexmedetomidine, the power of the analysis and conclusion of these studies is rather weak due to relatively smaller number of patients in these studies. In the present meta-analysis, we included a large number of patients, both children and adults, undergoing cardiac surgery, to address the efficacy of dexmedetomidine. Several databases were searched to identify clinical studies comparing the efficacy of dexmedetomidine in myocardial protection in patients undergoing cardiac surgery. Cardiac function related parameters including heart rate, blood pressure, tachycardia, arrhthmias, and bradycardia were measured. In accordance with the selection criteria, a total of 18 studies published between 2003 and 2016, with a total of 19,225 patients were included in the present meta-analysis. Dosage of dexmedetomidine was in the range of 0.5–1 µg/kg body weight loading followed by continuous infusion at a rate of 0.2–0.7 µg/kg/h. Dexmedetomidine treatment was found to lower heart rate, systolic blood pressure, incidence of tachycardia and arrhythmias in both adult and pediatric patients, but elevated the risk of bradycardia. In conclusion, results of this meta-analysis indicate that dexmedetomidine is an efficacious cardioprotective drug in adults and children undergoing cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Myocardial protective effects of dexmedetomidine in patients undergoing cardiac surgery: A meta-analysis and systematic review

Gong

Zhong

et al. 2017

Experimental and Therapeutic Medicine

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“…Depletion of Se state during the surgery triggers neutrophil accumulation in reperfused sites, which is the primary source of ROS and proteolytic enzyme generation (39). Crucially, the myocardial injury has been measured by serum cardiac enzymes (5,40). Although the value of cardiac biomarkers for adverse outcome following CABG is poorly understood, it is suggested that among myocardial necrosis markers, cardiac troponins are the gold standard for detection of the cardiac damage (9, 32) Multiple Tn isoforms have been detected in muscles, but CTnT and CTnI are known as cardiac specific isoforms.…”

Section: Discussionmentioning

confidence: 99%

Effect of Selenium on Ischemia-Reperfusion Injury in the Coronary Artery Bypass Graft Surgery: A Clinical Trial Study

Sedighinejad

Imantalab

Mirmansouri

et al. 2016

Iran Red Crescent Med J

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Background: In patients with coronary artery stenosis, coronary artery bypass graft surgery (CABG) is the most effective strategy to limit infarct size and improving outcomes. However, the rapid restoring of blood flow to the tissue can paradoxically induce cardiac damage. This phenomenon termed as myocardial ischemic/reperfusion (I/R) injury which is exacerbated under cardiopulmonary bypass (CPB) and is the cause of poor clinical outcomes. Therefore, it is essential to search for novel strategies with further cardio protective effects.

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“…Recent studies have suggested that Dex also has anti-inflammatory, antioxidant, and anti-apoptosis effects [10-12]. Xu et al demonstrated that Dex could alleviate LPS-induced acute lung injury in mouse by restraining the inflammatory reactions [13].…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Alleviates Hyperoxia-Induced Acute Lung Injury via Inhibiting NLRP3 Inflammasome Activation

Zhang¹,

Wu²,

Yang³

et al. 2017

Cell Physiol Biochem

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Background/Aims: Dexmedetomidine (Dex), a specific agonist of α2-adrenoceptor, has been reported to have extensive pharmacological effects. In this study, we focused on the protective effect of Dex on hyperoxia-induced acute lung injury and further explored its possible molecular mechanisms. Methods: The model of hyperoxia-induced acute lung injury was established by continuous inhalation of oxygen (FiO2= 0.90) for 7 d in neonatal rats in vivo. The in vitro experiments were carried out in LPS/ATP or hyperoxia-treated RAW264.7 cells. ELISA, western blot, TUNEL staining, and immunohistochemistry staining assays were performed and the commercial kits were used to assess the beneficial effect of Dex on hyperoxia-induced acute lung injury. Results: According to our results, Dex treatment attenuated hyperoxia-induced acute lung injury via decreasing the lung wet/dry(W/D) weight ratio and mitigating pathomorphologic changes. Moreover, the oxidative stress injury, inflammatory reaction, and apoptosis in lung epithelial cells were inhibited by Dex treatment. In addition, the activation of NLRP3 inflammasome was restrained by Dex both in lung tissue in vivo and RAW264.7 cells in vitro. Conclusion: These data provide evidence that Dex may ameliorate hyperoxia-induced acute lung injury, which suggests a potential clinical application of Dex in long-term supplemental oxygen therapy.

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Dexmedetomidine Attenuates Myocardial Injury in Off-Pump Coronary Artery Bypass Graft Surgery

Cited by 37 publications

References 30 publications

Myocardial protective effects of dexmedetomidine in patients undergoing cardiac surgery: A meta-analysis and systematic review

Myocardial protective effects of dexmedetomidine in patients undergoing cardiac surgery: A meta-analysis and systematic review

Effect of Selenium on Ischemia-Reperfusion Injury in the Coronary Artery Bypass Graft Surgery: A Clinical Trial Study

Dexmedetomidine Alleviates Hyperoxia-Induced Acute Lung Injury via Inhibiting NLRP3 Inflammasome Activation

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