Does Dexmedetomidine Provide Cardioprotection in Coronary Artery Bypass Grafting With Cardiopulmonary Bypass? A Pilot Study

Tosun, Zeynep; Baktir, Mehmet; Kahraman, Hüsnü; Başkol, Gülden; Güler, Gülen; Boyacı, Adem

doi:10.1053/j.jvca.2012.12.013

Cited by 38 publications

(42 citation statements)

References 18 publications

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“…Also, there were few studies indicating a lack of cardiac protection effects by dexmedetomidine in adult patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (24). This raised questions regarding the wider usefulness of dexmedetomidine, as a cardioprotective drug during cardiac surgery.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply oxygen to the heart . With the increasing incidence of CHD, more and more patients with CHD are undergoing non‐cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

Does dexmedetomidine have a cardiac protective effect during non‐cardiac surgery? A randomised controlled trial

Shen

et al. 2014

Clin Exp Pharma Physio

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This study was designed to determine the effects of dexmedetomidine on perioperative myocardial injury by observing peripheral circulatory changes in response to tracheal intubation and extubation, myocardial enzyme levels, myocardial ischaemia improvements, cardiovascular adverse events and cytokines in patients with coronary heart disease (CHD) undergoing non-cardiac surgery. This study was a prospective, randomized, double-blind trial. Eighty patients having CHD were scheduled for elective hip-replacement surgery and randomly allocated to receive a loading dose of 1 μg/kg dexmedetomidine followed by a 0.2 μg/kg per h infusion (Dex group; n = 40) or normal saline (control group; n = 40). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, rate-pressure product and changes in ST-T segment on the electrocardiogram were recorded every 5 min during surgery. Serum creatine kinase-MB (CK-MB), cardiac troponin I (cTnI), glycogen phosphorylase BB (GP-BB), interleukin (IL)-6 and tumour necrosis factor (TNF)-α protein levels were determined preoperatively, at the end of surgery and 12 and 24 h after surgery. The improvement rate of myocardial ischaemia was higher in the Dex than control group (87.5% vs 32.5%, respectively; P < 0.05). In addition, the Dex group had lower serum CK-MB, IL-6, cTnI and GP-BB concentrations than the control group (P < 0.05). There was no significance difference in TNF-α between the two groups (P > 0.05). Dexmedetomidine can reduce myocardial injury and cytokine levels in patients with CHD undergoing non-cardiac surgery.

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“…No reduction in myocardial damage was seen; however, mean pulmonary artery pressure tended to be lower in the dexmedetomidine group [55].…”

Section: Alpha 2 Agonistsmentioning

confidence: 73%

New therapy in cardioprotection

Chow

Liu²,

Irwin³

2015

Current Opinion in Anaesthesiology

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Does Dexmedetomidine Provide Cardioprotection in Coronary Artery Bypass Grafting With Cardiopulmonary Bypass? A Pilot Study

Cited by 38 publications

References 18 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

Does dexmedetomidine have a cardiac protective effect during non‐cardiac surgery? A randomised controlled trial

New therapy in cardioprotection

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