Influence of dextran-70 on systemic inflammatory response and myocardial ischaemia-reperfusion following cardiac operations

Károly Gombocz, Ágnes Beledi, Nasri Alotti, Gábor Kecskés, Valéria Gábor, L. Bogár, T. Kőszegi, János Garai

Research output: Contribution to journalArticle

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Abstract

Introduction: Experimental studies have demonstrated that dextran-70 reduces the leukocyte - endothelium interaction, but clinical evidence is still lacking. Our objective was to justify the anti-inflammatory effect of dextran-70 following cardiac operations. Methods: Forty patients undergoing coronary bypass surgery (n = 32) or aortic valve replacement (n = 8) were enrolled in this prospective, randomized, double-blind study. Two groups were formed. In group A (n = 20), dextran-70 infusion was administered at a dose of 7.5 ml/kg before the initiation of cardiopulmonary bypass and at a dose of 12.5 ml/kg after the cessation of cardiopulmonary bypass. Group B served as a control with identical amounts of gelatin infusion (n = 20). The plasma concentration of procalcitonin, C-reactive protein, IL 6, IL 6r, IL 8, IL 10, soluble endothelial leukocyte adhesion molecule-1, soluble intercellular adhesion molecule-1, cardiac troponin-I and various haemodynamic parameters were measured in the perioperative period. Multivariate methods were used for statistical analysis. Results: In group A, lower peak (median) plasma levels of procalcitonin (0.2 versus 1.4, p <0.001), IL 8 (5.6 versus 94.8, p <0.001), IL 10 (47.2 versus 209.7, p = 0.001), endothelial leukocyte adhesion molecule-1 (88.5 versus 130.6, p = 0.033), intercellular adhesion molecule-1 (806.7 versus 1,375.7, P = 0.001) and troponin-I (0.22 versus 0.66, p = 0.018) were found. There was no significant difference in IL 6, IL-6r and C-reactive protein values between groups. Higher figures of the cardiac index (p = 0.010) along with reduced systemic vascular resistance (p = 0.005) were noted in group A. Conclusion: Our investigation demonstrated that the use of dextran-70 reduces the systemic inflammatory response and cardiac troponin-I release following cardiac operation.

Original languageEnglish
Article numberR87
JournalCritical Care
Volume11
DOIs
Publication statusPublished - Aug 14 2007

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Myocardial Reperfusion
Dextrans
Troponin I
Myocardial Ischemia
E-Selectin
Calcitonin
Intercellular Adhesion Molecule-1
Cardiopulmonary Bypass
Interleukin-8
Interleukin-10
C-Reactive Protein
Interleukin-6
Perioperative Period
Gelatin
Aortic Valve
Double-Blind Method
Vascular Resistance
Endothelium
Leukocytes
Anti-Inflammatory Agents

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Influence of dextran-70 on systemic inflammatory response and myocardial ischaemia-reperfusion following cardiac operations. / Gombocz, Károly; Beledi, Ágnes; Alotti, Nasri; Kecskés, Gábor; Gábor, Valéria; Bogár, L.; Kőszegi, T.; Garai, János.

In: Critical Care, Vol. 11, R87, 14.08.2007.

Research output: Contribution to journalArticle

Gombocz, Károly ; Beledi, Ágnes ; Alotti, Nasri ; Kecskés, Gábor ; Gábor, Valéria ; Bogár, L. ; Kőszegi, T. ; Garai, János. / Influence of dextran-70 on systemic inflammatory response and myocardial ischaemia-reperfusion following cardiac operations. In: Critical Care. 2007 ; Vol. 11.
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AU - Gombocz, Károly

AU - Beledi, Ágnes

AU - Alotti, Nasri

AU - Kecskés, Gábor

AU - Gábor, Valéria

AU - Bogár, L.

AU - Kőszegi, T.

AU - Garai, János

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AB - Introduction: Experimental studies have demonstrated that dextran-70 reduces the leukocyte - endothelium interaction, but clinical evidence is still lacking. Our objective was to justify the anti-inflammatory effect of dextran-70 following cardiac operations. Methods: Forty patients undergoing coronary bypass surgery (n = 32) or aortic valve replacement (n = 8) were enrolled in this prospective, randomized, double-blind study. Two groups were formed. In group A (n = 20), dextran-70 infusion was administered at a dose of 7.5 ml/kg before the initiation of cardiopulmonary bypass and at a dose of 12.5 ml/kg after the cessation of cardiopulmonary bypass. Group B served as a control with identical amounts of gelatin infusion (n = 20). The plasma concentration of procalcitonin, C-reactive protein, IL 6, IL 6r, IL 8, IL 10, soluble endothelial leukocyte adhesion molecule-1, soluble intercellular adhesion molecule-1, cardiac troponin-I and various haemodynamic parameters were measured in the perioperative period. Multivariate methods were used for statistical analysis. Results: In group A, lower peak (median) plasma levels of procalcitonin (0.2 versus 1.4, p <0.001), IL 8 (5.6 versus 94.8, p <0.001), IL 10 (47.2 versus 209.7, p = 0.001), endothelial leukocyte adhesion molecule-1 (88.5 versus 130.6, p = 0.033), intercellular adhesion molecule-1 (806.7 versus 1,375.7, P = 0.001) and troponin-I (0.22 versus 0.66, p = 0.018) were found. There was no significant difference in IL 6, IL-6r and C-reactive protein values between groups. Higher figures of the cardiac index (p = 0.010) along with reduced systemic vascular resistance (p = 0.005) were noted in group A. Conclusion: Our investigation demonstrated that the use of dextran-70 reduces the systemic inflammatory response and cardiac troponin-I release following cardiac operation.

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