Volume 3 Supplement 2

International Symposium on the Pathophysiology of Cardiopulmonary Bypass

Open Access

Corticosteroids reduce early troponin-T release after cardiac surgery with cardiopulmonary bypass in men

  • Y Tabardel1,
  • D Schmartz2,
  • JL Leclerc2,
  • AA D'Hollander2,
  • JL Vincent2 and
  • J Duchateau3
Critical Care19993(Suppl 2):P27

https://doi.org/10.1186/cc338

Published: 2 March 1999

Objectives

To study whether administration of corticosteroids (CS) prior to cardiac surgery for coronary artery bypass grafting (CABG), can influence early troponin-T release after cardiac surgery with cardiopulmonary bypass (CPB).

Material and methods

Fifty-eight male patients with coronary artery disease undergoing programmed CABG with CPB were divided into five groups: Group 1 (Control; n = 10); Group 2 (methylprednisolone, (MPS) = 10 mg/kg, 4 h before CPB; n = 14); Group 3 (MPS = 10 mg/kg, at induction of anesthesia (IA); n = 10); Group 4 (MPS = 10 mg/kg, 12h before, as well as at IA; n = 10); Group 5 (MPS = 30 mg/kg 4 h before CPB; n = 14). CPB was conducted using a blood-free priming, a cold crystalloid cardioplegia and moderate hypothermia (29-30°C). Anesthesia consisted of continuous administration of midazolam, sufentanil and pancuronium. Aprotinin was not used. Plasmatic troponin-T levels were measured before induction of anesthesia (t0) and 4 h after CPB (t1) using specific ELISA.

Results

There was no significant difference in age, weight, duration of CPB, aorta clamping time and number of grafts between groups (Table). Troponin-T values at t0 were similar in all patients. Troponin-T levels measured 4h after the end of CPB were similar in control (Group 1), Group 3, and Group 4. In contrast, troponin-T levels were significantly lower in the 2 groups receiving MPS 4h before CPB (Group 2: 10 mg/kg and Group 5: 30 mg/kg) as compared to controls (*P = 0.001 and **P = 0.0004, respectively). There was no significant difference in troponin-T levels between Group 2 and Group 5.
 

Group control

Group 2:

Group 3:

Group 4:

Group 5:

  

MPS 10 mg/kg

MPS 10 mg/kg

MPS 2 × 10 mg/kg

MPS 30 mg/kg

  

(h-4)

(IA)

(h-12 + IA)

(h-4)

Tropo-T (ng/ml)

0.07 ± 0.2

0.10 ± 0.06

0 ± 0

0.04 ± 0.04

0.07 ± 0.3

(t=0) mean ± SEM

     

Tropo-T (ng/ml)

6.2 ± 2.0

1.4 ± 0.5*

5.0 ± 1.5

5.8 ± 1.9

1.0 ± 0.2**

(t=1) mean ± SEM

     

Age (years)

60 ± 3

63 ± 2

62 ± 5

64 ± 2

64 ± 2

Weight (kg)

86 ± 4

79 ± 2

79 ± 3

80 ± 3

82 ± 3

CPB (min)

95.3 ± 6.1

95.0 ± 7.5

95.0 ± 7.5

110.3 ± 4.4

104.5 ± 7.6

Ao cl (min)

65.6 ± 6.3

59.3 ± 5.9

64.6 ± 5.7

84.3 ± 4.6

59.2 ± 4.8

No. of grafts (n)

3.0 ± 0.2

2.6 ± 0.2

2.7 ± 0.3

3.5 ± 0.3

2.6 ± 0.2

Conclusion

Pharmacological doses of CS significantly reduce early troponin-T release after CPB. The timing of CS administration plays an important role, as the treatment was effective when CS were given 4 h prior to CPB but not at the beginning of surgery. Doses of 10 mg/kg and 30 mg/kg are equally effective.

Authors’ Affiliations

(1)
A de Rothschild Foundation
(2)
Free University of Brussels, Erasme Hospital
(3)
Free University of Brussels, Brugmann Hospital

Copyright

© Current Science Ltd 1999

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