34TH EACTA ANNUAL CONGRESS ABSTRACTS / Journal of Cardiothoracic and Vascular Anesthesia 33 (2019) S85 S104
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S.Y. Song, H.S. Yang, J.Y. Jung Daegu Catholic University Medical Center, Daegu, South Korea Introduction: To evaluate the improvement of systolic and diastolic left ventricular(LV) dysfunction by preconditioning and postconditioning with netrin-1 after acute myocardial infarction(MI) in rat model, we examined the changes of echocardiographic parameters and compared with them before and after MI.
of postoperative MI (aRR = 2.15; p = 0.03) in comparison to group I. Higher delirium prevalence in group III when compared with group II was observed in the first CPB quartile (aRR = 7.19; p = 0.035). Incidence of surgical reintervention was significantly lower in groups II and III, regardless of the dose, in the 4th CPB quartile, when compared with group I. Discussion: CPB duration is a surrogate for complexity of the surgical procedure. Therefore AKI, sepsis, and postoperative bleeding remained in correlation with CPB duration. Dexamethasone in a dose of 0.4 mg/kg was as effective as 1.0 mg/kg in attenuating post-operative SIRS parameters, but had no significant effect on early postoperative morbidity. Session: LEFT AND RIGHT CARDIAC DYSFUNCTION September 5, 2019 S17:03 Preconditioning and postconditioning with netrin-1 in acute myocardial infarction model of rat improves systolic and diastolic left ventricular dysfunction
Methods: Male, 8-to 9-week-old, Spraque-Dawley rats with a mean body weight of 277.40 §9.48 g were anesthesized with intraperitoneal injection of pentobarbital at a dose of 65 mg / kg, followed by intubation and positive pressure ventilation for 15 minutes as a stabilizing period. The acute MI model had the ligation of left coronary artery under heart exposure through 4-5th intercostal space then closed. After 30 minutes under mechanical ventilation, the left anterior descending artery (LAD) of the rat was ligated for 30 minutes And reperfusion for 2 hours to produce an ischemic / perfusion animal model of myocardial ischemia. After 30 minutes of ischemia, netrin-1(5mcg/kg) was slowly injected into MI group but vehicle(normal saline) into another MI group via tail vein. Netrin-1 preconditioning was administered intravenously 3 minutes before the induction of ischemia and 3 minutes after the induction of ischemia. Netrin-1 postconditioning was administered intravenously 5 minutes before the end of ischemic induction for 3 minutes and pentobarbital 35 mg / kg after 2 hours of reperfusion. And the echocardiographic evaluation was performed. Using Vevo2100, Echocardiographic studies were performed before surgery and After 120 minutes of reperfusion. Results: Fractional shortening values were significantly increased in the pre-isch, pre-netrin, post-isch and post-netrin groups compared to the vehicle group. The EF (ejection
Figure 1. Protocol
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34TH EACTA ANNUAL CONGRESS ABSTRACTS / Journal of Cardiothoracic and Vascular Anesthesia 33 (2019) S85 S104
Figure 2. Results
fraction), And in the post-netrin group, the left ventricular systolic function was improved. E’(initial diastolic velocity) values were significantly higher in the post-iso, post-isch, and post-netrin groups than in the vehicle group. E / E’, Post-isch, post-isch, and post-netrin, respectively. Discussion: Preconditioning and postconditioning with netrin-1 makes meaningful improvemet of systolic dysfunction with significant increase with FS and EF after acute MI. Also it helps E’ recovery for LV diastolic function and E/E’ ratio for left atrial pressure. REFERENCE: De Paulis D, Chiari P, Teixeira G, CoutureLepetit E, Abrial M, Argaud L, et al. Cyclosporine A at reperfusion fails to reduce infarct size in the in vivo rat heart. Basic Res Cardiol. 2013;108(5):379. Session: HEMODYNAMIC MONITORING 5, 2019
September
S18:03 The effect of common interventions in the intensive care unit on right ventricular function after cardiac surgery An intervention study
L. Grønlykke1, A. Korshin1, F. Gustafsson2, J.C. Nilsson1, H. Berg Ravn1 1
Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark 2 Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Introduction: Critical care following cardiac surgery is a complex task including both cardiac and pulmonary management strategies because optimal postoperative care is essential for outcome [1]. The effect of such interventions on right ventricular (RV) function has not been sufficiently explored. The aim of this study was to investigate what effect ICU interventions have on RV function. Methods: Thirty patients were studied in the ICU following coronary artery bypass graft surgery. Transoesophageal echocardiography (TEE) and a pulmonary artery catheter (PAC) were used to assess hemodynamic variables and echocardiographic measures of RV function. TEE evaluation included RV fractional area change, 3D RV ejection fraction, 3D RV stroke volume and RV global longitudinal strain (RV-GLS). Interventions were done separately and included: Trendelenburg position, PEEP 0, 5 and 10 cm