The Effects Of Adding Hydrogen In Cardiac Protection During Cardiopulmonary Bypass And Mitral Valve Replacement

Objective Comparative study in patients with mitral valve replacement in the heart during cardiopulmonary bypass (cardiopulmonary bypass, CPB), to give oral lactuloseoral-induced hydrogen (Hydrogen, H2) intervention to observe the impact of variousclinical indicators to explore the H2on myocardialand its possible mechanism ofprotection for myocardial protection during cardiopulmonary bypass a new path.Methods Ningxia Medical University General Hospital from May2011to April2012, selected40patients mitral valve replacement in patients with CPB surgery, were randomly divided into control and experimental groups,20cases of each patient. Patients undergoingconventional treatment, positive preoperative preparation, the experimental group in the preoperative oral lactulose oral measurement1ml/Kg. Two groups of patients, respectively, center venous blood drawn at specific time points (preoperative, after CPB and6h,12h,24h)5ml, the determination of cardiac troponin (Cardiac troponins, CTNI,,),creatine phosphate kinase isoenzyme (creatine kinase b isoenzyme, CK-MB) levelsbetween the two groups during cardiopulmonary bypass time, aortic cross-clamping time, automatic resuscitation rate, postoperative mechanical ventilation time, ICU staytime, postoperative vasoactive drugs dopamine, epinephrine, support time. Blood at each time point, while micro-electrochemical detector detecting the end of the quietbreath hydrogen concentration between the two groups were compared. All data were analyzed by SPSS statistic software Pack17.0. The measured data were expressed by mean+standard deviation (x±S),between the two groups using t test and between the sample rates using x2test for comparison. Results1. In40patients, the experimental group of20cases,20cases of control group.21males and19females. Age42-68years (57.40±7.26years), weight42-78kg (59.32±9.76kg). The two groups ingender, age, weight, cardiothoracic ratio, cardiac function were not statisticallysignificant (P>0.05).2. The two groups of patients in the observed indicators of perioperative cardiopulmonary bypass time, aortic cross-clamping time was no significant difference (P>0.05). The experimental group of auto-resuscitation rate of85%(17/20), the control group automatically resuscitation rate of75%(15/20) The difference was not statistically significant (P>0.05). Postoperative ventilator support time, ICU stay between the two groups no significant difference (P>0.05). Postoperative vasoactive drugs dopamine, epinephrine support was no significant difference between the two groups (P>0.05).3. Two groups of patients surgery before of cTnI, CK-MB and calm breath hydrogen contentat the end of no statistical significance (P>0.05), but the aortic6h after the experimental group and control group, end-expiratory hydrogen content lhigh andbetween-group significant difference (P<0.01), the cTnI,CK-MB between the two groups was statistically significant (P<0.05), and the statistics of the two groups of patients beforeand after open aortic6h of myocardial enzymes was statistically significant(P <0.05).Aortic12hcTnI, the value of CK-MB peak, a significant difference (P<0.05) between the two groups, the hydrogen content in end-expiratory returned to preoperative levels and no significant difference between the two groups (P>0.05). The aortic24hcTnI, the amountof CK-MB decreased but did not recover to preoperative levels between the two groupswas statistically significant (P<0.05), end-expiratory hydrogen content between the two groups was not statistically significant (P>0.05).Conclusions cardiopulmonary bypass and mitral valve Replacement surgery, the way by oral administration of lactulose can play to interfere with the purpose of H2; cardiopulmonary bypass surgery Lactulose-induced H2on myocardial cells, ischemic reperfusion injury in the early protection.