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Bulow NMH, Colpo E, Pereira RP, Correa EFM, Waczuk EP, Duarte MF, Rocha JBT. Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass. Braz J Med Biol Res 2016; 49:e4646. [PMID: 26909786 PMCID: PMC4792505 DOI: 10.1590/1414-431x20154646] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 08/31/2015] [Indexed: 11/22/2022] Open
Abstract
Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males). The endpoints used to assess inflammatory and biochemical responses to mini-CPB were plasma interleukin (IL)-1, IL-6, IL-10, interferon (INF)-γ, tumor necrosis factor (TNF)-α, C-reactive protein, creatine phosphokinase, creatine phosphokinase-MB, cardiac troponin I, cortisol, and glucose levels. These variables were determined before anesthesia, 90 min after beginning CPB, 5 h after beginning CPB, and 24 h after the end of surgery. Endpoints of oxidative stress, including thiobarbituric acid reactive species and delta-aminolevulinate dehydratase activity in erythrocytes were also determined. DEX+TIVA use was associated with a significant reduction in IL-1, IL-6, TNF-α, and INF-γ (P<0.0001) levels compared with TIVA (two-way ANOVA). In contrast, the surgery-induced increase in thiobarbituric acid reactive species was higher in the DEX+TIVA group than in the TIVA group (P<0.01; two-way ANOVA). Delta-aminolevulinate dehydratase activity was decreased after CPB (P<0.001), but there was no difference between the two groups. DEX as an adjuvant in anesthesia reduced circulating IL-1, IL-6, TNF-α, and INF-γ levels after mini-CPB. These findings indicate an interesting anti-inflammatory effect of DEX, which should be studied in different types of surgical interventions.
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Affiliation(s)
- N M H Bulow
- Departamento de Bioquímica e Biologia Molecular, Programa de Pós-graduação em Ciências Biológicas - Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - E Colpo
- Departamento de Cirurgia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - R P Pereira
- Departamento de Química, Programa de Pós-graduação em Química Aplicada, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil
| | - E F M Correa
- Departamento de Bioquímica e Biologia Molecular, Programa de Pós-graduação em Ciências Biológicas - Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - E P Waczuk
- Departamento de Bioquímica e Biologia Molecular, Programa de Pós-graduação em Ciências Biológicas - Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - M F Duarte
- Departamento de Bioquímica e Biologia Molecular, Programa de Pós-graduação em Ciências Biológicas - Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - J B T Rocha
- Departamento de Bioquímica e Biologia Molecular, Programa de Pós-graduação em Ciências Biológicas - Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
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Cassol V, Rizzato T, Teche S, Basso D, Hirata V, Maldonado M, Colpo E, Solé D. Prevalence and Severity of Asthma among Adolescents and its Relationship with the Body Mass Index. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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