|
1. Some evidence that hyperbaric preconditioning
results in better myocardial function following coronary artery bypass
grafting |
Citation/s:
1. Yogaratnam JZ, Laden G, Madden LA, Guvendik L, Cowen M, Greenman M, Seymour
AM, Cale A, Griffin S. Hyperbaric oxygen preconditioning promotes
cardioprotection following ischemic reperfusion injury by improving myocardial
function, limiting necrosis and enhancing the induction of Hsp72. Undersea and
Hyperbaric Medicine 2007; 34(4):301-302
Lead author's name and fax: Jaysen Yogaratnam, Dept Cardiac Surgery
Castle Hill Hospital, Hull, UK
Three-part Clinical Question: For patients expected to undergo
myocardial ischaemia-reperfusion injury, does preconditioning with hyperbaric
oxygenation ameliorate the injury?
Search Terms: Ischaemia-reperfusion, CABG, myocardial function
The Study:
Single-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Patients scheduled to undergo coronary artery bypass
grafting with cardiopulmonary bypass
Control group (N = 40; 40 analysed): Standard per-operative surgical
management
Experimental group (N = 41 ; 41 analysed): Hyperbaric oxygenation four
hours prior to CABG at 2.4 ATA for 90 minutes.
The Evidence:
|
Non-Event
Outcomes |
Time to
outcome/s |
Difference
|
P-value |
|
Increase in stroke volume |
24 hours post-op |
Greater increase in experimental group |
0.01 |
|
Left ventricular stroke work |
24 hours post-op |
Greater increase in experimental group |
0.005 |
Comments:
1. Abstract only with limited data.
2. A single hyperbaric exposure rather than the three previously used by this
group (see Alex)
Appraised by: Mike Bennett, Sydney ; Friday, 7 December 2007
Email: m.bennett@unsw.edu.au
Kill or Update By: December 2008