Postoperative circulatory support in adult cardiac surgery recent experience from one center 英文参考文献.docVIP

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Postoperative circulatory support in adult cardiac surgery recent experience from one center 英文参考文献.doc

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Postoperative circulatory support in adult cardiac surgery recent experience from one center 英文参考文献

Available online /supplements/7/S3 Critical Care Volume 7 Suppl 3, 2003 Second International Symposium on Intensive Care and Emergency Medicine for Latin America S?o Paulo, Brazil, 25–28 June 2003 Published online: 25 June 2003 These abstracts are online at /supplements/7/S3 ? 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) CARDIOLOGY P1 Impact of peroperative administration of steroid over inflammatory response and pulmonary dysfunction following cardiac surgery HTF Mendon?a Filho1,2, LAA Campos1, RV Gomes1, FES Fagundes1, EM Nunes1, R Gomes2, F Bozza2, PT Bozza2, HC Castro-Faria-Neto2 1Surgical Intensive Care Unit, Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil; 2Laboratory of Immunopharmacology, Department of Pharmacodymamics, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil Critical Care 2003, 7(Suppl 3):P1 (DOI 10.1186/cc2197) Introduction Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI). As an attempt to dampen inflammatory response, steroids have been perioperatively administered to patients. Macrophage migration inhibitory factor (MIF), a regulator of the endotoxin receptor, is implicated in the pathogenesis of ALI. We have previously detected peak circulating levels of MIF, 6 hours post CPB. Experimental data have shown that steroids may induce MIF secretion by mononuclear cells. This study aims to correlate levels of MIF assayed 6 hours post CPB to the intensity of postoperative pulmonary dysfunction, analysing the impact of perioperative steroid administration. NS (n=37). MIF circulating levels were assayed at the anesthesia induction, 3, 6, and 24hours after CPB. A standard weaning proto- col with fast track strategy was adopted, and indicators of organ dysfunction and therapeutic intervention were registered during the first 72hours postoperative. Results Levels of MIF