Bettex
Fakultäten » Medizinische Fakultät » Kinderspital: Chirurgische Klinik » Kinderanästhesie » Prof. Dr. Markus Weiss » Bettex
Current research project
| Title / Titel | Role of volatile anaesthetics for myocardial protection during cardiac surgery by children | ||||
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| Abstract (PDF, 14 KB) | |||||
| Summary / Zusammenfassung | Cardiac surgery in children consists mostly of corrective surgery for congenital anomalies using open heart procedures. Open heart surgery requires cardiopulmonary bypass including most of the time aortic cross-clamping and induction of cardiac arrest using cardioplegia. The global myocardial ischemic arrest and subsequent reperfusion has profound consequences that extend into the postoperative period. Both diastolic and systolic myocardial dysfunction as well as a more or less generalized inflammatory reaction, with its negative consequences on the liver, the lungs and the kidneys has been described. Clinical studies in adult patients undergoing coronary surgery or aortic valve replacement have suggested a potential beneficial effect of volatile anaesthetics in protecting the myocardium, liver, renal and pulmonary function against these insults. In paediatric cardiac surgery this phenomenon has been poorly studied so far. We hypothesize that the use of volatile anaesthetics may offer a considerable benefit in children undergoing open heart surgery. In this prospective randomised study, we would assess the potential protective effect of sevoflurane on children undergoing cardiac surgery under cardiopulmonary bypass and cardioplegia on postoperative myocardial function (echocardiography, CK, CKMB, Troponin I, pro BNP), liver function (GOT, GPT, LDH, gamma-GT) renal function (creatinine, creatinine clearance, cystatine C, urine output) and pulmonary function (blood gases, PaO2/FIO2 ratio, radiography). Anaesthetic preconditioning in paediatric cardiac surgery would be a very promising protective strategy against myocardial ischemia-reperfusion injury, which is unfortunately unavoidable in open heart surgery under aortic clamping and cardioplegia. On top of that, a possible protective effect of volatile anaesthetics on liver, renal and pulmonary functions could decrease significantly the morbidity associated with CPB. This strategy might have a great potential to improve clinical outcome in children undergoing open heart surgery. |
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| Publications / Publikationen | Zaugg, M., E. Lucchinetti, D. R. Spahn, T. Pasch, and M. C. Schaub. 2002. Volatile anesthetics mimic cardiac preconditioning by priming the activation of mitochondrial K(ATP) channels via multiple signaling pathways. Anesthesiology 97(1):4-14.Suter, D., D. R. Spahn, S. Blumenthal, L. Reyes, C. Booy, R. Z'Graggen B, and B. Beck-Schimmer. 2007. The immunomodulatory effect of sevoflurane in endotoxin-injured alveolar epithelial cells. Anesth Analg 104(3):638-45. | ||||
| Keywords / Suchbegriffe | protection, myocardial, anaesthetics, volatile, children | ||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Others |
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| Duration of Project / Projektdauer | Jan 2008 to Dec 2012 |