Skip Navigation



BJA Advance Access published online on April 15, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei142
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
94/6/805    most recent
aei142v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Malagon, I.
Right arrow Articles by Bovill, J. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Malagon, I.
Right arrow Articles by Bovill, J. G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted February 10, 2005

Clinical Investigation

Effect of three different anaesthetic agents on the postoperative production of cardiac troponin T in paediatric cardiac surgery

I. Malagon 1*, K. Hogenbirk 2, J. van Pelt 3, M. G. Hazekamp 4, and J. G. Bovill 1

1 Department of Anaesthesia, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands
2 Department of Paediatric Intensive Care, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands
3 Department of Clinical Chemistry, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands
4 Department of Paediatric Cardiac Surgery, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands

* To whom correspondence should be addressed.
I. Malagon, E-mail: jmalagon{at}lumc.nl


  Abstract

Background. Paediatric cardiac surgery is associated with some degree of myocardial injury. Ischaemic preconditioning (IP) has been investigated widely in the adult population. Volatile agents have been shown to simulate IP providing extra protection to the myocardium during adult cardiopulmonary bypass (CPB) while propofol seems to act through different mechanisms. IP has not been investigated in the paediatric population to the same extent. Cardiac troponin T (cTnT) is a reliable marker of myocardial injury in neonates and children. We have investigated the relationship between three anaesthetic agents, midazolam, propofol, and sevoflurane, and postoperative production of cTnT.

Methods. Ninety patients undergoing repair of congenital heart defect with CPB were investigated in a prospective randomized study. cTnT was measured four times during the first 24 h following admission to the paediatric intensive care unit. Other variables measured included arterial blood gases, lactate, fluid balance, use of inotropic drugs, PaO2/FIO2 ratio and ventilator hours.

Results. cTnT was elevated in all three groups throughout the study period. The differences between the three groups were not statistically significant. Eight hours after admission to the intensive care unit cTnT concentrations tended to be higher in the midazolam group [mean (95% confidence intervals)]; 2.7 (1.9-3.5) ng ml-1. Patients receiving a propofol-based anaesthesia had similar concentrations 2.6 (1.7-3.5) ng ml-1 while those receiving sevoflurane tended to have a lower cTnT production 1.7 (1.3-2.2) ng ml-1.

Conclusions. Midazolam, propofol, and sevoflurane appear to provide equal myocardial protection in paediatric cardiac surgery when using cTnT as a marker of myocardial damage.

Keywords: anaesthesia; protein, troponin T; surgery, paediatric cardiac.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
L. H. Mildh, V. Pettila, H. I. Sairanen, and P. H. Rautiainen
Cardiac Troponin T Levels for Risk Stratification in Pediatric Open Heart Surgery
Ann. Thorac. Surg., November 1, 2006; 82(5): 1643 - 1648.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.