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The protective effect of propofol on erythrocytes during cardiopulmonary bypass
1Department of Anesthesiology, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022.
Insights
Propofol protects red blood cells from injury during cardiopulmonary bypass (CPB). Elevated intracellular calcium in erythrocytes during CPB correlates with cell damage, an effect mitigated by propofol.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Hematology
Background:
- Cardiopulmonary bypass (CPB) can lead to erythrocyte (red blood cell) injury.
- Intracellular calcium overload is a potential mechanism for this injury.
- Understanding protective strategies is crucial for pediatric cardiac surgery.
Purpose of the Study:
- To investigate the link between erythrocyte intracellular calcium levels and cell injury during CPB.
- To evaluate the protective effects of propofol on erythrocytes in children undergoing CPB.
Main Methods:
- 40 children with congenital heart disease undergoing CPB were studied.
- Patients were randomized into control (isoflurane) and propofol anesthesia groups.
- Erythrocyte intracellular calcium, enzyme activities (Ca(2+)-Mg(2+)-ATPase, Na(+)-K(+)-ATPase), erythrocyte filtration index, mean corpuscular volume, and plasma free hemoglobin were measured.
Main Results:
- In the control group, erythrocyte intracellular calcium, filtration index, mean corpuscular volume, and plasma free hemoglobin increased, while enzyme activities decreased.
- A linear correlation was observed between increased erythrocyte intracellular calcium and markers of cell injury.
- The propofol group showed significant improvements in all measured parameters compared to the control group (P < 0.05).
Conclusions:
- Erythrocyte injury during CPB is associated with elevated intracellular calcium levels.
- Propofol demonstrates a protective effect against erythrocyte injury in this context.
- These findings suggest propofol as a potential therapeutic agent to mitigate red blood cell damage during CPB.
Abstract:
To evaluate the relationship between erythrocyte injury and intracellular calcium ion overload, and the protective effect of propofol on erythrocytes during cardiopulmonary bypass (CPB), 40 children with congenital heart diseases who underwent surgical repair under CPB were studied. The patients were randomly divided into two groups: control group (group C) and propofol group (group P). Anesthesia was maintained in the patients in group P with 6 mg.kg-1.h-1 propofol, and those in the group C inhaled 1%-2% isoflurane. The blood samples were taken before CPB, at the 30th min of CPB, at the end of CPB, and 2 h and 24 h after CPB to measure the content of erythrocyte intracellular calcium ion (E-Ca2+), Ca(2+)-Mg(2+)-ATPase and Na(+)-K(+)-ATPase activities, index filtration of erythrocytes (IF), mean corpuscular volume (MCV) and the concentration of plasma free hemoglobin (F-HB). Results showed that in the control group, E-Ca2+, IF, MCV and F-Hb were gradually increased and Ca(2+)-Mg(2+)-ATPase and Na(+)-K(+)-ATPase activities were decreased. The increase of E-Ca2+ was linearly paralleled to IF, MCV and F-Hb. In propofol group, all the above-mentioned parameters were significantly improved (P < 0.05). This study suggests that erythrocyte injury is related to elevation of intracellular calcium during CPB and propofol has a protective effect on erythrocyte injury.