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[Brain protective effects of ginkgo biloba leaf extract (ginaton) in patients undergoing hypothermic cardiopulmonary
Yun-kun Deng1, Fang Wei, Da-guo Zhang
1Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang. dyk126@163.com
Insights
Ginkgo biloba extract (Ginaton) protects the brain during heart surgery by improving oxygen supply and reducing harmful byproducts. This study shows Ginaton enhances brain function in patients undergoing cardiopulmonary bypass.
Area of Science:
- Cardiovascular Surgery
- Neuroprotection
- Pharmacology
Context:
- Hypothermic cardiopulmonary bypass (CPB) is associated with neurological complications.
- Rheumatic heart disease patients undergoing mitral valve replacement require careful perioperative management.
- Assessing cerebral oxygenation and metabolic markers is crucial during CPB.
Purpose:
- To evaluate the neuroprotective effects of Ginkgo biloba leaf extract (Ginaton) during hypothermic cardiopulmonary bypass.
- To investigate Ginaton's impact on cerebral oxygen supply and oxidative stress markers.
- To determine if Ginaton mitigates brain injury associated with CPB.
Summary:
- Patients receiving Ginaton showed improved cerebral oxygen extraction (Ca-jvO2) and reduced cerebral oxygen extraction ratio (ERO2) compared to controls.
- Ginaton administration led to significantly lower lactate acid levels, arteriojugular lactate difference (ADVL), and malonaldehyde (MDA) content.
- Superoxide dismutase (SOD) activity was markedly higher in the Ginaton group, indicating reduced oxidative stress.
Impact:
- Ginaton demonstrates significant brain protective effects in patients undergoing CPB.
- The extract improves cerebral oxygenation and enhances antioxidant capacity.
- Results suggest Ginaton is a promising adjunct therapy for neuroprotection during cardiac surgery.
Objective:
To investigate the brain protective effects of Ginkgo biloba leaf extract (Ginaton) in patients who underwent hypothermic cardiopulmonary bypass (CPB).
Methods:
Sixty patients with rheumatic heart disease of ASA grade II-III, who were scheduled for mitral valve replacement with intravenous anaesthesia, were randomly assigned to two groups, the Ginaton group (30 patients) treated with Ginaton 1 mg/kg by intravenous dripping before open heart for CPB, and the control group (30 patients) with normal saline instead. Blood was synchronously collected from arteriae radialis and vena jugularis interna at 5 time points, namely, before CPB (T1), nasopharyngeal temperature (lowered to 30-31 degrees C) stabilized stage (T2), nasopharyngeal temperature restoration (36 degrees C) stage (T3), 30 min after CPB (T4) and 3 after CPB (Ts) for determining blood gas, lactate acid concentration, activity of superoxide dismutase (SOD) and malonaldehyde (MDA) content. And the oxygen content in artery (CaO2) and jugular vein (CjvO2), the difference of oxygen contents in arterial and jugular vein (Ca-jvO2), the cerebral oxygen extraction ratio (ERO2) as well as the arteriojugular lactate difference (ADVL) were calculated.
Results:
After the beginning of CPB, as compared with those in the control group, in the Ginaton group, the reduction of Ca-jvO2 and ERO2 was significantly higher (P < 0.05 or P < 0.01) and the increase of lactate acid, ADVL and MDA were significantly lower, and with a remarkably higher SOD activity (P < 0.01).
Conclusion:
Ginaton could improve cerebral oxygen supply, promote SOD activity to inhibit production of free radicals in patients undergoing CPB, and thus shows an evident protective effect in the brain.
