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Plasma adenosine changes during cardiac surgery.

R A Mueller1, L S Saltzman, M R Isley

  • 1Department of Anesthesiology, University of North Carolina, Chapel Hill School of Medicine 27599-7010.

Journal of Cardiothoracic and Vascular Anesthesia
|October 1, 1991
PubMed
Summary
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Plasma adenosine and inosine levels increase during cardiac surgery anesthesia and after cardiopulmonary bypass. These changes may influence cardiovascular responses after intubation and CPB discontinuation.

Area of Science:

  • Cardiovascular Physiology
  • Anesthesiology
  • Biochemistry

Background:

  • Cardiac surgery involves significant physiological stress.
  • Anesthesia and cardiopulmonary bypass (CPB) can alter endogenous nucleoside levels.
  • Adenosine and inosine play roles in cardiovascular regulation.

Purpose of the Study:

  • To measure plasma adenosine and inosine changes during high-dose narcotic anesthesia and cardiac surgery.
  • To investigate the temporal relationship between these nucleosides and specific surgical phases (intubation, CPB).

Main Methods:

  • Arterial and mixed venous blood sampling at eight intervals from preanesthesia to post-CPB.
  • Measurement of plasma adenosine and inosine concentrations.
  • Comparison of changes between coronary artery bypass grafting (CABG) and valve replacement (V) patients.

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Main Results:

  • Arterial adenosine significantly elevated post-intubation, particularly in CABG patients.
  • Mixed venous adenosine and inosine consistently elevated after CPB discontinuation.
  • A separate study confirmed increased arterial adenosine immediately after intubation.

Conclusions:

  • Adenosine and inosine levels fluctuate significantly during cardiac surgery.
  • These nucleoside changes may contribute to cardiovascular responses after intubation and CPB.
  • Further research is warranted to elucidate the precise role of adenosine and inosine in perioperative cardiovascular dynamics.