Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Endothelial Function and Hypoxic-Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial

Irina A. Mandel
* ORCID logo ,
Yuriy K. Podoksenov
,
Sergey L. Mikheev
,
Irina V. Suhodolo
,
Yulia S. Svirko
,
Vladimir M. Shipulin
ORCID logo ,
Andrey G. Yavorovskiy
,
Andrey I. Yaroshetskiy
Version 1 : Received: 13 February 2023 / Approved: 20 February 2023 / Online: 20 February 2023 (15:14:26 CET)

A peer-reviewed article of this Preprint also exists.

Mandel, I.A.; Podoksenov, Y.K.; Mikheev, S.L.; Suhodolo, I.V.; Svirko, Y.S.; Shipulin, V.M.; Ivanova, A.V.; Yavorovskiy, A.G.; Yaroshetskiy, A.I. Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial. Biomedicines 2023, 11, 1044. Mandel, I.A.; Podoksenov, Y.K.; Mikheev, S.L.; Suhodolo, I.V.; Svirko, Y.S.; Shipulin, V.M.; Ivanova, A.V.; Yavorovskiy, A.G.; Yaroshetskiy, A.I. Endothelial Function and Hypoxic–Hyperoxic Preconditioning in Coronary Surgery with a Cardiopulmonary Bypass: Randomized Clinical Trial. Biomedicines 2023, 11, 1044.

Abstract

Background: The hypothesis is that a hypoxic-hyperoxic preconditioning (HHP) is associated with a protective effect on myocardial function by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: Patients (n=120) were randomly assigned to an HHP and a control group. A safe inhaled oxygen fraction for the hypoxic preconditioning phase (10-14% oxygen for 10 minutes) was determined by measuring the anaerobic threshold. At hyperoxic phase, 75-80% oxygen fraction was used during 30 minutes. Results: The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs 23 (41.1%), p=0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low more than 24 h in control group. The endothelial damage markers appeared to be predictors of postoperative complications. Conclusion: The HHP with individual parameters based on the anaerobic threshold is a safe procedure, it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications.

Keywords

oxygen transport; cardioprotection; hypoxic-hyperoxic preconditioning; ischemia-reperfusion injury; cardiopulmonary bypass; endothelial damage markers

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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