Effects of autotransfusion of mediastinal shed blood on biochemical markers of myocardial damage in coronary surgery.
BACKGROUND
Previous studies have shown conflicting results regarding the effect of autotransfusion of mediastinal shed blood after coronary artery bypass grafting (CABG) on the serum levels of myocardial band (MB) isoenzymes of creatine kinase (CK-MB) and cardiac troponins. The effect of autotransfusion on serum levels of human heart fatty acid binding protein (H-FABP), another marker of myocardial necrosis, has not been studied. The aim of the present study was to investigate the effects of autotransfusion of mediastinal shed blood on the serum levels of CK-MB, cardiac troponin T (cTnT), and H-FABP after uncomplicated primary CABG.


METHODS
Fifty patients were randomized to post-operative autotransfusion of mediastinal shed blood or no autotransfusion. Blood samples for the analysis of the biochemical markers of myocardial damage were drawn pre-operatively and 1, 4, 12, 24, 48, and 72 h after the termination of cardiopulmonary bypass. Samples from the mediastinal shed blood were collected after 1 and 4 h.


RESULTS
The levels of the biochemical markers of myocardial injury were all markedly elevated in mediastinal shed blood. Autotransfusion did not significantly affect the serum levels of cTnT or H-FABP. However, during the early post-operative hours, there was a trend towards a higher level of cTnT and H-FABP in the autotransfusion group. During the first 24 h after surgery, the autotransfusion group had a significantly higher serum level of CK-MB.


CONCLUSIONS
Post-operative autotransfusion of mediastinal shed blood may contribute to elevated serum levels of biochemical markers of myocardial injury.
Pleym
H
H
Department of Cardiothoracic Anesthesia and Intensive Care, St. Olav University Hospital, Trondheim, Norway. hilde.pleym@stolav.no
Tjomsland
O
O
Asberg
A
A
Lydersen
S
S
Wahba
A
A
Bjella
L
L
Dale
O
O
Stenseth
R
R
D000368:Aged; D015415:Biomarkers; D001804:Blood Transfusion, Autologous; D009202:Cardiomyopathies / Q000209:etiology* / Q000378:metabolism* / Q000473:pathology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003402:Creatine Kinase / Q000378:metabolism; D050556:Fatty Acid-Binding Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000502:physiology; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011183:Postoperative Complications / Q000378:metabolism*; D011446:Prospective Studies; D020107:Troponin T / Q000378:metabolism
D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; D020107:Troponin T; D003402:Creatine Kinase