Troponin repercussion of defibrillation at the end of cardiopulmonary bypass.
OBJECTIVE
Cardiopulmonary bypass (CPB) is a relatively common procedure in cardiac surgery. At the end, the heart is electrically defibrillated if not already beating. External and internal cardioversion by specific catheters do not raise plasma troponin concentration, but the possible repercussion on troponin of the direct cardioversion of the heart has not been documented.


METHODS
Prospective comparative trial in a surgical intensive care unit in a university hospital was conducted. The study sample comprised 364 consecutive patients undergoing cardiac surgery with CPB and without perioperative myocardial infarction.


RESULTS
The number of cardioversions applied was recorded and three groups were obtained: A/no cardioversion; B/one or two cardioversions; and C/more than two cardioversions. Serum troponin I and CK-MB were determined at admission and after 6, 12, 24, and 48 hours. Significant differences were found between group C and groups A and B for troponin I and creatine kinase (CK-MB) curves, being higher for both variables in group C.


CONCLUSIONS
With more than two cardioversions post-CPB, both troponin I and CK-MB may present an additional increase.
Rodriguez-Castro
David
D
Department of Intensive Care, Hospital Universitari de Bellvitge, Barcelona, Spain. 28136drc@comb.es
Farrero
Elisabet
E
Javierre
Casimiro
C
Carrio
Maria L
ML
Diaz-Prieto
Antonio
A
Valero
Jose
J
Fontanillas
Carles
C
Castells
Eduard
E
Ventura
Josep L
JL
D000368:Aged; D002315:Cardiopulmonary Bypass; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis; D011446:Prospective Studies; D019210:Troponin I / Q000097:blood*
D019210:Troponin I; D052279:Creatine Kinase, MB Form