title: Influence of dextran-70 on systemic inflammatory response and myocardial ischaemia-reperfusion following cardiac operations.
abstract: BACKGROUND
  Experimental studies have demonstrated that dextran-70 reduces the leukocyte-endothelium interaction, but clinical evidence is still lacking. Our objective was to justify the anti-inflammatory effect of dextran-70 following cardiac operations.
  
  
  METHODS
  Forty patients undergoing coronary bypass surgery (n = 32) or aortic valve replacement (n = 8) were enrolled in this prospective, randomized, double-blind study. Two groups were formed. In group A (n = 20), dextran-70 infusion was administered at a dose of 7.5 ml/kg before the initiation of cardiopulmonary bypass and at a dose of 12.5 ml/kg after the cessation of cardiopulmonary bypass. Group B served as a control with identical amounts of gelatin infusion (n = 20). The plasma concentration of procalcitonin, C-reactive protein, IL 6, IL 6r, IL 8, IL 10, soluble endothelial leukocyte adhesion molecule-1, soluble intercellular adhesion molecule-1, cardiac troponin-I and various haemodynamic parameters were measured in the perioperative period. Multivariate methods were used for statistical analysis.
  
  
  RESULTS
  In group A, lower peak (median) plasma levels of procalcitonin (0.2 versus 1.4, p < 0.001), IL 8 (5.6 versus 94.8, p < 0.001), IL 10 (47.2 versus 209.7, p = 0.001), endothelial leukocyte adhesion molecule-1 (88.5 versus 130.6, p = 0.033), intercellular adhesion molecule-1 (806.7 versus 1,375.7, P = 0.001) and troponin-I (0.22 versus 0.66, p = 0.018) were found. There was no significant difference in IL 6, IL-6r and C-reactive protein values between groups. Higher figures of the cardiac index (p = 0.010) along with reduced systemic vascular resistance (p = 0.005) were noted in group A.
  
  
  CONCLUSIONS
  Our investigation demonstrated that the use of dextran-70 reduces the systemic inflammatory response and cardiac troponin-I release following cardiac operation.
  
  
  BACKGROUND
  ISRCTN38289094.
authors: Zala County Hospital, Department of Cardiac Surgery, University of Pécs, Zalaegerszeg, Hungary. gomboczk@freemail.hu
authors: Károly
authors: K
authors: Gombocz
authors: Agnes
authors: A
authors: Beledi
authors: Nasri
authors: N
authors: Alotti
authors: Gábor
authors: G
authors: Kecskés
authors: Valéria
authors: V
authors: Gábor
authors: Lajos
authors: L
authors: Bogár
authors: Tamás
authors: T
authors: Koszegi
authors: János
authors: J
authors: Garai
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003911:Dextrans / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; C000606589:CALCA protein, human; D003911:Dextrans; D016209:Interleukin-8; D011498:Protein Precursors; D018799:Intercellular Adhesion Molecule-1; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
references: Eur J Cardiothorac Surg. 1999 Sep;16 Suppl 1:S107-11
references: 10536961
references: Ann Thorac Surg. 1997 Aug;64(2):460-5
references: 9262594
references: J Trauma. 1998 Feb;44(2):313-9
references: 9498503
references: Thorac Cardiovasc Surg. 1999 Feb;47(1):26-31
references: 10218617
references: Ann Thorac Surg. 1999 Jul;68(1):52-6; discussion 56-7
references: 10421114
references: Anesthesiology. 2005 Oct;103(4):759-67
references: 16192768
references: Am J Physiol Heart Circ Physiol. 2006 Apr;290(4):H1642-50
references: 16299261
references: Ann Clin Lab Sci. 2006 Summer;36(3):345-52
references: 16951278
references: Anesth Analg. 2007 Mar;104(3):624-30
references: 17312221
references: J Surg Res. 2000 Dec;94(2):145-52
references: 11104654
references: Anaesthesist. 1997 Nov;46(11):927-37
references: 9490579
references: Intensive Care Med. 1999 Dec;25(12):1381-5
references: 10660845
references: Cardiovasc Res. 2000 Mar;45(4):853-9
references: 10728410
references: J Cardiothorac Vasc Anesth. 2000 Jun;14(3 Suppl 1):22-36; discussion 37-8
references: 10890471
references: Anesthesiology. 2000 Nov;93(5):1210-6; discussion 5A
references: 11046208
references: Thorac Cardiovasc Surg. 2000 Dec;48(6):364-9
references: 11145406
references: Acta Anaesthesiol Scand. 2001 Mar;45(3):385-9
references: 11207478
references: Transfusion. 2001 Aug;41(8):1064-8
references: 11493740
references: Perfusion. 2001 Sep;16(5):353-60
references: 11565890
references: Circulation. 2001 Sep 18;104(12 Suppl 1):I265-9
references: 11568067
references: Ann Thorac Surg. 2002 Jan;73(1):123-9; discussion 129-30
references: 11833998
references: J Cardiothorac Vasc Anesth. 2002 Feb;16(1):47-53
references: 11854878
references: Perfusion. 2002 Mar;17(2):103-9
references: 11958300
references: Intensive Care Med. 2002 Aug;28(8):1094-102
references: 12185431
references: J Trauma. 2003 Jun;54(6):1065-74; discussion 1075-6
references: 12813324
references: Curr Drug Targets Inflamm Allergy. 2003 Sep;2(3):242-56
references: 14561159
references: Can J Anaesth. 2003 Dec;50(10):1009-16
references: 14656778
references: Heart. 2004 Jan;90(1):99-106
references: 14676259
references: Adv Exp Med Biol. 1977 Jul 4-7;94:383-9
references: 613781
references: Ann Surg. 1981 Jan;193(1):99-104
references: 6161586
references: J Surg Res. 1985 Sep;39(3):183-91
references: 2412002
references: Crit Care Med. 1988 Mar;16(3):266-71
references: 2449312
references: Eur Surg Res. 1988;20(2):101-9
references: 2455645
references: Crit Care Med. 1989 Dec;17(12):1306-9
references: 2480205
references: Ann Thorac Surg. 1990 Feb;49(2):279-83
references: 2306150
references: Crit Care Med. 1991 Mar;19(3):316-8
references: 1999090
references: Anesthesiology. 1995 Apr;82(4):975-82
references: 7717571
references: Infusionsther Transfusionsmed. 1995 Dec;22(6):332-8
references: 8589592
references: Crit Care Med. 1996 Mar;24(3):385-91
references: 8625624
references: Transfusion. 1997 Mar;37(3):264-8
references: 9122898
references: J Cardiothorac Vasc Anesth. 1997 May;11(3):355-66
references: 9161905