title: Effect of intralipid postconditioning on myocardial injury in patients undergoing valve replacement surgery: a randomised controlled trial.
abstract: This study was conducted to determine whether the administration of intralipid just before aortic cross-unclamping would reduce myocardial injury in patients undergoing valve replacement surgery.
  
  
  
  Seventy-three adult patients, scheduled for elective aortic or mitral valve surgery without significant coronary stenosis (>70%), were randomly assigned to the intralipid postconditioning (ILPC) group (n=37) or control group (n=36): the ILPC group received an intravenous infusion of 20% intralipid (2 mL/kg) just 10 min before aortic cross-unclamping, and the control group received an equivalent volume of normal saline. Serum cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) was measured before surgery and at 4, 12, 24, 48 and 72 hours after surgery. The primary end points were the 72-hour area under the curve (AUC) for cTnT and CK-MB.
  
  
  
  No significant difference between the ILPC and control arm was observed, including the age, sex or number of aortic versus mitral valves or left ventricular ejection fraction at baseline. The total 72-hour AUC of cTnT and CK-MB in patients assigned to ILPC were significantly reduced by 32.3% (p=0.004) and 26.4% (p=0.0185) compared with control, respectively. None of the treated patients had abnormal blood lipid metabolism, abnormal renal or hepatic function or significant related complications.
  
  
  
  The protective effect of postischaemic administration of intralipid prior to aortic cross-unclamping on reperfusion injury was found when determined by biomarkers of myocardial injury but not by cardiac function or other clinical outcomes in patients undergoing valve replacement surgery. Hence, clinical benefits of this protection need larger clinical trials to confirm.
  
  
  
  ClinicalTrials.gov ID: ChiCTR-IOR-14005318.
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Rong-Hua
authors.initials: RH
authors.lastname: Zhou
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Xiao-Rong
authors.initials: XR
authors.lastname: Yin
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Hai
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Chan
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Ji-Yue
authors.initials: JY
authors.lastname: Xiong
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Qin
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Zhao-Xia
authors.initials: ZX
authors.lastname: Tan
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
authors.forename: Ting
authors.initials: T
authors.lastname: Liu
mesh_terms: D017558:Elective Surgical Procedures / Q000009:adverse effects; D004655:Emulsions / Q000008:administration & dosage; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D057775:Ischemic Postconditioning / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D010743:Phospholipids / Q000008:administration & dosage*; D011446:Prospective Studies; D016037:Single-Blind Method; D013024:Soybean Oil / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil
keywords: Cardiac surgery; Valve disease surgery