Perioperative erythropoietin protects the CNS against ischemic lesions in patients after open heart surgery

Summary Aim The aim of this study was to establish erythropoietin as a protective factor against brain ischemia during open heart surgery. Methods A total of 36 consecutive patients scheduled for revascularization heart surgery were included in the study. Of the patients 18 received 3 intravenous do...

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Bibliographic Details
Published in:Wiener Klinische Wochenschrift 2016-12, Vol.128 (23-24), p.875-881
Main Authors: Lakič, Nikola, Mrak, Miha, Šušteršič, Miha, Rakovec, Peter, Bunc, Matjaž
Format: Article
Language:English
Subjects:
Aged
Brain Ischemia - diagnostic imaging
Brain Ischemia - etiology
Brain Ischemia - prevention & control
Cardiac Surgical Procedures
Coronary Artery Bypass - adverse effects
Double-Blind Method
Endocrinology
Erythropoietin - administration & dosage
Female
Gastroenterology
Humans
Internal Medicine
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Neuroprotective Agents - administration & dosage
Original Article
Placebo Effect
Pneumology/Respiratory System
Premedication
Preoperative Care - methods
Prognosis
Prospective Studies
Thoracotomy - adverse effects
Treatment Outcome
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Summary:Summary Aim The aim of this study was to establish erythropoietin as a protective factor against brain ischemia during open heart surgery. Methods A total of 36 consecutive patients scheduled for revascularization heart surgery were included in the study. Of the patients 18 received 3 intravenous doses of recombinant human erythropoietin (rHuEpo, 24,000 IU) and 18 patients received a placebo. Magnetic resonance imaging (MRI) to detect new brain ischemic lesions was performed. Additionally, S100A, S100B, neuron-specific enolase A and B (NSE-A and B) and the concentration of antibodies against N‑methyl-D-aspartate receptors (NMDAR) to identify new neurological complications were determined. Results Patients who received rHuEpo showed no postoperative ischemic changes in the brain on MRI images. In the control group 5 (27.8 %) new ischemic lesions were found. The NMDAR antibody concentration, S100A, S100B and NSE showed no significant differences between the groups for new cerebral ischemia. High levels of lactate before and after external aortic compression ( p  = 0.022 and p  = 0.048, respectively) and duration of operation could predict new ischemic lesions ( p  = 0.009). Conclusions The addition of rHuEpo reduced the formation of lesions detectable by MRI in the brain and could be used clinically as neuroprotection in cardiac surgery.
ISSN:0043-5325
1613-7671
DOI:10.1007/s00508-016-1063-0