Effects Of Ketamine On Neutrophil Induced Inflammatory Response In Patients Associate With Cardiopulmonary Bypass

Objective:To evaluation the efficacy of ketamine on the express of adhension molecular CR3 and intracellular cAMP/cGMP in neutrophils from patients associated with cardiopulmonary bypass(CPB),as well as the cardiovascular function.Methods:Patients were randomized to 1 of 4 groups:placebo;ketamine,0.1 mg/kg; ketamine,0.5mg/kg;or ketamine,1mg/kg.Each group included 15 cases.Venous blood samples were obtained at anesthesia induction(T₁),10 min before CPB(T₂),end of CPB(T₃) and 24 h after operation(T₄).The expression of CR3 was measured by Flow cytometry and the concentration of cAMP / cGMP by HPLC.Results:ketamine with various dosages decreased the expression of CR3 at the T₃ and T₄ compared with placebo(p＜0.05).0.5mg/kg group and 1mg/kg group had more significant effect than 0.1mg/kg group.0.5mg/kg and 1mg/kg ketamine increased the intracellular cAMP at the T₃ and T₄ compared with 0.1mg/kg group and placebo (p＜0.05),respectively.However,cGMP was lower in 0.5mg/kg and 1mg/kg group than 0.1mg/kg group and placebo(p＜0.05) atthe T₃.Further,mean artery blood pressure was higher in 0.5mg/kg and lmg/kg group at T₄.Only 1mg/kg group required less dose of postoperative inotropic drugs supports.Conclusion:low-dose ketamine inhibits the activation of PMN during CPB and reduces systematic inflammatory response...