Effect Of 6% HES 130/0.4 Priming Solution On Vascular Endothelial Cells After Cardiopulmonary Bypass

Objective: To observe the effect of 6% HES 130/0.4(Voluven) as priming solution on soluble adhesion molecule-1(sICAM-1), plasma thrombomodulin(TM) and circulati- ng endothelial cell(CEC) levels in open cardiac surgery under cardiopulmonary bypass(CPB). To evaluate whether 6% HES 130/0.4 show protective effect on vascular endothelial cells injured in CPB and open cardiac surgery.Methods: Forty patients scheduled for elective mitral valve replacement under CPB with moderate hypothermia were randomized divided into two groups according to different priming fluid, that is control group with Gelofusine(n=20) and study group with 6% HES 130/0.4(n=20). Fluid therapy was given perioperatively and continued for 48 hours postoperation. The levers of CEC,sICAM-1 and TM were measured after induction of anesthesia(T1), at the end of CPB(T2), as well as 2 hours(T3), 24 hours (T4) and 48 hours(T5) after the end of ECC for both groups.Results: After induction of anaesthesia(T1), there is no significant difference between the two groups in CEC,sICAM-1 and TM levels(P>0.05). Compared with T1, levels of CEC increased at T2 and T3(P<0.05), and reverted to baseline at T4(P>0.05). Meanwhile, there is significant difference between the two groups at T3(P<0.05), and lower in control group. Compared with T1, levels of sICAM-1 increased at T3(P<0.05), and at T4 it reverted to baseline with study group(P>0.05), but higher than baseline with control group though it begine to decline. Meanwhile, there is significant difference between the two groups at T3(P<0.05), and higher in control group. Compared with T1, levels of TM increased at T2,T3 and T4.(P<0.05), and reverted to baseline at T5(P>0.05). Meanwhile, there is significant difference between the two groups at T3 and T4 (P<0.05), and lower in control group.Conclusions: 1 There is injury of VEC with patients for elective mitral valve replacement under CPB.2 6% HES 130/0.4 is safe as priming solution for CPB,and can protect the VEC and their function effectively, and can alleviate SIR that result from CPB.