Effects Of Ambroxol On Cardiopulmonary Bypass-induced Oxidant And Preinflammatory Cytokine Response

Objective: To evaluate the effects of Ambroxol iv by drip before open-heart surgery on cardiopulmonary bypass induced oxidant and preinflammatory cytokine response. Methods: Forty congenital heart disease (ventricular septal defect,VSD) patients scheduled to undergo cardiac operations with cardiopulmonary bypass (CPB) were devided randomly into two groups: GroupA(Ambroxol group) and GroupB(control group), each with 20 patients. The patients in GroupA received Ambroxol iv by drip: 10mg/kg/day respectively the operation day and the two days before the surgery day; The patients in GroupB received 0.9﹪NaCl with the same volume accordingly.The methods of CPB and infusion in GroupA and GroupB was the same.Blood samples were collected in both groups respectiveiy before CPB(T1) ,During CPB20minutes(T2) ,and after-CPB 20minutes,4hours,24hours(T3,T4,T5).Then the content of malondialdehyde (MDA) ,tumor necrosis factor -alpha (TNF-α),interleukin-8(IL-8) in plasma of all blood samples was tested. In the meantime,the totle CPB time and the aortic cross-clamp time were observed.Results:1. The mean age , mean weight, CPB time and aortic cross-clamp time were comparable between the two groups.There was no significant differences between the two groups as to the plasma concentration of MDA, TNF-α,IL-8 before CPB(T1).2. In both groups MDA concentrations fromT2 to T4 increased significantly as compared with T1,and reached the peak at T3 ,then returned to the pre-CPB level at T5.The changes were more severe in the control group than that in the Ambroxol-treated group.3. TNF-α levels of Group A at T2,T3,T4were much higer than that of T1,and reached the peak at T3;in Group B,the changes were milder.4. In both Group A and Group B,IL-8 levels were increased from T2 to T5,T3 is the highest one; each one was significantly lower in the treated group than in the control group accordingly.Conclussion:Ambroxol iv by drip before cardiac operation has a better anti-oxidant effect and can attenuate preinflammatory cytokines response.