The Effects Of Esmolol On During Cardiopulmonary Bypass In Patients Undergoing Cardiac Valve Replacement With Plasma NT-ProBNP

Objective:To observe the heart stop application of esmolol in cardiopulmonary bypass in valve replacement patients jump, whether alleviate myocardial ischemia reperfusion injury and is beneficial to the heart function recovery, on plasma N-terminal pro brain natriuretic peptide (NT proBNP) precursors as myocardial protection in patients undergoing cardiac surgery with cardiopulmonary bypass refers to the feasibility of the subject.Methods:In the aged 18-70 years, conforms to the research conditions and undergoing cardiopulmonary bypass heart stopped jump valve replacement patients, according to randomly select 40 cases, were randomly divided into experimental group (s group) and control group (C group),20 cases in each group. Two groups were treated with the same static inhalation anesthesia, group s:at the start of CPB and ascending one minute before the opening of the aorta, respectively, giving esmolol injection (2mg/kg) was administered pipeline through extracorporeal circulation tube, group C did not give esmolol injection, given 0.9% NaCl injection 10ml each time. The other treatment was the same in the two groups. At the end of the skin (T1),5 min (T2) after the cardiopulmonary bypass (T3),6 h (T4) after surgery, blood samples from radial artery were collected and plasma NT-ProBNP concentration was determined.. Observation record T1～T4 each time point two groups of plasma NT proBNP changes recording two groups of patients in T1～T4 at each time point of the central venous pressure (CVP), heart rate (HR), mean arterial pressure (map); records of patients with aortic cross clamping time, turn flow time, operation time, postoperative ventilator assisted breathing time, postoperative CCU stay the operation time and hospitalization time; record open aorta after cardiac resuscitation, postoperative dopamine injection rate and postoperative complications. Using SPSS 16.0 software for statistical analysis, measurement data to x±s said that the two samples were test by t test group and the control group mean compared with repeated measures analysis of variance analysis, count data compared with chi square test and detection level of alpha 0.05, P< 0.05 for a statistically significant difference.Results:Two groups of patients with gender, age, preoperative EF value, disease and operation indexes had no significant difference; blocking time, bypass time, operation time, postoperative ventilation time, postoperative CCU stay time, postoperative hospitalization time and postoperative complications had no significant difference in two groups the two group of the ascending aorta; aortic opening ltheresuscitationofhearts:group S automatic Rebeating in 19 cases (19/20,95%),14 cases in C group (16/20,80%), there were significant differences between the two groups (χ2=4.329,P=0.037); the two group of T1～T4 at different time points CVP, HR and MAP was not statistically significant (P>0.05); group two T2～T4 time point of plasma NT-ProBNP values were higher than T1, and the T1 was statistically significant (P<0.05, T2～T4) in the two time points of plasma NT-ProBNP values were statistically significant (P<0.05), the experimental group compared with control group, plasma NT-ProBNP value is low.Conclusion:In the beating heart valve replacement with cardiopulmonary bypass after certain time of cardiac function in patients did not recover to normal and extracorporeal circulation during the application of esmolol on postoperative heart function recovery have certain protective effect. NT-ProBNP concentration can reflect the recovery of cardiac function in patients with cardiopulmonary bypass valve replacement.