Volatile Anesthetics Reduce Biochemical Markers of Brain Injury and Brain Magnesium Disorders in Patients Undergoing Coronary Artery Bypass Graft Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia 2012-06, Vol.26 (3), p.395-402
• Main Authors: Dabrowski, Wojciech, MD, PhD, Rzecki, Ziemowit, MD, PhD, Czajkowski, Marek, MD, PhD, Pilat, Jacek, MD, PhD, Wacinski, Piotr, MD, PhD, Kotlinska, Edyta, MD, PhD, Sztanke, Małgorzata, MD, PhD, Sztanke, Krzysztof, PhD, Stazka, Krzysztof, MD, Pasternak, Kazimierz, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Anesthetics, Inhalation - therapeutic use; Biomarkers - blood; Brain - metabolism; Brain Injuries - diagnosis; Brain Injuries - etiology; Brain Injuries - prevention & control; Coronary Artery Bypass - adverse effects; coronary artery bypass graft surgery; Critical Care; extracorporeal circulation; Female; glial fibrillary acidic protein; Glial Fibrillary Acidic Protein - blood; Humans; isoflurane; Isoflurane - therapeutic use; magnesium; Magnesium - blood; Male; Matrix Metalloproteinase 9 - blood; matrix metalloproteinase-9; Methyl Ethers - therapeutic use; Middle Aged; Neuroprotective Agents - therapeutic use; sevoflurane
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2011.10.014

Objectives Neuropsychological disorders are some of the most common complications of coronary artery bypass graft (CABG) surgery. The early diagnosis of postoperative brain damage is difficult and mainly based on the observation of specific brain injury markers. The aim of this study was to analyze the effects of volatile anesthesia (VA) on plasma total and ionized arteriovenous magnesium concentrations in the brain circulation (a-vtMg and a-viMg), plasma matrix metalloproteinase-9 (MMP-9), and glial fibrillary acidic protein (GFAP) in adult patients undergoing CABG surgery. Design An observational study. Setting The Department of Cardiac Surgery in a Medical University Hospital. Patients and Methods Studied parameters were measured during surgery and in the early postoperative period. Patients were assigned to 3 groups: group O, patients who did not receive VA; group ISO, patients who received isoflurane; and group SEV, patients who received sevoflurane. Results Ninety-two patients were examined. CABG surgery increased MMP-9 and GFAP. The highest MMP-9, GFAP, and the most dramatic disorders in a-vtMg and a-viMg were noted in group O. Conclusions Cardiac surgery increased plasma MMP-9 and GFAP concentrations. Changes in MMP-9, GFAP, and arteriovenous tMg and iMg were significantly higher in group O. Volatile anesthetics, such as ISO or SEV, reduced plasma MMP-9, GFAP concentrations, and disturbances in a-vtMg and a-viMg.