Cerebral protective effects of hyperbaric oxygen preconditioning on patients un-dergoing cardiac valve replacement

Wu Fan; Zhou Kai; Gao Feng; Zhang Jin-bao; Fu Xi; Guo Xin; He Chun-yang

doi:10.13498/j.cnki.chin.j.ecc.2015.02.06

Abstract：Objective To observe the cerebralprotective effects of preoperative hyperbaric oxygen(HBO) preconditioning on patients after cardiac valve replacement by means of cardiopulmonary bypass( CPB) . Methods Forty-two cases who were going to re?ceive mitral or aortic valve replacement were randomized into control group (n=20) and preconditioning group (n=12) .Three ses?sions of HBO preconditioning were given to preconditioning group before operation. A comparative study was made to the changes of neurocognitive testing, as well as serum concentration of protein S100βand neuron-specific enolase ( NSE) between both groups perio?peratively. Results (1) The clinical data during perioperation between both groups showed no statistical difference ( P>0.05). (2) There existed no statistical difference among neurocognitive test scores between both groups 48 h before operation ( P >0.05). The scores of neurocognitive test except Trail Making Test in both groups all declined 1 week after operation. No statistical difference existed between preoperative and postoperative scores ( P>0.05) while Digit Symbol Test scores went down sharply 1 week after operation ( P<0.05). Besides, 8 cases (40.0%) underwent post operative cognitive dysfunction (POCD) in control group compared to precondi?tioning group where 2 cases (9.1%) suffered from POCD ( P<0.05).(3) The serum concentration of protein S100β and NSE in?creased from 30 min after CPB, peaked at 1 h after the end of CPB, and declined gradually, but the level were higher than that of pre?operation at 24 h after the end of CPB ( P<0.05) . The concentration of protein S100βat 1, 12 h after the end of CPB and NSE at 1, 12, 24 h in preconditioning group were lower than that of control group ( P<0.05) . Conclusion Hyperbaric oxygen preconditioning before operation acted as a protector of brain for patients undergoing cardiac valve replacement surgery.