Effect of dexmedetomidine on postoperative inflammatory response and oxidative stress in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass

Zhang Qian; Wang Huan; Meng Cheng; Wang Jihong

doi:10.13498/j.cnki.chin.j.ecc.2025.03.08

Abstract：Objective To investigate the effects of different doses of dexmedetomidine(DEX)on postoperative inflammatory response and oxidative stress in patients undergoing coronary artery bypass grafting(CABG)with cardiopulmonary bypass(CPB),and to provide evidence for postoperative recovery and prevention of complications.Methods A total of 212 CABG+CPB patients admitted to our hospital from October 2019 to June 2023 were randomly divided into four groups:control group,low-dose DEX group(0.3 μg/kg/h),medium-dose DEX group(0.6 μg/kg/h),and high-dose DEX group(1.0 μg/kg/h),with 53 patients in each group.The hemodynamic parameters,postoperative recovery period complications,hospital recovery status,entropy index,cognitive function,inflammatory cytokines,and oxidative stress markers were compared among the four groups.Results The incidence of airway infection,mechanical ventilation dependence,arrhythmias,hypotension,and acute renal injury in the medium and high-dose groups were lower than those in the control and low-dose groups,but the differences were not statistically significant.The length of hospital stay,ICU duration,and time to spontaneous breathing recovery were significantly shorter in the medium and high-dose groups compared to the control and low-dose groups(P<0.05).The central venous pressure in the high-dose DEX group was significantly higher than in the other groups,and cardiac index was lowest at intubation and post-sternotomy in the high-dose group.The systemic vascular resistance index significantly decreased,particularly in the high-dose group(P<0.01).DEX treatment significantly affected entropy indices,with higher response and state entropy in the high-dose group at intubation(P<0.01).Postoperative cognitive function assessment(MoCA)showed that the scores of the medium and high-dose groups on postoperative day 3 were significantly higher than those of the control and low-dose groups(P<0.01).Inflammatory markers(TNF-α,IL-6,IL-1β)and oxidative stress markers(malondialdehyde,superoxide dismutase,glutathione peroxidase)increased on postoperative day 3,but were significantly lower in the medium and high-dose groups on postoperative days 3 and 7 compared to the control group(P<0.01).Conclusion High-dose DEX effectively regulates hemodynamics,improves postoperative cognitive function,and significantly inhibits inflammation and oxidative stress.Medium-and high-dose DEX may offer better clinical outcomes after CABG,with the medium dose providing the most stable hemodynamic effects.