机构：[1]Department of Cardiology Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China临床科室心脏外科中心首都医科大学附属安贞医院[2]Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China临床科室麻醉中心首都医科大学附属安贞医院[3]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Background: The Stanford type A acute aortic dissection (AAD) carries a high risk of mortality and morbidity, and patients undergoing AAD surgery often bleed excessively and require blood products and transfusions. Thus, we studied how xenon alters coagulation using thromboelastography (TKG) and conventional hemostatic tests for patients with AAD undergoing aortic arch surgery involving cardiopulmonary bypass (CPB)/deep hypothermic circulatory arrest (DHCA). Methods: This prospective single-center nonrandomized controlled clinical trial, registered in the Chinese Clinical Trial Registry (ChiCTR-ICR-15006435), assessed perioperative clinical variables and serological results from 50 subjects undergoing pulmonary static inflation with 50% nitrogen/50% oxygen from January 2013 to January 2014 and 50 subjects undergoing pulmonary static inflation with 50% xenon/50% oxygen from January 2014 to December 2014 during CPB for Stanford type A AAD. Repeated measures ANOVA were used to identify the effects of xenon on coagulation after surgery. The primary endpoint was perioperative changes in coagulation and fibrinolysis after intubation and 10 minutes, and 6 hours after the operation. The secondary endpoint was to assess tire perioperative changes in scrum level of tissue factor (TF), tissue factor pathway inhibitor (TFPI) and tissue plasminogen activator (tPA) after intubation and 10 minutes, and 6 hours after the operation. Results: Mean prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), median fibrinogen degradation product (FDP), and D-dimer peaked and then decreased over 6 hours after surgery. TEG followed a similar trend. From the start to the end of surgery and until 6 h after surgery, mean TF decreased in controls (beta -2.61, P<0.001 and beta -2.83, P<0.001, respectively), but was maintained relatively stable in xenon group (beta -0.5, P<0.001 and beta -0.96, P<O.001, respectively). Conclusions: Deterioration of coagulation function and activated fibrinolysis was confirmed by conventional tests and TFG analysis after Stanford ty pe A AAD repair. Pulmonary static inflation with 50% xenon attenuates decline in TF in patients undergoing Stanford type A AAD repair.
基金：
Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z151100004015133, Z161100000513067, Z171100001017083]; National Science and Technology Support Program of China [2015BAI12B03]
第一作者机构：[1]Department of Cardiology Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Cardiology Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China[3]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China[*1]Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.[*2]Department of Cardiology Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China
推荐引用方式(GB/T 7714)：
Xudong Pan,Jiakai Lu,Weiping Cheng,et al.Pulmonary static inflation with 50% xenon attenuates decline in tissue factor in patients undergoing Stanford type A acute aortic dissection repair[J].JOURNAL OF THORACIC DISEASE.2018,10(7):4368-4376.doi:10.21037/jtd.2018.06.95.
APA：
Xudong Pan,Jiakai Lu,Weiping Cheng,Yanwei Yang,Junming Zhu&Mu Jin.(2018).Pulmonary static inflation with 50% xenon attenuates decline in tissue factor in patients undergoing Stanford type A acute aortic dissection repair.JOURNAL OF THORACIC DISEASE,10,(7)
MLA：
Xudong Pan,et al."Pulmonary static inflation with 50% xenon attenuates decline in tissue factor in patients undergoing Stanford type A acute aortic dissection repair".JOURNAL OF THORACIC DISEASE 10..7(2018):4368-4376
