Abstract
High expression of cluster of differentiation (CD)39 and CD73 has cardio-protective effects. We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing open heart surgery (OHS). The objective of this prospective randomized trial was to compare the changes in CD39 and CD73 levels in CD4+ T cells between propofol- and sevoflurane-based anaesthesia during OHS. The study randomly allocated 156 patients undergoing OHS to a propofol or sevoflurane group. Blood was obtained preoperatively and up to 48 hours after weaning from cardiopulmonary bypass (CPB). The expression levels of CD39 and CD73 in circulating CD4+ T cells, serum cytokines and other laboratory parameters were analysed. The primary outcome was the expression of CD39 and CD73 on CD4+ T cells. Demographic data and perioperative haemodynamic changes did not show significant differences between the two groups. The expression of CD39 and CD73 in the sevoflurane group was significantly lower than in the propofol group (P < 0.001). Other laboratory findings including cardiac enzymes and cytokine levels, did not show significant intergroup differences. Propofol attenuated the decrease in CD39 and CD73 in circulating CD4+ T cells compared to sevoflurane-based anaesthesia during OHS.
Highlights
Open heart surgery (OHS) with aortic cross clamping induces ischemia-reperfusion injury (IRI) accompanied by a systemic inflammatory response, resulting in critical postoperative complications[1,2,3]
We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing open heart surgery (OHS)
This study showed that the expression of CD39 and CD73 in circulating helper T cells was low immediately after weaning from cardiopulmonary bypass (CPB) and recovered over time
Summary
Open heart surgery (OHS) with aortic cross clamping induces ischemia-reperfusion injury (IRI) accompanied by a systemic inflammatory response, resulting in critical postoperative complications[1,2,3]. Propofol and volatile anaesthetics are the most popular agents for OHS, and propofol may be a useful organ-protective anaesthetic due to its anti-inflammatory properties[4,5]. A comparison of the change in CD39 and CD73 expression between propofol- and volatile anaesthetic-based anaesthesia during OHS has not been conducted. Anaesthetised by propofol or volatile anaesthetics during OHS could increase our understanding on the mechanism underlying the anti-inflammatory effect of propofol and volatile anaesthetics against IRI during OHS. We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing OHS. This study was designed to investigate the expression CD39 and CD73 in the circulating CD4+ T cells of patients undergoing OHS under propofol- and sevoflurane-based anaesthesia
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