The study aimed to evaluate the combined effects of cyclosporine and remote ischemic preconditioning on MDA, calcium cytosol concentration, and mitochondrial edema in tetralogy Fallot patients undergoing corrective surgery.
Forty patients undergoing tetralogy Fallot corrective surgery were randomized to RIPC and cyclosporine (n=20) and control (n=20). Cyclosporin was administered 2 hour pre induction of anesthesia with the dose of 3 mg/kg body weight intravenously. RIPC was performed preoperatively after induction of anesthesia by inflating pressure cuff on the extremity 30 mmHg higher than systolic blood pressure of the patient for 5x5 minutes with 5 minutes reperfusion interval. Blood samples from coronary sinus and biopsies from the myocardial infundibulum were obtained three times at the condition of pre ischemic, ischemic, and reperfusion. MDA was measured from the blood samples, meanwhile calcium cytosol concentration and mitochondrial edema was measured from the biopsy samples.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
Cyclosporin was administered intravenously with the dose of 3 mg/ kg body weight
Performed by inflating pressure cuff on the extremity 30 mmHg higher than systolic blood pressure of the patient for 5x5 minutes with 5 minutes reperfusion interval
Intravenous placebo
Indonesia University
Jakarta, DKI Jakarta, Indonesia
Malondialdehyde (MDA)
ROS level is determined by measuring MDA concentration (nmol/mL)
Time frame: 1 year
Calcium cytosol concentration
Calcium concentration (nmol/mL) in cytosol is determined by ratiometric analysis on Fura Red- dyed heart cells.
Time frame: 1 year
Mitochondrial edema
Mitochondrial edema (%) is measured by decreasing of optical density that indicates change in mitochondrial matrix volume.
Time frame: 1 year
Cardiac index
Examined with echocardiography, unit of measurement is litres per minute per square metre (L/min/m2).
Time frame: 1 year
Troponin I
Measured from venous blood, unit of measurement is nanograms per milliliter (ng/mL).
Time frame: 1 year
Creatine kinase- MB (CKMB)
Measured from venous blood, unit of measurement is units per liter (IU/L).
Time frame: 1 year
Vasoactive inotropic score (VIS)
VIS was calculated as: dopamine dose (μg/kg/min) + dobutamine dose (μg/kg/min) + 100 × epinephrine dose (μg/kg/min) + 10 × milrinone dose (μg/kg/min) + 10 000 × vasopressin dose (unit/kg/min) + 100 × norepinephrine dose (μg/kg/min).
Time frame: 1 year
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