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Mechanisms of Cardioprotection of Halogenated Agents During Extracorporeal Circulation in Cardiac Surgery

Author(s):

M. Ramirez-Aliaga, J. J. Escalona- Belmonte, Alicia Ramirez-Fernandez*, M. Rubio-Navarro and J. Cruz-Manas   Pages 1 - 10 ( 10 )

Abstract:


The implementation of cardioprotective strategies involving pre-, intra-, and postoperative interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal of this study was to review the physiopathology of and protection strategies against myocardial damage secondary to ECC during cardiac surgery. The administration of halogenated anesthetics for cardiac anesthesia is commonplace due to their well-known cardioprotective effects and their capacity to ensure hypnosis. An optimal myocardial protection strategy requires that a comprehensive approach is adopted to cover pre-, intra-, and post-operative interventions. Pre-conditioning and post-conditioning share numerous pathways, mainly based on mitochondrial signaling, antiapoptotic pathways, and reduced inflammatory mediators. However, volatile anesthetic can also be administered during ECC, which mechanism of action during this period has been scantly investigated, and its biology is still unknown.

Keywords:

Preconditioning, Postconditioning, extracorporeal circulation, hypnotic agents

Affiliation:

Department of Cardio-Anaesthesiology. University Hospital Virgen de la Victoria. Malaga, Department of Cardio-Anaesthesiology. University Hospital Virgen de la Victoria. Malaga, Department of Cardio-Anaesthesiology. University Hospital Virgen de la Victoria. Malaga, Department of Cardio-Anaesthesiology. University Hospital Virgen de la Victoria. Malaga, Department of Cardio-Anaesthesiology. University Hospital Virgen de la Victoria. Malaga



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