Étude du syndrome vasoplégique en post opératoire de chirurgie cardiaque avec circulation extracorporelle : approche physiopathologique par le biais de la flow-mediated dilatation

Abstract : Background: Vasoplegic syndrome (VS) affects up to 30% of cardiac surgery patients. The occurrence of VS may be linked to the administration of nitric oxide (NO). The brachial artery’s response to NO can be assessed with flow-mediated vasodilatation (FMD). The present study’s main objective was to assess the brachial artery’s diameter and FMD response immediately after cardiac surgery. Methods: We performed a prospective, observational study at a tertiary care centre in Amiens, France. The main inclusion criterion was elective cardiac surgery with cardiopulmonary bypass. Patients had brachial artery diameter and FMD measurement before surgery and at intensive care unit admission. The primary outcome measure was the occurrence of VS in the first 48 hours postoperative care. Results: Of the 28 patients included, 11 (39%) developed VS. Brachial artery diameter and FMD differed when comparing VS and non-VS patients. On ICU admission, the mean ± standard deviation brachial artery diameter was larger in VS patients than in non-VS patients (3.9 mm ± 0.7 and 3.0 mm ± 0,8, respectively; p=0.002). Likewise, the FMD response after surgery was greater in VS patients than in non-VS patients (42% ± 8 vs. 31% ± 1; respectively; p=0.014). The brachial artery diameter and the FMD response after surgery were both predictive of VS, with an area under the curve [95% confidence interval] of 0.850 [0.705‒0.995] (p=0.002) and 0.755 [0.56‒0.95] (p=0.047), respectively. Conclusion: Patients who developed VS had a larger brachial artery diameter and FMD response after cardiac surgery than in non-VS group. Cardiac surgery with cardiopulmonary bypass appears to alter the NO-mediated endothelial vasomotor response.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [22 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-02058882
Contributor : Philippe Barbey <>
Submitted on : Wednesday, March 6, 2019 - 11:21:58 AM
Last modification on : Saturday, March 9, 2019 - 1:18:20 AM
Long-term archiving on : Friday, June 7, 2019 - 4:21:04 PM

File

Lucie Martineau. Thèse d'exer...
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-02058882, version 1

Collections

Citation

Lucie Martineau. Étude du syndrome vasoplégique en post opératoire de chirurgie cardiaque avec circulation extracorporelle : approche physiopathologique par le biais de la flow-mediated dilatation. Médecine humaine et pathologie. 2018. ⟨dumas-02058882⟩

Share

Metrics

Record views

16

Files downloads

34