Abstract：
OBJECTIVE: Coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CPB) is associated with myocardial ischemia-reperfusion injury (IRI), which may limit the benefit of the surgery. Both experimental and clinical studies suggest that Intralipid, a lipid emulsion commonly used for parenteral nutrition, can limit myocardial IRI. We therefore aimed to investigate whether Intralipid administered at reperfusion can reduce myocardial IRI in patients undergoing CABG on CPB.
METHODS: We conducted a randomized, double-blind, pilot trial in which 29 adult patients scheduled for CABG were randomly assigned (on a 1:1 basis) to receive either 1.5 ml/kg Intralipid 20% or Ringer\'s Lactate 3 min before aortic cross unclamping. The primary endpoint was the 72-h area under the curve (AUC) for troponin I.
RESULTS: Of the 29 patients randomized, 26 were included in the study (two withdrew consent and one was excluded before surgery). The 72-h AUC for troponin I did not significantly differ between the control and Intralipid group (546437 ± 205518 versus 487561 ± 115724 arbitrary units, respectively; P = 0.804). Other outcomes (including 72-h AUC for CK-MB, C-reactive protein, need for defibrillation, time to extubation, length of ICU and hospital stay, and serious adverse events) were similar between the two groups.
CONCLUSIONS: In patients undergoing CABG on CPB, Intralipid did not limit myocardial IRI compared to placebo.
BACKGROUND: ClinicalTrials.gov Identifier: NCT02807727 (registration date: 16 June 2016).
METHODS: We conducted a randomized, double-blind, pilot trial in which 29 adult patients scheduled for CABG were randomly assigned (on a 1:1 basis) to receive either 1.5 ml/kg Intralipid 20% or Ringer\'s Lactate 3 min before aortic cross unclamping. The primary endpoint was the 72-h area under the curve (AUC) for troponin I.
RESULTS: Of the 29 patients randomized, 26 were included in the study (two withdrew consent and one was excluded before surgery). The 72-h AUC for troponin I did not significantly differ between the control and Intralipid group (546437 ± 205518 versus 487561 ± 115724 arbitrary units, respectively; P = 0.804). Other outcomes (including 72-h AUC for CK-MB, C-reactive protein, need for defibrillation, time to extubation, length of ICU and hospital stay, and serious adverse events) were similar between the two groups.
CONCLUSIONS: In patients undergoing CABG on CPB, Intralipid did not limit myocardial IRI compared to placebo.
BACKGROUND: ClinicalTrials.gov Identifier: NCT02807727 (registration date: 16 June 2016).
摘要：
目的：体外循环（CPB）下冠状动脉旁路移植术（CABG）与心肌缺血再灌注损伤（IRI）有关，这可能会限制手术的好处。实验和临床研究都表明，内脂，一种常用于肠外营养的脂质乳剂，可以限制心肌IRI。因此，我们旨在研究在再灌注时服用Intralipid是否可以降低CPB中接受CABG的患者的心肌IRI。
方法：我们进行了随机，双盲,试验中,29例CABG成年患者被随机分配(以1:1为基础),在主动脉阻断前3分钟接受1.5ml/kg20%Intralipal或Ringer乳酸。主要终点是肌钙蛋白I的72小时曲线下面积（AUC）。
结果：在随机分组的29例患者中，26人被纳入研究（2人撤回同意，1人在手术前被排除）。肌钙蛋白I的72小时AUC在对照组和内脂组之间没有显着差异（546437±205518与487561±115724任意单位，分别；P=0.804)。其他结果（包括CK-MB的72小时AUC，C反应蛋白,需要除颤，拔管时间，ICU的长度和住院时间，和严重不良事件）两组之间相似。
结论：在CPB下接受CABG的患者中，与安慰剂相比，脂质内脂不限制心肌IRI。
背景：ClinicalTrials.gov标识符：NCT02807727（注册日期：2016年6月16日）。
方法：我们进行了随机，双盲,试验中,29例CABG成年患者被随机分配(以1:1为基础),在主动脉阻断前3分钟接受1.5ml/kg20%Intralipal或Ringer乳酸。主要终点是肌钙蛋白I的72小时曲线下面积（AUC）。
结果：在随机分组的29例患者中，26人被纳入研究（2人撤回同意，1人在手术前被排除）。肌钙蛋白I的72小时AUC在对照组和内脂组之间没有显着差异（546437±205518与487561±115724任意单位，分别；P=0.804)。其他结果（包括CK-MB的72小时AUC，C反应蛋白,需要除颤，拔管时间，ICU的长度和住院时间，和严重不良事件）两组之间相似。
结论：在CPB下接受CABG的患者中，与安慰剂相比，脂质内脂不限制心肌IRI。
背景：ClinicalTrials.gov标识符：NCT02807727（注册日期：2016年6月16日）。
