The Gastrointestinal Protective Effect of Omeprazole on Children Undergoing Thoracoscopic Heart Surgery with Cardiopulmonary Bypass_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WEI Xufeng , DONG Xiaochao , YANG Jian

Department of Cardiovascular Surgery,Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, P.R.China YI Ding-hua, E-mail: yidh@fmmu.edu.cn;

Corresponding author：

Keywords：

Thoracoscope; Omeprazole; Cardiopulmonary Bypass; Cardiosurgery; Gastric juice pH; Gastrin; Gastrointestinal tract protection

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Objective To investigate the gastrointestinal(GI) protective effect of Omeprazole on children undergoing thoracoscopic heart surgery with cardiopulmonary bypass (CPB). Methods One hundred and twenty seven patients who were scheduled for cardiac surgery with CPB were randomly equally divided into three groups. Group A and B underwent thoracoscopic heart surgery, while the control group underwent conventional heart surgery by sternotomy. Before CPB, group A was treated with Omeprazole 10mg added to the priming solution.? Group B and the control group were treated by adding the same amount of normal saline (to the priming solution). pH and red blood cell count of gastric secretion and serum gastric level (Assay Designs ELISA) were measured at the following intervals: before CPB, 30 minutes into CPB, at termination of CPB,4 and 24 hours after termination of CPB. Results Compare to prior to CBP, the value of the gastric pH in group A was significantly higher (P lt;0.01), and that of group B was significantly lower (P lt;0.05)at the end of CPB. The same value in the control group was significantly lower (P lt;0.05)4h, after the end of CPB. Compared to prior CPB, the mean red blood cell count of gastric secretion and serum gastric level were significantly descent (P lt;0.01) in all there group post CBP. Compare to the control group, the mean gastric pH level in group A was significantly elevated at all time intervals post CBP; while the mean gastric secretin red blood cell count was significantly decreased. The mean serum level in group A 30 min post CBP was significantly lower than that in group B and the control group. Compared to the control group, the mean gastric pH level was significantly lower in group B but returned to the pre-CPB level in 24 h. The mean gastric secretin red blood cell amount and serums gastric level in group B at all time intervals were significantly decreased compare to those of the control group. Conclusion Thoracoscopic heart surgery of children with CPB

Citation： WEI Xufeng,DONG Xiaochao,YANG Jian,XU Xuezeng,YI Dinghua,YU Shiqiang. The Gastrointestinal Protective Effect of Omeprazole on Children Undergoing Thoracoscopic Heart Surgery with Cardiopulmonary Bypass. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(6): 429-. doi: Copy

1.	Mercado PD, Farid H, O’Connell TX, et al. Gastrointestinal complications associated with cardiopulmonary bypass procedures. Am J Surg,1994,60(10):789-792.
2.	Tsiotos GG, Mullany CJ, Zietlow S, et al. Abdominal complications following cardiac surgery. Am J Surg, 1994,167(6):553-557.
3.	Nakamoto H, Suzuki T, Sugahara S, et al. Successful use of thoracoscopic pericardiectomy in elderly patients with massive pericardial effusion caused by uremic pericarditis. Am J Kidney Dis,2001,37(6):1294-1298.
4.	Schoreyers P, Wellens F, De Geest R, et al. Minimally invasive video-assistedo mitral valve repair: short and mid-term results. J Heart Valve Dis, 2001,10(5):579-583.
5.	Thomson JD, Aburawi EH, Watterson KG, et al. Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost. Heart,2002,87(5):466-469.
6.	Apple FS, Wu AH. Myocardial infarction redefined: role of cardiac troponin testing. Clin Chem, 2001,? 47(3):377-379.
7.	俞世强，程云阁,蔡振杰,等. 胸腔镜心脏手术并发症分析. 第四军医大学学报, 2003,24(3):263-264.
8.	Sartori S, Trevisani L, Nielsen I, et al. Randomized trial of omeprazole or ranitidime versus placebo in the prevention of chemotherapy induced gastroduodenal injury. J Clin Oncol, 2000, 18(3):463-467.
9.	Fornai M, Natale G, Colucci R, et al. Mechanisms of protection by pantoprazole against NSAID-induced gastric mucosal damage. Naunyn Schmiedebergs Arch Pharmacol, 2005,372(1):79-87.
10.	Handa O, Yoshida N, Fujita N, et al. Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors. Inflamm Res,2006,55(11):476-480.
11.	Olbe L, Cederberg C, Lind T, et al. Effect of omeprazole on gastric acid secretion a plasma gastrin man. Scand J Gastroenterol,1989,166(Suppl):27-32.
12.	Hou W, Schubert ML. Gastric secretion. Curr Opin Gastroenterol, 2006,22(6):593-598.
13.	Sikiri′c P, Seiwerth S, Deskovi′c S, et al. New midel of cytoprotection/adaptive cytoprotection in rats: endogenous small irritants,antiulcer agents and indomethacin. Eur J Pharmacol, 1999,364(1):23-31.
14.	徐鹏，易定华.兔体外循环对促胃泌素及其受体的影响. 第四军医大学学报, 2000, 21(4):502-504.

1. 　Mercado PD, Farid H, O’Connell TX, et al. Gastrointestinal complications associated with cardiopulmonary bypass procedures. Am J Surg,1994,60(10):789-792.
2. 　Tsiotos GG, Mullany CJ, Zietlow S, et al. Abdominal complications following cardiac surgery. Am J Surg, 1994,167(6):553-557.
3. 　Nakamoto H, Suzuki T, Sugahara S, et al. Successful use of thoracoscopic pericardiectomy in elderly patients with massive pericardial effusion caused by uremic pericarditis. Am J Kidney Dis,2001,37(6):1294-1298.
4. 　Schoreyers P, Wellens F, De Geest R, et al. Minimally invasive video-assistedo mitral valve repair: short and mid-term results. J Heart Valve Dis, 2001,10(5):579-583.
5. 　Thomson JD, Aburawi EH, Watterson KG, et al. Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost. Heart,2002,87(5):466-469.
6. 　Apple FS, Wu AH. Myocardial infarction redefined: role of cardiac troponin testing. Clin Chem, 2001,? 47(3):377-379.
7. 　俞世强，程云阁,蔡振杰,等. 胸腔镜心脏手术并发症分析. 第四军医大学学报, 2003,24(3):263-264.
8. 　Sartori S, Trevisani L, Nielsen I, et al. Randomized trial of omeprazole or ranitidime versus placebo in the prevention of chemotherapy induced gastroduodenal injury. J Clin Oncol, 2000, 18(3):463-467.
9. 　Fornai M, Natale G, Colucci R, et al. Mechanisms of protection by pantoprazole against NSAID-induced gastric mucosal damage. Naunyn Schmiedebergs Arch Pharmacol, 2005,372(1):79-87.
10. 　Handa O, Yoshida N, Fujita N, et al. Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors. Inflamm Res,2006,55(11):476-480.
11. 　Olbe L, Cederberg C, Lind T, et al. Effect of omeprazole on gastric acid secretion a plasma gastrin man. Scand J Gastroenterol,1989,166(Suppl):27-32.
12. 　Hou W, Schubert ML. Gastric secretion. Curr Opin Gastroenterol, 2006,22(6):593-598.
13. 　Sikiri′c P, Seiwerth S, Deskovi′c S, et al. New midel of cytoprotection/adaptive cytoprotection in rats: endogenous small irritants,antiulcer agents and indomethacin. Eur J Pharmacol, 1999,364(1):23-31.
14. 　徐鹏，易定华.兔体外循环对促胃泌素及其受体的影响. 第四军医大学学报, 2000, 21(4):502-504.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The Gastrointestinal Protective Effect of Omeprazole on Children Undergoing Thoracoscopic Heart Surgery with Cardiopulmonary Bypass

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