The antiendotoxin agent taurolidine potentially reduces ischemia/reperfusion injury through its metabolite taurine.
AuthorsDoddakula, Kishore K
Neary, Peter M
Wang, Jiang H
Bouchier-Hayes, David J
Redmond, Henry P
AffiliationDepartment of Cardiac Surgery, University College Cork, Cork University Hospital, Cork, Ireland.
Coronary Artery Bypass
Heart Arrest, Induced
Length of Stay
MetadataShow full item record
CitationThe antiendotoxin agent taurolidine potentially reduces ischemia/reperfusion injury through its metabolite taurine. 2010, 148 (3):567-72 Surgery
AbstractCardiopulmonary bypass results in ischemia/reperfusion (I/R)-induced endotoxemia. We conducted a prospective randomized trial to investigate the effect of taurolidine, an antiendotoxin agent with antioxidant and membrane-stabilizing properties, on patients undergoing coronary artery bypass grafting (CABG).
A total of 60 patients undergoing CABG were randomized into 4 groups. St Thomas' Hospital cold crystalloid cardioplegia was used in groups A and B, and cold blood cardioplegia in groups C and D. Groups A and C received a placebo infusion of normal saline, whereas groups B and D were administered intravenous taurolidine. Arrhythmias induced by pro- and anti-inflammatory cytokines (interleukin [IL]-6 and IL-10), and I/R were assessed perioperatively.
Administration of taurolidine in crystalloid cardioplegia patients resulted in a significant decrease in serum IL-6 and an increase in serum IL-10 at 24 hours postaortic unclamping compared to placebo (P < .0001). Although not statistically significant, this trend in serum IL-6 decrease was mirrored in the blood cardioplegia patients (P = .068). Taurolidine treatment also significantly decreased I/R-induced arrhythmias compared to placebo in the crystalloid cardioplegia patients (P < .003). There were fewer I/R-induced arrhythmias compared to placebo in the blood cardioplegia patients; the difference, however, was marginal and not statistically significant (P = .583).
This study demonstrates that administration of taurolidine in CABG patients induces a potent anti-inflammatory response that is associated with a significant decrease in arrhythmias.
- Cardioprotective effect of cold-blood cardioplegia enriched with N-acetylcysteine during coronary artery bypass grafting.
- Authors: Koramaz I, Pulathan Z, Usta S, Karahan SC, Alver A, Yaris E, Kalyoncu NI, Ozcan F
- Issue date: 2006 Feb
- Intermittent aortic cross-clamping versus St. Thomas' Hospital cardioplegia in extensive aorta-coronary bypass grafting. A randomized clinical study.
- Authors: Flameng W, Van der Vusse GJ, De Meyere R, Borgers M, Sergeant P, Vander Meersch E, Geboers J, Suy R
- Issue date: 1984 Aug
- Effect of N-acetylcysteine in attenuating ischemic reperfusion injury in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass.
- Authors: Prabhu A, Sujatha DI, Kanagarajan N, Vijayalakshmi MA, Ninan B
- Issue date: 2009 Sep-Oct
- Does retrograde administration of blood cardioplegia improve myocardial protection during first operation for coronary artery bypass grafting?
- Authors: Carrier M, Pelletier LC, Searle NR
- Issue date: 1997 Nov
- Nifedipine as an adjunct to St. Thomas' Hospital cardioplegia. A double-blind, placebo-controlled, randomized clinical trial.
- Authors: Flameng W, De Meyere R, Daenen W, Sergeant P, Ngalikpima V, Geboers J, Suy R, Stalpaert G
- Issue date: 1986 May