• Pierre-Grégoire Guinot, Omar Ellouze, Sandrine Grosjean, Vivien Berthoud, Tiberiu Constandache, Mohamed Radhouani, Jean-Baptiste Anciaux, Serge Aho-Glele, Marie-Catherine Morgant, Claude Girard, Maxime Nguyen, and Belaid Bouhemad.
• Department of Anesthesiology and Critical Care Medicine, Dijon University Medical Center.
• Medicine (Baltimore). 2020 Dec 11; 99 (50): e23253.

BackgroundTo evaluate the effect of anaesthesia and ICU sedation with sevoflurane to protect the myocardium against ischemia-reperfusion injury associated to cardiac surgery assessed by troponin release.MethodsWe performed a prospective, open-label, randomized study in cardiac surgery with cardiopulmonary bypass. Patients were randomized to an algorithm-based intervention group and a control group. The main outcome was the perioperative kinetic of cardiac troponin I (cTnI). The secondary outcomes included composite endpoint, GDF-15 (macrophage inhibitory cytokine-1) value, arterial lactate levels, and the length of stay (LOS) in the ICU.ResultsOf 82 included patients, 81 were analyzed on an intention-to-treat basis (intervention group: n = 42; control group: n = 39). On inclusion, the intervention and control groups did not differ significantly in terms of demographic and surgical data. The postoperative kinetics of cTnI did not differ significantly between groups: the mean difference was 0.44 ± 1.09 μg/ml, P = .69. Incidence of composite endpoint and GDF-15 values were higher in the sevoflurane group than in propofol group. The intervention and control groups did not differ significantly in terms of ICU stay and hospital stay.ConclusionThe use of an anaesthesia and ICU sedation with sevoflurane was not associated with a lower incidence of myocardial injury assessed by cTnI. Sevoflurane administration was associated with higher prevalence of acute renal failure and higher GDF-15 values.

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