Adoption of rescue colloid during burn resuscitation decreases fluid administered and restores end-organ perfusion

ABSTRACT Two techniques for organ perfusion with blood are described which provide a basis for exploring metabolic or endocrine dynamics. The technique of in situ perfusion with autogenous arterial blood is suitable for glands or small organs which receive a small fraction of the animal's cardiac output; thus, test stimulatory or inhibitory substances can be added to the perfusing blood and undergo sufficient dilution in systemic blood after passage through the perfused organ so that recirculation does not compromise experimental control over test substance concentration in the perfusate. Experimental studies with the in situ perfused adrenal are described. The second technique, termed the pilot organ method, is suitable for organs which receive a large fraction of the cardiac output, such as the liver. Vascular connections are made between the circulation of an intact, anaesthetized large (> 30 kg) dog and the liver of a small (< 3 kg) dog. The small dog's liver (pilot liver) is excised and floated in a bath of canine ascites, and its venous effluent is continuously returned to the large dog. Test substances are infused into either the hepatic artery or portal vein of the pilot liver, but the small size of the pilot liver and its blood flow in relation to the large dog minimize recirculation effects. A number of functional parameters of the pilot liver are described.

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EVALUATION OF MECHANICAL SYSTEMS USED IN PERFUSION

Acta Endocrinologica ◽

10.1530/acta.0.069s044b ◽

1972 ◽

Vol 68 (2_Supplb) ◽

pp. S44-S73 ◽

Cited By ~ 3

Author(s):

Eugene F. Bernstein

Keyword(s):

Mechanical Systems ◽

Organ Perfusion ◽

Critical Factors ◽

System 2 ◽

Common Problems ◽

Mechanical Components ◽

Perfusion Experiment ◽

Selection Of

ABSTRACT Among the critical factors in organ perfusion are (1) the mechanical components of the system, (2) the composition of the perfusate, and (3) the perfusing conditions. In this review, particular consideration is given to the pump, the oxygenator, and cannulas in such systems. Emphasis is placed upon the selection of pertinent equipment for the goals of a particular perfusion experiment, based upon the criteria of adequacy of the perfusion. Common problems in organ perfusion are summarized, and potential solutions to the perfusion problem, involving either biologic or mechanical extracorporeal systems, are suggested.

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Studies of Metabolism Mediated Mutagenicity In Vitro

Alternatives to Laboratory Animals ◽

10.1177/026119299001800124.1 ◽

1990 ◽

Vol 18 (1_part_1) ◽

pp. 243-250

Author(s):

Dag Jenssen ◽

Lennart Romert

Keyword(s):

Cell Lines ◽

Biological Effects ◽

Animal Experiments ◽

Culture Technique ◽

Organ Perfusion ◽

Isolated Cells ◽

Toxicological Effect ◽

In Vitro Methods

To understand the cause of the biological effects of xenobiotic metabolism in mammals, investigators have traditionally performed animal experiments by comparing the results of biochemical methods, such as measurement of enzyme activity analysis of the metabolites produced, with the observed toxicological effect. This article deals with in vitro methods for genotoxicity combined with drug metabolising preparations at the organelle, cell or organ levels, as exemplified by microsome preparations, isolated cells/cell lines and organ perfusion systems, respectively. The advantage of some of these methods for studying metabolism-mediated mutagenicity is that the measured endpoint reflects not only the bioactivating phase I reactions, but also the detoxifying phase II reactions, and the transfer of the non-conjugated reactive metabolites to other cells and their ability to cause mutations in these cells. In vivo, all these events are important factors in the initiation of cancer. A mechanistic advantage of the methods for metabolism-mediated mutagenicity in vitro is that the relevance of the different steps in metabolism for the mutational events can seldom be investigated in an in vivo assay. Furthermore, human studies can easily be performed using the co-culture technique with isolated human cells or cell lines.

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Generation of vascular chimerism within donor organs

Scientific Reports ◽

10.1038/s41598-021-92823-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shahar Cohen ◽

Shirly Partouche ◽

Michael Gurevich ◽

Vladimir Tennak ◽

Vadym Mezhybovsky ◽

...

Keyword(s):

Ex Vivo ◽

Patient Specific ◽

Machine Perfusion ◽

Organ Perfusion ◽

Perfusion Process ◽

Hind Limbs ◽

Porcine Organs ◽

Immunological Barrier

AbstractWhole organ perfusion decellularization has been proposed as a promising method to generate non-immunogenic organs from allogeneic and xenogeneic donors. However, the ability to recellularize organ scaffolds with multiple patient-specific cells in a spatially controlled manner remains challenging. Here, we propose that replacing donor endothelial cells alone, while keeping the rest of the organ viable and functional, is more technically feasible, and may offer a significant shortcut in the efforts to engineer transplantable organs. Vascular decellularization was achieved ex vivo, under controlled machine perfusion conditions, in various rat and porcine organs, including the kidneys, liver, lungs, heart, aorta, hind limbs, and pancreas. In addition, vascular decellularization of selected organs was performed in situ, within the donor body, achieving better control over the perfusion process. Human placenta-derived endothelial progenitor cells (EPCs) were used as immunologically-acceptable human cells to repopulate the luminal surface of de-endothelialized aorta (in vitro), kidneys, lungs and hind limbs (ex vivo). This study provides evidence that artificially generating vascular chimerism is feasible and could potentially pave the way for crossing the immunological barrier to xenotransplantation, as well as reducing the immunological burden of allogeneic grafts.

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A simple and inexpensive membrane “lung” for small organ perfusion

The Journal of Lipid Research ◽

10.1016/s0022-2275(20)36824-3 ◽

1974 ◽

Vol 15 (2) ◽

pp. 182-186

Author(s):

R.L. Hamilton ◽

M.N. Berry ◽

M.C. Williams ◽

E.M. Severinghaus

Keyword(s):

Organ Perfusion ◽

Membrane Lung

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Impella RP versus pharmacologic vasoactive treatment in profound cardiogenic shock due to right ventricular failure: Unloading and end-organ perfusion in a large animal model

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.170 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

J Josiassen ◽

OKL Helgestad ◽

NLJ Udesen ◽

A Banke ◽

PH Frederiksen ◽

...

Keyword(s):

Animal Model ◽

Cardiogenic Shock ◽

Oxygen Saturation ◽

Treatment Strategies ◽

Large Animal Model ◽

Similar Degree ◽

Large Animal ◽

Organ Perfusion ◽

Venous Oxygen Saturation ◽

Cerebral Venous Oxygen Saturation

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Unrestricted research grant from Abiomed Background No strong evidence exists regarding the treatment of cardiogenic shock (CS) caused by acute right ventricular (RV) failure which has mainly consisted of vasoactive drugs. There is expert agreement that treatment with the recently developed Impella RP is feasible, but no previous studies have compared vasoactive treatment strategies with the Impella RP in terms of cardiac unloading and end-organ perfusion. Hypothesis Treatment with the Impella RP device will be associated with lower RV myocardial workload (pressure-volume area) compared to vasoactive treatment strategies and can furthermore be achieved without compromising organ perfusion. Methods CS was induced by a stepwise injection of polyvinyl alcohol microspheres into the right coronary artery in twenty adult female Danish landrace pigs weighing 75-80 kg. After induction of CS, the pigs were allocated to one of the two interventions for 180 minutes: 1) vasoactive therapy comprised a continuous infusion of norepinephrine (0.1 µg/kg/min) for the first 30 minutes, supplemented by an infusion of milrinone (0.4 µg/kg/min) for the remaining 150 minutes or 2) immediate insertion of and treatment with the Impella RP. The results are presented as median [Q1;Q3]. Results Treatment with the Impella RP was associated with a lower RV workload compared to the vasoactive group, while no difference was observed with regards to left ventricular workload among intervention groups, Figure 1. Renal venous oxygen saturation increased to a similar degree following both interventions compared to the state of CS. A trend towards a higher cerebral venous oxygen saturation was observed with norepinephrine compared to Impella RP (Impella RP 51 [47;61] % vs Norepinephrine 62 [57;71] % ; p = 0.07), which became significantly higher with the addition of milrinone (Impella RP 45 [32;63] % vs Norepinephrine +Milrinone 73 [66;81] %; p = 0.002). Conclusion In this large animal model of profound CS caused by predominantly RV failure the Impella RP unloaded the failing RV. The vasoactive treatment, however, caused a higher cerebral venous oxygen saturation, while both interventions increased renal venous oxygen saturation to a similar degree. Abstract Figure 1

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Effects of Acute Bleeding Followed by Hydroxyethyl Starch 130/0.4 or a Crystalloid on Propofol Concentrations, Cerebral Oxygenation, and Electroencephalographic and Haemodynamic Variables in Pigs

Veterinary Medicine International ◽

10.1155/2014/710394 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Aura Silva ◽

Ana Liza Ortiz ◽

Carlos Venâncio ◽

Almir P. Souza ◽

Luísa Maria Ferreira ◽

...

Keyword(s):

Cardiac Output ◽

Hydroxyethyl Starch ◽

Cerebral Oxygenation ◽

Plasma Concentrations ◽

Volume Replacement ◽

Cerebral Oximetry ◽

Total Power ◽

Organ Perfusion ◽

Acute Bleeding ◽

Young Pigs

Bleeding changes the haemodynamics, compromising organ perfusion. In this study, the effects of bleeding followed by replacement with hydroxyethyl starch 130/0.4 (HES) or lactated Ringer’s (LR) on cerebral oxygenation and electroencephalogram-derived parameters were investigated. Twelve young pigs under propofol-remifentanil anaesthesia were bled 30 mL/kg and, after a 20-minute waiting period, volume replacement was performed with HES (GHES;N=6) or LR (GRL;N=6). Bleeding caused a decrease of more than 50% in mean arterial pressure (P<0.01) and a decrease in cerebral oximetry (P=0.039), bispectral index, and electroencephalogram total power (P=0.04andP<0.01, resp.), while propofol plasma concentrations increased (P<0.01). Both solutions restored the haemodynamics and cerebral oxygenation similarly and were accompanied by an increase in electroencephalogram total power. No differences between groups were found. However, one hour after the end of the volume replacement, the cardiac output (P=0.03) and the cerebral oxygenation (P=0.008) decreased in the GLRand were significantly lower than in GHES(P=0.02). Volume replacement with HES 130/0.4 was capable of maintaining the cardiac output and cerebral oxygenation during a longer period than LR and caused a decrease in the propofol plasma concentrations.

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Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

BioMed Research International ◽

10.1155/2014/973758 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Paola Frati ◽

Vittorio Fineschi ◽

Matteo Gulino ◽

Gianluca Montanari Vergallo ◽

Natale Mario Di Luca ◽

...

Keyword(s):

Organ Donation ◽

Organ Donor ◽

Legal Framework ◽

Organ Donors ◽

Organ Perfusion ◽

Medical Mission ◽

Legal Implications ◽

Legal Context ◽

Successful Transplantation ◽

Italian Context

A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation.

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