scholarly journals Prevention of ischemia/reperfusion-induced pulmonary dysfunction after cardiopulmonary bypass with terminal leukocyte-depleted lung reperfusion

2010 ◽  
Vol 139 (1) ◽  
pp. 174-180 ◽  
Author(s):  
Hiroshi Kagawa ◽  
Kiyozo Morita ◽  
Ryuichi Nagahori ◽  
Gen Shinohara ◽  
Katsushi Kinouchi ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ischemia Reperfusion ◽  
Pulmonary Dysfunction

Pulmonary Protection During Cardiac Surgery: Systematic Literature Review

2008 ◽  
Vol 16 (6) ◽  
pp. 503-507 ◽  
Author(s):  
Enisa MF Carvalho ◽  
Edmo A Gabriel ◽  
Tomas A Salerno
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Literature Review ◽  
Heart Surgery ◽  
Ischemia Reperfusion Injury ◽  
Current Knowledge ◽  
Ischemia Reperfusion ◽  
Pulmonary Dysfunction ◽  
Pulmonary Protection ◽  
Postoperative Pulmonary Dysfunction

Ischemia-reperfusion injury occurs during heart surgery in which cardiopulmonary bypass is used. Current knowledge of the factors contributing to postoperative pulmonary dysfunction and the measures to avoid it are reviewed.

scholarly journals Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Blood Electrolytes and Metabolites—A Randomized Controlled Trial

2018 ◽  
Vol 7 (11) ◽  
pp. 462 ◽  
Author(s):  
Katrine Buggeskov ◽  
Raluca Maltesen ◽  
Bodil Rasmussen ◽  
Munsoor Hanifa ◽  
Morten Lund ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Enzyme Linked Immunosorbent Assay ◽  
Resonance Spectroscopy ◽  
Pulmonary Dysfunction ◽  
Blood Gas ◽  
Arterial Blood ◽  
Htk Solution

Cardiac surgery with cardiopulmonary bypass (CPB) causes an acute lung ischemia-reperfusion injury, which can develop to pulmonary dysfunction postoperatively. This sub-study of the Pulmonary Protection Trial aimed to elucidate changes in arterial blood gas analyses, inflammatory protein interleukin-6, and metabolites of 90 chronic obstructive pulmonary disease patients following two lung protective regimens of pulmonary artery perfusion with either hypothermic histidine-tryptophan-ketoglutarate (HTK) solution or normothermic oxygenated blood during CPB, compared to the standard CPB with no pulmonary perfusion. Blood was collected at six time points before, during, and up to 20 h post-CPB. Blood gas analysis, enzyme-linked immunosorbent assay, and nuclear magnetic resonance spectroscopy were used, and multivariate and univariate statistical analyses were performed. All patients had decreased gas exchange, augmented inflammation, and metabolite alteration during and after CPB. While no difference was observed between patients receiving oxygenated blood and standard CPB, patients receiving HTK solution had an excess of metabolites involved in energy production and detoxification of reactive oxygen species. Also, patients receiving HTK suffered a transient isotonic hyponatremia that resolved within 20 h post-CPB. Additional studies are needed to further elucidate how to diminish lung ischemia-reperfusion injury during CPB, and thereby, reduce the risk of developing severe postoperative pulmonary dysfunction.

Establishment of a full-body ischemia/reperfusion model utilizing cardiopulmonary bypass in rats

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
M Engels ◽  
P Akhyari ◽  
H Steinbrenner ◽  
A Pinto ◽  
E Bilgic ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ischemia Reperfusion ◽  
Full Body

Abstract 297: Therapeutic Effects of SK Channel Activator on Cardioprotection in the Setting of Cardioplegic Ischemia-Reperfusion and Cardiopulmonary Bypass

2019 ◽  
Vol 125 (Suppl_1) ◽  
Author(s):  
Zhiqi Zhang ◽  
Neel R Sodha ◽  
Vasile Pavlov ◽  
Ahmad Aboulgheit ◽  
Richard Clements ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ischemia Reperfusion ◽  
Therapeutic Effects ◽  
Sk Channel ◽  
Channel Activator

Efficacy of Nitric Oxide Administration in Attenuating Ischemia/Reperfusion Injury During Neonatal Cardiopulmonary Bypass

2020 ◽  
Vol 11 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Chawki Elzein ◽  
Cynthia Urbas ◽  
Bonnie Hughes ◽  
Yi Li ◽  
Cheryl Lefaiver ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiopulmonary Bypass ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Controlled Trial ◽  
Postoperative Recovery ◽  
Norwood Procedure ◽  
Protective Effects ◽  
Aortic Cross Clamp Time ◽  
To Receive

Objective: Nitric oxide (NO) plays several protective roles in ischemia/reperfusion (I/R) injury. Neonates undergoing the Norwood procedure are subject to develop I/R injury due to the immaturity of their organs and the potential need to interrupt or decrease systemic flow during surgery. We hypothesized that NO administration during cardiopulmonary bypass (CPB) ameliorates the I/R and could help the postoperative recovery after the Norwood procedure. Methods: Twenty-four neonates who underwent a Norwood procedure were enrolled in a prospective randomized blinded controlled trial to receive NO (12 patients) or placebo (12 patients) into the oxygenator of the CPB circuit during the Norwood procedure. Markers of I/R injury were collected at baseline (T0), after weaning from CPB before modified ultrafiltration (T1), after modified ultrafiltration (T2), and at 12 hours (T3) and 24 hours (T4) after surgery, and they were compared between both groups, as well as other postoperative clinical variables. Results: There was no difference in age, weight, anatomical diagnosis, CPB, and aortic cross-clamp time between both groups. Troponin levels were lower in the study group at T1 (0.62 ± 58 ng/mL vs 0.87 ± 0.58 ng/mL, P = .31) and became significantly lower at T2 (0.36 ± 0.32 ng/mL vs 0.97 ± 0.48 ng/mL, P = .009).There were no significant differences between both groups for all other markers. Despite a lower troponin level, there was no difference in inotropic scores or ventricular function between both groups. Time to start diuresis, time to sternal closure and extubation, and intensive care unit and hospital stay were not different between both groups. Conclusion: Systemic administration of NO during the Norwood procedure has myocardial protective effects (lower Troponin levels) but we observed no effect on postoperative recovery. Larger sample size may be needed to show clinical differences.

scholarly journals Influence of Hypoxic and Hyperoxic Preconditioning on Endothelial Function in a Model of Myocardial Ischemia-Reperfusion Injury with Cardiopulmonary Bypass (Experimental Study)

2020 ◽  
Vol 21 (15) ◽  
pp. 5336
Author(s):  
Irina A. Mandel ◽  
Yuri K. Podoksenov ◽  
Irina V. Suhodolo ◽  
Darya A. An ◽  
Sergey L. Mikheev ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiopulmonary Bypass ◽  
Endothelial Function ◽  
Light Microscopy ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Control Group ◽  
Endothelin 1 ◽  
Nitric Oxide Metabolites

The aim of the experiment was to evaluate the effect of preconditioning based on changes in inspiratory oxygen fraction on endothelial function in the model of ischemia-reperfusion injury of the myocardium in the condition of cardiopulmonary bypass. The prospective randomized study included 32 rabbits divided into four groups: hypoxic preconditioning, hyperoxic preconditioning, hypoxic-hyperoxic preconditioning, and control group. All animals were anesthetized and mechanically ventilated. We provided preconditioning, then started cardiopulmonary bypass, followed by induced acute myocardial infarction (ischemia 45 min, reperfusion 120 min). We investigated endothelin-1, nitric oxide metabolites, asymmetric dimethylarginine during cardiopulmonary bypass: before ischemia, after ischemia, and after reperfusion. We performed light microscopy of myocardium, kidney, lungs, and gut mucosa. The endothelin-1 level was much higher in the control group than in all preconditioning groups after ischemia. The endothelin-1 even further increased after reperfusion. The total concentration of nitric oxide metabolites was significantly higher after all types of preconditioning compared with the control group. The light microscopy of the myocardium and other organs revealed a diminished damage extent in the hypoxic-hyperoxic preconditioning group as compared to the control group. Hypoxic-hyperoxic preconditioning helps to maintain the balance of nitric oxide metabolites, reduces endothelin-1 hyperproduction, and enforces organ protection.

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