Leukocyte depletion results in improved lung function and reduced inflammatory response after cardiac surgery

AbstractThe occurrence of cardiac surgery-associated acute kidney injury (CSA-AKI) increases hospital stay and mortality. MicroRNAs has a crucial role in AKI. This objective of the current study is to explore the function of hsa-miR-494-3p in inflammatory response in human kidney tubular epithelial (HK2) cells with hypoxia/reoxygenation. According to KDIGO standard, patients after cardiac surgery with cardiopulmonary bypass were divided into two groups: AKI (n = 10) and non-AKI patients (n = 8). HK2 were raised in the normal and hypoxia/reoxygenation circumstances and mainly treated by overexpression ofmiR-494-3p and HtrA3. The relationship between miR-494-3p and HtrA3 was determined by dual-luciferase reporter assay. Our result showed that Hsa-miR-494-3p was elevated in the serum of patients with CSA-AKI, and also induced in hypoxic reoxygenated HK2 cells. Hsa-miR-494-3p also increased a hypoxia-reoxygenation induced inflammatory response in HK2 cells. Moreover, as a target gene of miR-494-3p, overexpression of HtrA3 downregulated the hypoxia-reoxygenation induced inflammatory response in HK2 cells. Overexpression of hsa-miR-494-3p-induced inflammatory response was inhibited by overexpression of HtrA3. Collectively, we identified that hsa-miR-494-3p, a miRNA induced in both circulation of AKI patients and hypoxia-reoxygenation-treated HK2 cells, enhanced renal inflammation by targeting HtrA3, which may suggest a possible role as a new therapeutic target for CSA-AKI.

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Effect of sevoflurane on the inflammatory response during cardiopulmonary bypass in cardiac surgery: the study protocol for a randomized controlled trial

Trials ◽

10.1186/s13063-020-04809-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Thiago Augusto Azevedo Maranhão Cardoso ◽

Gudrun Kunst ◽

Caetano Nigro Neto ◽

José de Ribamar Costa Júnior ◽

Carlos Gustavo Santos Silva ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Inflammatory Response ◽

Controlled Trial ◽

Artery Bypass ◽

Bypass Graft ◽

Volatile Anesthetic ◽

Serum Levels ◽

Randomized Controlled

Abstract Background Recent experimental evidence shows that sevoflurane can reduce the inflammatory response during cardiac surgery with cardiopulmonary bypass. However, this observation so far has not been assessed in an adequately powered randomized controlled trial. Methods We plan to include one hundred patients undergoing elective coronary artery bypass graft with cardiopulmonary bypass who will be randomized to receive either volatile anesthetics during cardiopulmonary bypass or total intravenous anesthesia. The primary endpoint of the study is to assess the inflammatory response during cardiopulmonary bypass by measuring PMN-elastase serum levels. Secondary endpoints include serum levels of other pro-inflammatory markers (IL-1β, IL-6, IL-8, TNFα), anti-inflammatory cytokines (TGFβ and IL-10), and microRNA expression in peripheral blood to achieve possible epigenetic mechanisms in this process. In addition clinical endpoints such as presence of major complications in the postoperative period and length of hospital and intensive care unit stay will be assessed. Discussion The trial may determine whether adding volatile anesthetic during cardiopulmonary bypass will attenuate the inflammatory response. Trial registration ClinicalTrials.gov NCT02672345. Registered on February 2016 and updated on June 2020.

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A TUMOR NECROSIS FACTOR GENE POLYMORPHISM INFLUENCES THE INFLAMMATORY RESPONSE FOLLOWING CARDIAC SURGERY

Critical Care Medicine ◽

10.1097/00003246-200212001-00166 ◽

2002 ◽

Vol 30 (Supplement) ◽

pp. A47

Author(s):

Stefan Schroeder ◽

Lutz E Lehmann ◽

Christian Putensen ◽

Andreas Hoeft ◽

Frank Stueber

Keyword(s):

Cardiac Surgery ◽

Tumor Necrosis Factor ◽

Inflammatory Response ◽

Gene Polymorphism ◽

Tumor Necrosis ◽

Factor Gene ◽

Tumor Necrosis Factor Gene ◽

Necrosis Factor

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Myocardial Protection With Leukocyte Depletion in Cardiac Surgery

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/stcs.2001.22740 ◽

2001 ◽

Vol 13 (1) ◽

pp. 73-81 ◽

Cited By ~ 13

Author(s):

Yoshiki Sawa ◽

Hikaru Matsuda

Keyword(s):

Cardiac Surgery ◽

Myocardial Protection ◽

Leukocyte Depletion

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Monitoring of Lung Function and Hemodynamics after Cardiac Surgery by Use of a Computer Assisted ICU

Computers in Critical Care and Pulmonary Medicine ◽

10.1007/978-1-4615-6704-2_38 ◽

1982 ◽

pp. 175-176 ◽

Cited By ~ 1

Author(s):

K. van Deyk ◽

H. Junger ◽

F. Münch ◽

M. Kopp ◽

E. Epple ◽

...

Keyword(s):

Cardiac Surgery ◽

Lung Function ◽

Computer Assisted

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Técnicas respiratórias na melhora da função pulmonar de cardiopatas: Uma Revisão Integrativa

Revista de Saúde ◽

10.21727/rs.v12i3.2641 ◽

2021 ◽

Vol 12 (3) ◽

pp. 26-32

Author(s):

Danyele Holanda da Silva ◽

Tassiane Maria Alves Pereira ◽

Janaína De Moraes Silva

Keyword(s):

Cardiac Surgery ◽

Lung Function ◽

Surgical Procedure ◽

Respiratory Muscle ◽

Lung Compliance ◽

Integrative Review ◽

World Health ◽

Respiratory Muscle Training ◽

Breathing Exercises ◽

Cardiac Surgical Procedure

Introduction: Cardiovascular Diseases (CVD) are the main cause of morbidity and mortality in developed and developing countries. According to World Health Organization estimates, 17.9 million people died of CVD in 2016, representing 31% of all global deaths. Material and Method: Integrative review carried out in the databases PubMed, SciELO, Lilacs and PEDro, based on the guiding question of the search: “what is the effect of respiratory techniques on the lung function of patients undergoing cardiac surgery?”, And crossing of the terms: breathing exercises AND preoperative AND cardiac surgery (all terms present in MEsh and DeCs) from May to June 2020. Results: 104 articles were found in the selected databases, 67 articles were excluded, 37 were selected for full reading, eight of which were part of this review. Discussion: The present integrative review aimed to analyze the effects of respiratory techniques on lung function in patients undergoing cardiac surgery. Patients undergoing a cardiac surgical procedure, mainly develop postoperative pulmonary dysfunction with significant reduction in lung volumes, impaired respiratory function, decreased lung compliance and increased respiratory work. Final Considerations: Respiratory techniques such as breathing exercises and / or respiratory muscle training employed in patients undergoing a cardiac surgical procedure, improve lung function, consequently improving respiratory muscle strength as a whole, also interfering in the reduction of post-respiratory complications. CRM in this population.Keywords: Cardiac surgery; Breathing Exercises; Preoperative.

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Abstract 11053: The Association Between the Systemic Immune-Inflammation Index with the Duration of Cardiopulmonary Bypass in Cardiac Surgery: A Retrospective, Single-Center Study

Circulation ◽

10.1161/circ.144.suppl_2.11053 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Yanan Hu ◽

Yi Liu ◽

Yongzhe Liu ◽

Hui Chen ◽

Wei Jiang ◽

...

Keyword(s):

Cardiac Surgery ◽

Inflammatory Response ◽

Hospital Stay ◽

Time Course ◽

Ischemia Reperfusion ◽

Systemic Inflammatory Response ◽

Surgical Trauma ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Immune Inflammation

Introduction: Systemic inflammatory response evoked by cardiac surgery involving a cardio-pulmonary bypass (CPB) in combination of surgical trauma, ischemia/reperfusion injury, hypothermia, and endotoxin release contributed to the postoperative morbidity and mortality. This study aimed to explore the potential of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) as novel markers to evaluate and predict the adverse clinical outcomes after longer CPB time in cardiac surgery. Methods: Patients who underwent cardiac surgery with or without CPB were allocated into two groups, CPB group (n=11) and N-CPB group (n=21). The time course of NLR, PLR, SII, and C-reactive protein (CPR) were analyzed at preoperative day 1 and postoperative day 1, 3, and 7. The baseline and postoperative parameters, the ICU and hospital stay were recorded. Results: There were no differences of baseline parameters between groups. The level of NLR, PLR, SII, and CPR at postoperative day 1 was higher than that in the preoperative day 1 in both groups (p < 0.01). The level of NLR, SII and CPR at postoperative day 3 was higher than that in the preoperative day 1 in both groups (p < 0.05). The NLR and SII at postoperative day 3 were higher in CPB group than that in N-CPB group (p < 0.05). The ICU and hospital stay was longer in CPB group than N-CPB group (p < 0.05). Conclusions: The longer duration of CPB time induced higher systemic inflammatory response characterized by higher level of NLR, PLR and SII. The SII predicted the poor outcome after longer CPB. The peak of systemic inflammatory response occurred on the third day after cardiac surgery.

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