Will high-dose heparin affect blood loss and inflammatory response in patients undergoing cardiopulmonary bypass?

Perfusion ◽  
2020 ◽  
Vol 36 (1) ◽  
pp. 63-69
Author(s):  
Erik Braatz ◽  
Vanja Sesartic ◽  
Jan Liska
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Tumor Necrosis ◽  
Standard Dose ◽  
Intervention Group ◽  
Control Group ◽  
Control Versus ◽  
Factor Α ◽  
Necrosis Factor

Introduction: We performed a randomized study to investigate if a high versus a standard dose of heparin dose during cardiopulmonary bypass could affect intra- and post-operative bleeding and reduce the inflammatory response. Methods: A total of 30 patients undergoing elective coronary artery bypass grafting were randomized into high or standard dose of heparin during cardiopulmonary bypass. Blood loss was documented peri- and post-operatively, and interleukin-6, tumor necrosis factor-α, and C3 were measured in conjunction with cardiopulmonary bypass. Results: Data from 29 patients were analyzed after exclusion of one patient. The mean initial bolus and total heparin doses were 43,000 ± 5,800 IU versus 35,000 ± 4,100 IU, (p < 0.001), and 58,000 ± 9,500 IU versus 45,000 ± 7,900 IU, (p < 0.001) in the intervention and the control group, respectively. The median intra-operative bleeding was 150 mL (interquartile range 100-325) in the control versus 225 mL (IQR 200-350) in the intervention group, p = 0.15. The median chest tube blood loss 12 hour post-operatively was 300 mL (interquartile range 250-385) in the control versus 450 mL (IQR 315-505) in the intervention group, p = 0.029. There was no significant difference between the control group and the intervention group during cardiopulmonary bypass for the measured inflammatory markers interleukin-6 (p = 0.98), tumor necrosis factor-α (p = 0.72), or C3 (p = 0.13). Conclusion: This small study showed a small increase of post-operative bleeding associated with higher heparin dosage in conjunction with cardiopulmonary bypass but did not demonstrate an effect of heparin on the inflammatory response to cardiopulmonary bypass.

Importance of Markers of Sepsis in Surgical Patients

2018 ◽  
Vol 84 (6) ◽  
pp. 1058-1063 ◽  
Author(s):  
Marek Smolár ◽  
Ivana Dedinská ◽  
Michal Hošala ◽  
Július Mazúch ◽  
L'Udovit Laca
Keyword(s):  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Serum Levels ◽  
Control Group ◽  
Risk Of Death ◽  
Significant Difference ◽  
Important Position ◽  
Factor Α ◽  
Necrosis Factor ◽  
Septic Condition

Sepsis, severe sepsis, and septic shock represent a serious medicinal and general social problem and still maintain an important position among the present issues in the basic and clinical research. In the prospective analysis of patients satisfying the criteria of septic condition, we determined serum levels of bioparameters in three consecutive days from the first signs of sepsis depending on the stage or advancement of the septic condition. We determined the most significant parameter/parameters which are able to determine the stage of sepsis or to predict patient's death. In the group of 68 patients, all monitored biomarkers showed significant difference in serum concentrations versus the control group (P = 0.001). The strongest positive connection between the seriousness of sepsis and serum level is in case of procalcitonin. Predictor of mortality (r = -0.468; P = 0.001), transferrin (r = -0.506; P = 0.003), and tumor necrosis factor-α (r = 0.939; P = 0.001). Our results show that the monitored parameters (procalcitonin, C-reactive protein, tumor necrosis factor-a, and interleukin 6) have strong correlations between the serum levels and the stage of disease. Examination of at least one cytokine in normal clinical practice might lead to better interpretation of the patient's condition, determining the risk of death.

The change of proinflammatory cytokine tumor necrosis factor α level in the use of meloxicam in rat model of osteoarthritis

2019 ◽  
Vol 30 (6) ◽  
Author(s):  
Junaidi Khotib ◽  
Naning Windi Utami ◽  
Maria Apriliani Gani ◽  
Chrismawan Ardianto
Keyword(s):  
Tumor Necrosis Factor ◽  
Rat Model ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Control Group ◽  
Treatment Groups ◽  
Tnf Α ◽  
Α Level ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background Osteoarthritis (OA) is a chronic disease in the joints. One of the proinflammatory cytokines that is thought to have a major role in the inflammatory process, the emergence of pain, and cartilage damage in OA is tumor necrosis factor α (TNF-α). Meloxicam is a nonsteroidal anti-inflammatory drug class of drugs that is relatively selective in inhibiting the activity of cyclooxygenase 2 (COX-2) formation. This study is conducted to prove the change in TNF-α level in the use of meloxicam with model in animals suffering from OA. Methods The OA rat model was induced with sodium monoiodoacetate intra-articularly. Rats were divided into 5 groups: negative control group, positive control group, and treatment groups with various doses of meloxicam. Hyperalgesia effect was evaluated using a warm plate test, and TNF-α level was determined using enzyme-linked immunosorbent assay. Results The treatment groups that received meloxicam at a dose of 1.0, 3.0, or 10.0 mg/kg body weight (BW) did not show significant differences in rat knee joint diameter (p = 0.99), but showed a significant difference in sensitivity to heat stimulation (p = 0.02) compared to the control group. Osteoarthritis rats experienced a significant reduction in TNF-α level after being given meloxicam at a dose of 10 mg/kg BW compared with the control group. This shows that the 10 mg/kg BW of meloxicam is a potential dose in reducing the TNF-α level in OA rat models. Conclusions Based on these data, it can be concluded that the inhibition of pain and the development of OA by meloxicam in animal models may be assigned to a decreased level of TNF-α.

scholarly journals Application of Dexmedetomidine in Cardiopulmonary Bypass Prefilling

Dose-Response ◽  
2020 ◽  
Vol 18 (3) ◽  
pp. 155932582093976 ◽  
Author(s):  
Li Wang ◽  
Shaowei Wang ◽  
Zhen Xing ◽  
Fulong Li ◽  
Jinliang Teng ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Anesthesia Induction ◽  
Tnf Α ◽  
Factor Α ◽  
Necrosis Factor

Objective: The purpose of this study was to explore the application of dexmedetomidine (Dex) in cardiopulmonary bypass. Methods: A total of 60 patients undergoing elective cardiopulmonary bypass were divided into control (C) group and Dex group. In the Dex group, appropriate amount of Dex was added into the membrane lung prefilling solution before anesthesia induction, while those in control group were given normal saline. The levels of mean arterial pressure (MAP) and heart rate (HR) at different times were measured. The levels of cardiac troponin I (CTNI), malondialdehyde (MDA), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) at different points (T0/T1/T2/T3/T4) in both groups were measured by enzyme-linked immunosorbent assay kits. Results: The intraoperative and postoperative levels of MAP and HR in the 2 groups were significantly lower than those preoperatively ( P < .05). The levels of MAP and HR in the Dex group were significantly lower than those of the C group ( P < .05). The levels of CTNI/MDA/IL-6/TNF-α at different points in both groups were significantly higher than those at T0 ( P < .05). The serum levels of CTNI, MDA, IL-6, and TNF-α in the Dex group at T1/T2/T3/T4 were significantly lower than those in the C group ( P < .05). The rate of arrhythmia in the Dex group was significantly lower than that in the C group ( P < .05). Conclusion: Dexmedetomidine has a stable effect in cardiopulmonary priming solution.

scholarly journals PSIX-9 Dietary β-sitosterol improves immunity and antioxidant status in broilers

2019 ◽  
Vol 97 (Supplement_3) ◽  
pp. 346-346
Author(s):  
Yefei Cheng ◽  
Yueping Chen ◽  
Chao Wen ◽  
Yanmin Zhou
Keyword(s):  
Superoxide Dismutase ◽  
Tumor Necrosis Factor ◽  
Immunoglobulin G ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Control Group ◽  
Hepatic Glutathione ◽  
Factor Α ◽  
Necrosis Factor ◽  
Serum Tumor Necrosis

Abstract The application effects of phytosterols on poultry production have been reported. However, due to the mixed compositions, it is difficult to explain their action mode and physiological functions. β-sitosterol, the most abundant phytosterol, is naturally widespread in plant products. Information, however, is scarce in terms of effects of β-sitosterol on broilers. This research therefore investigated effects of dietary β-sitosterol with different levels on immunity and antioxidant capacity in broilers. Two hundred and forty one-day-old chicks were randomly allocated into five treatments of six replicates. Chickens in the five groups were fed a basal diet supplemented with 0 (control group), 40, 60, 80, and 100 mg/kg β-sitesterol for 42 days, respectively. Data were analyzed by one-way analysis of variance. Polynomial contrasts were used to test the linear and quadratic response to β-sitosterol levels. Difference among groups was evaluated using Tukey’s test, which was considered significant if P &lt; 0.05. Dietary β-sitosterol linearly increased (P &lt; 0.05) contents of serum immunoglobulin G and hepatic glutathione, activities of serum superoxide dismutase and catalase, whereas linearly decreased (P &lt; 0.05) concentrations of serum tumor necrosis factor α and hepatic malondialdehyde. Serum interleukin 1β level was linearly and quadratically reduced by β-sitosterol inclusion (P &lt; 0.05). Compared with the control group, dietary β-sitosterol with higher levels than 60 mg/kg increased concentrations of serum immunoglobulin G and hepatic glutathione, activities of serum superoxide dismutase and catalase (P &lt; 0.05), whereas decreased serum tumor necrosis factor α content (P &lt; 0.05). Its dosages higher than 40 mg/kg reduced serum interleukin 1β content (P &lt; 0.05), and 100 mg/kg of which lowered hepatic malondialdehyde concentration (P &lt; 0.05). The results indicated that dietary β-sitosterol could improve immunity and antioxidant ability in broilers. Also, a level of 80 mg/kg β-sitosterol supplementation was recommended into broiler diet.

Effects of intra-arterial heparin on cytokine levels in the ischemic tissue

Open Medicine ◽  
2010 ◽  
Vol 5 (2) ◽  
pp. 165-171
Author(s):  
Sami Karapolat ◽  
Bilgehan Erkut
Keyword(s):  
Tumor Necrosis Factor ◽  
Femoral Artery ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Assay Method ◽  
Control Group ◽  
Group A ◽  
Α Level ◽  
Factor Α ◽  
Necrosis Factor

AbstractThe purpose of this study was to evaluate the effects of systemic and intra-arterial application of heparin by measuring tissue levels of inflammatory cytokines. Twenty-one adult male Wistar albino rats were divided into three groups (Group A, B and C). All the rats had undergone ligation of the right femoral artery with 4-0 silk suture to induce limb ischemia. Group A was the control group. In Group B, unfractionated heparin of 1500 U/kg/day was given through the tail vein for 10 days, the same dose was given to distal part of ligated right femoral artery for 10 days in Group C. On the 3rd, 5th, and 10th days, biopsies were taken from rectus femoris muscle on the ischemic extremities. Tumor necrosis factor-α, interleukin-1β, and vascular cell adhesion molecule levels in muscle tissue were measured by a standard enzyme-linked immunoabsorbent assay method. An increase in tumor necrosis factor-α level was found in all three groups throughout the duration of the experiment. The increase in Group C was statistically significant as compared with the other groups. The significant increases that occurred in tumor necrosis factor-α level as a result of intra-arterial application of heparin can be postulated to be one of the results of angiogenesis induced by the heparin in ischemic extremities. This might delay the formation of a necrosis in ischemic extremities, depending on the increased angiogenesis response by means of intra-arterial heparin application and may result in extended vitality of an extremity.

The effects of sildenafil and n-acetylcysteine on ischemia and reperfusion injury in gastrocnemius muscle and femoral artery endothelium

Vascular ◽  
2014 ◽  
Vol 23 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Volkan Aksu ◽  
Volkan Yüksel ◽  
Serchat Chousein ◽  
Ebru Taştekin ◽  
Şahin İşcan ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Reperfusion Injury ◽  
Femoral Artery ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Gastrocnemius Muscle ◽  
Ischemia Reperfusion ◽  
Control Group ◽  
Factor Α ◽  
Necrosis Factor

Purpose We aimed to examine the effects of sildenafil and n-acetylcystein on ischemia/reperfusion injury in femoral artery endothelium and gastrocnemius muscle. Basic methods 32 rats of Sprague-Dawley breed were randomly divided into four groups (n = 8). Median laparotomy was performed, then a 120-minute ischemia was created by microvascular clamping of infrarenal aorta, followed by the release of clamping. In sildenafil group, 1 mg/kg of sildenafil infusion and in the n-acetylcystein group, 100 mg/kg of n-acetylcystein infusion was administered after release of clamps. Blood samples and tissue samples of femoral artery and gastrocnemius muscle were extracted for a histopathological evaluation. Principal findings Serum levels of malondialdehyde in ischemia/reperfusion group (6.16 ± 0.79) were higher compared to the control group (4.69 ± 0.33), whereas a significant decrease was detected in sildenafil (5.17 ± 0.50) and n-acetylcystein (4.96 ± 0.49) groups. Femoral artery tissue sections of the control group, mean tumor necrosis factor alpha and hypoxy-induced factor-1 alpha immunoreactivity were found to be negative. In the ischemia/reperfusion group, mean tumor necrosis factor α immunoreactivity was intense and mean hypoxy-induced factor-1 alpha immunoreactivity was 51–75%. In the ischemia/reperfusion + Sildenafil and ischemia/reperfusion + NAS groups, mean tumor necrosis factor α immunoreactivity was slight and mean hypoxy-induced factor-1 alpha immunoreactivity was 26–50%. Conclusions In conclusion, sildenafil and n-acetylcystein may reduce femoral artery endothelium and gastrocnemius muscle injury following lower extremity ischemia/reperfusion.

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