Effects of biocompatible extracorporeal bypass circuit coating Bioline in cardiac surgery patients

Biocompatibility of heparin-based coating for extracorporeal circuits, the Bioline, was evaluated in cardiac surgery setting. Thirty six CABG pts, aged from 30 to 69 yrs, were randomly perfused with a circuit containing Bioline-coated Quadrox oxygenator (Bioline, n=18) or with a similar non-coated circuit (control, n=18). Leukocyte and platelet counts, levels of tumor necrosis factor, interleukin-6 and fibrinogen were assessed in arterial blood before, during and after cardiopulmonary bypass (CPB). Oxygenation and ventilation indices before and after surgery, post-operative chest tube drainage and transfusion volume as well as the duration of assisted ventilation were also measured. A platelet count and fibrinogen dropped less in the Bioline group significantly compared with that in control at the end of CPB (p<0,05) and after protamine administration (p<0,05). A leukocyte count and an interleukin-6 level increased more in controls after CPB (p<0,05) as well as oxygenation and ventilation indices, bleeding volume and intubation time (all p<0,05). Our results suggest surface heparinization with Bioline coating limited to the oxygenator ameliorates the inflammatory response, preserves fibrinogen and platelets, reduces blood loss postoperatively and improves lung function during CPB.

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Conservative versus conventional oxygen therapy for cardiac surgical patients: A before-and-after study

Anaesthesia and Intensive Care ◽

10.1177/0310057x19838753 ◽

2019 ◽

Vol 47 (2) ◽

pp. 175-182 ◽

Cited By ~ 1

Author(s):

Glenn M Eastwood ◽

Matthew J Chan ◽

Leah Peck ◽

Helen Young ◽

Johan Mårtensson ◽

...

Keyword(s):

Cardiac Surgery ◽

Oxygen Therapy ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Surgical Patients ◽

Arterial Blood Gas ◽

Conservative Group ◽

Arterial Blood ◽

Before And After ◽

Therapy Target

Avoiding hypoxaemia is considered crucial in cardiac surgery patients admitted to the intensive care unit (ICU). However, avoiding hyperoxaemia may also be important. A conservative approach to oxygen therapy may reduce exposure to hyperoxaemia without increasing the risk of hypoxaemia. Using a before-and-after design, we evaluated the introduction of conservative oxygen therapy (target SpO2 88%–92% using the lowest FiO2) for cardiac surgical patients admitted to the ICU. We studied 9041 arterial blood gas (ABG) datasets: 4298 ABGs from 245 ‘conventional’ and 4743 ABGs from 298 ‘conservative’ oxygen therapy patients. During mechanical ventilation (MV) and while in the ICU, compared to the conventional group, conservative group patients had significantly lower FiO2 exposure and PaO2 values ( P < 0.001 for each). Accordingly, using the mean PaO2 during MV, more conservative group patients were classified as normoxaemic (226 versus 62 patients, P < 0.01), fewer as hyperoxaemic (66 versus 178 patients, P < 0.01) and no patient in either group as hypoxaemic or severely hypoxaemic. Moreover, more ABG samples were hyperoxaemic or severely hyperoxaemic during conventional treatment ( P < 0.001). Finally, there was no difference in ICU or hospital length of stay, ICU or hospital mortality or 30-day mortality between the groups. Our findings support the feasibility and physiological safety of conservative oxygen therapy in patients admitted to ICU after cardiac surgery.

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Investigating Cyclooxygenase Inhibition in a Rat Pulmonary Contusion Model: A Laboratory Study Finding No Improvement with Ibuprofen

The American Surgeon ◽

10.1177/000313481708300635 ◽

2017 ◽

Vol 83 (6) ◽

pp. 666-672

Author(s):

John P. Sharpe ◽

Nick R. Khan ◽

Arindam R. Chatterjee ◽

Jinsong Huang ◽

Louis J. Magnotti ◽

...

Keyword(s):

Tumor Necrosis Factor ◽

Interleukin 6 ◽

Tumor Necrosis ◽

Pulmonary Contusion ◽

Control Group ◽

Respiratory Compromise ◽

Cyclooxygenase Inhibition ◽

Arterial Blood ◽

The Impact ◽

Necrosis Factor

Minimal advances have been made in the management of pulmonary contusions (PCs). The purpose of this study was to evaluate the impact of cyclooxygenase inhibition on outcomes following PC in a rat model. PC was induced in anesthetized adult rats. Ibuprofen was given to the treatment group (TG) and water was given to the control group (CG). Lung injury was assessed with pulse oximetry, arterial blood gases, CT, and histopathologic examination. Inflammation was measured with both serum and bronchoalveolar lavage (BAL) levels of tumor necrosis factor a and interleukin-6. Rats in the TG did not differ from rats in the CG with respect to oxygenation. Pathologic examination demonstrated a trend toward more inflammatory infiltrate in the CG, yet the sizes of the contusions were larger in the TG. The CG trended toward decreased levels of interleukin-6 in the serum and BAL at both three and seven days. While BAL levels of tumor necrosis factor a were increased in the TG at three days compared to the CG, they trended toward a reduced amount at seven days. Our data do not support cyclooxygenase inhibition for treatment to decrease the respiratory compromise associated with PC in this model of rat PCs.

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Responses of interleukin-6 and tumor necrosis factor during and after cardiac surgery undergoing cardiopulmonary bypass and pancreatoduodenectomy

Journal of Anesthesia ◽

10.1007/bf02479846 ◽

1995 ◽

Vol 9 (2) ◽

pp. 146-150

Author(s):

Mitsuhiro Nishimura ◽

Kazuo Abe ◽

Tetsuo Sakakibara ◽

Kazuyasu Nakao ◽

Ikuto Yoshiya

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Tumor Necrosis Factor ◽

Interleukin 6 ◽

Tumor Necrosis ◽

Necrosis Factor

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Responses of interleukin-6 and tumor necrosis factor during and after cardiac surgery undergoing cardiopulmonary bypass and pancreatoduodenectomy

Journal of Anesthesia ◽

10.1007/s0054050090146 ◽

1995 ◽

Vol 9 (2) ◽

Author(s):

Mitsuhiro Nishimura ◽

Kazuo Abe ◽

Tetsuo Sakakibara ◽

Kazuyasu Nakao ◽

Ikuto Yoshiya

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Tumor Necrosis Factor ◽

Interleukin 6 ◽

Tumor Necrosis ◽

Necrosis Factor

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Exercise and the cytokines-interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α): A review

Annals of Medical Physiology ◽

10.23921/amp.2017v1i1.263485 ◽

2017 ◽

Vol 1 (1) ◽

pp. 3-8 ◽

Cited By ~ 3

Author(s):

Ambarish Vijayaraghava ◽

Venkatesh Doreswamy

Keyword(s):

Tumor Necrosis Factor ◽

Interleukin 6 ◽

Normative Data ◽

Tumor Necrosis ◽

Tumor Necrosis Factor Α ◽

Plasma Samples ◽

Tnf Α ◽

Before And After ◽

Factor Α ◽

Necrosis Factor

Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were one of the first few cytokines to be discovered. The normative data for levels of cytokines IL-6 and TNF-α in particular and all other cytokines in general have not yet been established well. The normal levels for each of the cytokines vary from one race to another. Therefore, all studies need to be done in cases and controls belonging to the same race or same populations. The kits for cytokine assays are expensive and running the assays is laborious and time consuming. It is recommended that the serum/plasma samples are run in duplicates and triplicates to avoid error. Immunology and the field of cytokines is an area which has many domains unexplored. As yet, it is not clearly understood by what mechanisms and pathways each of the cytokines alter the levels of other cytokines. Exercise or physical activity is an intervention which can be administered easily and levels of cytokines measured before and after intervention in same individuals taking all the above mentioned factors into consideration. Hence it is imperative that we look into studies on exercise and cytokines to do further research in the field of cytokines.

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