Universität zu Köln

Slottosch, Ingo, Liakopoulos, Oliver, Kuhn, Elmar, Deppe, Antje, Lopez-Pastorini, Alberto, Schwarz, David ORCID: 0000-0002-4580-8383, Neef, Klaus, Choi, Yeong-Hoon, Jung, Kristina, Muehlfeld, Christian and Wahlers, Thorsten (2014). Controlled lung reperfusion to reduce pulmonary ischaemia/reperfusion injury after cardiopulmonary bypass in a porcine model. Interact Cardiovasc. Thorac. Surg., 19 (6). S. 962 - 971. OXFORD: OXFORD UNIV PRESS. ISSN 1569-9285

Full text not available from this repository.

Abstract

OBJECTIVES: Ischaemia/reperfusion (I/R) injury of the lungs contributes to pulmonary dysfunction after cardiac surgery with cardiopulmonary bypass (CPB), leading to increased morbidity and mortality of patients. This study investigated the value of controlled lung reperfusion strategies on lung ischaemia-reperfusion injury in a porcine CPB model. METHODS: Pigs were subjected to routine CPB for 120 min with 60 min of blood cardioplegic cardiac arrest (CCA). Following CCA, the uncontrolled reperfusion (UR, n = 6) group was conventionally weaned from CPB. Two groups underwent controlled lung reperfusion strategies (CR group: controlled reperfusion conditions, n = 6; MR group: controlled reperfusion conditions and modified reperfusate, n = 6) via the pulmonary artery before CPB weaning. Sham-operated pigs (n = 7) served as controls. Animals were followed up until 4 h after CPB. Pulmonary function, haemodynamics, markers of inflammation, endothelial injury and oxidative stress as well as morphological lung alterations were analysed. RESULTS: CPB (UR group) induced deterioration of pulmonary function (lung mechanics, oxygenation index and lung oedema). Also, controlled lung reperfusion groups (CR and MR) presented with pulmonary dysfunction after CPB. However, compared with UR, controlled lung reperfusion strategies (CR and MR) improved lung mechanics and reduced markers of oxidative stress, but without alteration of haemodynamics, oxygenation, inflammation, endothelial injury and lung morphology. Both controlled reperfusion groups were similar without relevant differences. CONCLUSION: Controlled lung reperfusion strategies attenuated a decrease in lung mechanics and an increase in oxidative stress, indicating an influence on CPB-related pulmonary injury. However, they failed to avoid completely CPB-related lung injury, implying the need for additional strategies given the multifactorial pathophysiology of postoperative pulmonary dysfunction.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje UNSPECIFIED UNSPECIFIED UNSPECIFIED Lopez-Pastorini, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarz, David UNSPECIFIED orcid.org/0000-0002-4580-8383 UNSPECIFIED Neef, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Muehlfeld, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-422514
DOI:	10.1093/icvts/ivu270
Journal or Publication Title:	Interact Cardiovasc. Thorac. Surg.
Volume:	19
Number:	6
Page Range:	S. 962 - 971
Date:	2014
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1569-9285
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INFLAMMATORY RESPONSE; CARDIAC-SURGERY; BLOOD-FLOW; OFF-PUMP; ISCHEMIA; DYSFUNCTION; TRANSPLANTATION; PERFUSION Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42251