Systemic inflammatory response syndrome is reduced by preoperative plasma-thrombo-leukocyte aphaeresis in a pig model of cardiopulmonary bypass
Jazyk angličtina Země Česko Médium print-electronic
Typ dokumentu časopisecké články
PubMed
27049532
DOI
10.5507/bp.2016.010
Knihovny.cz E-zdroje
- Klíčová slova
- cardiopulmonary bypass, plasma‑thrombo-leukocyte aphaeresis, systemic inflammatory response syndrome,
- MeSH
- ischemická choroba srdeční etiologie MeSH
- kardiopulmonální bypass metody MeSH
- krevní plazma MeSH
- leukaferéza metody MeSH
- leukocyty fyziologie MeSH
- miniaturní prasata MeSH
- modely nemocí na zvířatech MeSH
- plazmaferéza metody MeSH
- prasata MeSH
- předoperační období MeSH
- separace krevních složek metody MeSH
- syndrom systémové zánětlivé reakce prevence a kontrola MeSH
- terapeutická hypotermie metody MeSH
- trombocyty MeSH
- vyvolaná zástava srdce metody MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: The systemic inflammatory response syndrome (SIRS) after cardiac surgery with cardiopulmonary bypass (CPB) exacerbates organ dysfunction and increases postoperative mortality. The aim of this study was to reduce SIRS after CPB in a pig model by profoundly decreasing all blood defence factors (complement, coagulation and fibrinolytic and contact systems, leukocytes and thrombocytes) using pre‑operative aphaeresis. METHODS: Thirty-three pigs underwent 3 h of hypothermic CPB with 2 h of cardioplegic arrest, followed by 4 days of observation. One half of the sample underwent prebypass plasma-thrombo-leukocyte aphaeresis with the adjuvant leukofiltration. RESULTS: In the control group, there were classical signs of SIRS (tachycardia, tachypnea and leukocytosis) postoperatively. There was also myocardial ischaemia and the need for inotropic support in 90% of the control animals. Neutrophils showed an increase in superoxide anion production (P < 0.001), and surface neutral protease activity (P < 0.001) and blood endotoxin levels increased (P < 0.01) compared with preoperative levels. In contrast, in the aphaeretic group, there were no classical signs of SIRS; no myocardial ischaemia; minimum neutrophil production of the superoxide anion and protease activity were recorded (P < 0.001); and endotoxin levels were also decreased (P < 0.05) compared with the controls. In the control group, the haemodynamic problems associated with disconnecting from CPB correlated with the histologic findings in the myocardium (leukocyte endothelial adhesion and leukodiapedesis). CONCLUSIONS: Pre‑operative plasma‑thrombo-leukocyte aphaeresis significantly reduces the major symptoms of SIRS and organ dysfunction after 3 h of CPB without adverse effects, such as bleeding and infection, during the postoperative course.
Centre of Cardiovascular and Transplant Surgery Pekarska 53 656 91 Brno Czech Republic
Charles University 1 Faculty of Medicine Ke Karlovu 11 128 08 Prague Czech Republic
International Clinical Research Center St Anne's University Hospital Brno Brno Czech Republic
Masaryk University Faculty of Medicine Komenskeho 2 602 00 Brno Czech Republic
University of Veterinary Medicine Palackeho 1 3 612 42 Brno Czech Republic
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