The effect of hyperoxia on inflammation and platelet responses in an ex vivo extracorporeal membrane oxygenation circuit.

Autor: Passmore MR; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia., Ki KK; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia.; Research and Development, Australian Red Cross Lifeblood, Brisbane, Australia., Chan CHH; Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Department of Engineering and Built Environment, Griffith University, Gold Coast, Australia., Lee T; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia., Bouquet M; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia., Wood ES; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia., Raman S; Paediatric Intensive Care Unit, Queensland Children's Hospital, Brisbane, Australia., Rozencwajg S; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Medical Intensive Care Unit, Institute of Cardiometabolism and Nutrition, Hôpital de la Pitié-Salpetrière, Hôpitaux de Paris, Assistance Publique, Paris, France., Burrell AJC; Department of Intensive Care, The Alfred Hospital, Melbourne, Australia., McDonald CI; Department of Anaesthesia and Perfusion, The Prince Charles Hospital, Brisbane, Australia., Langguth D; Department of Immunology, Sullivan and Nicolaides Pathology, Brisbane, Australia., Shekar K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia., Malfertheiner MV; Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany., Fraser JF; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia., Suen JY; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Australia.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2020 Dec; Vol. 44 (12), pp. 1276-1285. Date of Electronic Publication: 2020 Aug 04.
DOI: 10.1111/aor.13771
Abstrakt: Use of extracorporeal membrane oxygenation (ECMO) is expanding, however, it is still associated with significant morbidity and mortality. Activation of inflammatory and innate immune responses and hemostatic alterations contribute to complications. Hyperoxia may play a role in exacerbating these responses. Nine ex vivo ECMO circuits were tested using fresh healthy human whole blood, with two oxygen levels: 21% inspired fraction of oxygen (FiO 2 ; mild hyperoxia; n = 5) and 100% FiO 2 (severe hyperoxia; n = 4). Serial blood samples were taken for analysis of platelet aggregometry, leukocyte activation, inflammatory, and oxidative stress markers. ECMO resulted in reduced adenosine diphosphate- (P < .05) and thrombin receptor activating peptide-induced (P < .05) platelet aggregation, as well as increasing levels of the neutrophil activation marker, neutrophil elastase (P = .013). Additionally, levels of the inflammatory chemokine interleukin-8 were elevated (P < .05) and the activity of superoxide dismutase, a marker of oxidative stress, was increased (P = .002). Hyperoxia did not augment these responses, with no significant differences detected between mild and severe hyperoxia. Our ex vivo model of ECMO revealed that the circuit itself triggers a pro-inflammatory and oxidative stress response, however, exposure to supra-physiologic oxygen does not amplify that response. Extended-duration studies and inclusion of an endothelial component could be beneficial in characterizing longer term changes.
(© 2020 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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