| Abstrakt: |
Thompson-Torgerson CS, Champion HC, Santhanam L, Harris ZL, Shoukas AA. Cyclohexanone contamination from extracorporeal circuits impairs cardiovascular function. Am J Physiol Heart Circ Physiol 296: H1926-H1932, 2009. First published May 1,2009; doi: 10.1152/ajpheart.00184.2009.-Extracorporeal circulation provides critical life support in the face of cardiopulmonary or renal failure, but it also introduces a host of unique morbidities characterized by ederpa formation, cardiac insufficiency, autonomic dysfunction, and altered vasomotor function. We tested the hypothesis that cyclohexanope (CHX), a solvent used in production of extracorporeal circuits and Intravenous (IV) bags, leaches into the contained fluids and can replicate these clinical morbidities. Crystalloid fluid samples from circuits and IV bags were analyzed by gas chromatography-mass spectrometre to provide a range of clinical CHX exposure levels, revealing CFIX contamination of sampled fluids (9.63-3,694 μg/l). In vivo rat studies were conducted (n = 49) to investigate the effects of a bolus IV infusion of CHX vs. saline alone on cardiovascular function, baroreflex responsiveness, and edema formation. Cardiovascular function was evaluated by cardiac output, heart rate, stroke volume, vascular resistance, arterial pressure, and ventricular contractility. Baroreflex function was assessed by mean femoral arterial pressure responses to bilateral carotid occlusion. Edema formation was assessed by the ratio of wet to dry organ weights for lungs, liver, kidneys, and skin. CHX infusion led to systemic hypotension; pulmonary hypertension; depressed contractility, heart rate, stroke volume, and cardiac output; and elevated vascular resistance (P < 0.05). Mean arterial pressure responsiveness to carotid occlusion was dampened after CHX infusion (from + 17.25 ± 1.8 to +5.61 ± 3.2 mmHg; P < 0.05). HX infusion led to significantly higher wet-to-dry weight ratios vs. saline only (3.8 ± 0.06 vs. 3.5 ± 0.05; P < 0.05). CHX can reproduce clinical cardiovascular, neurological, and edema morbidities associated with extracorporeal circulatory treatment. [ABSTRACT FROM AUTHOR] |
