Effect of variation in systemic blood flow on plasma TNF-alpha in a pig model with left ventricular assist device
| Autor: | Sektiari L. Bambang, Hidetoshi Yamauchi, Walid C. Dihmis, Yasuhiro Uozaki, Madeleine Moczar, Fabien Pasteau, Daniel Loisance, D. Tixier, Masatoshi Miyama |
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| Rok vydání: | 2001 |
| Předmět: |
Cardiac output
medicine.medical_specialty Haemodynamic response Swine Heart Ventricles Biomedical Engineering Cardiac index Medicine (miscellaneous) Hemodynamics Bioengineering Sensitivity and Specificity Statistics Nonparametric law.invention Biomaterials law medicine.artery Internal medicine medicine Cardiopulmonary bypass Animals Probability Aorta Analysis of Variance business.industry Tumor Necrosis Factor-alpha General Medicine Stroke volume Oxygen Disease Models Animal Pulmonary artery Cardiology Heart-Assist Devices business Blood Flow Velocity |
| Zdroj: | Artificial organs. 25(2) |
| ISSN: | 0160-564X |
| Popis: | Tumor necrosis factor-alpha (TNF-alpha) release has been implicated in a sepsis-like syndrome following cardiopulmonary bypass (CPB). This also may be important in patients who have had a left ventricular assist device (LVAD) implanted. This report investigates the effect of reducing systemic blood flow on hemodynamic response, mixed venous oxygen saturation (SvO(2)), and the release of TNF-alpha. LVADs were implanted in 9 pigs. The aorta was clamped, and thus the LVAD flow represented the entire systemic blood flow. Plasma TNF-alpha in the femoral artery (FA) and superior mesenteric vein (SMV) was measured at baseline and following systemic blood flow changes. Simultaneously, hemodynamic parameters and oxygen saturation in the pulmonary artery (SvO(2)) were measured. Following reductions in systemic blood flow, plasma TNF-alpha increased gradually to a maximum level at a systemic blood flow of 20%. There was no significant difference between TNF-alpha levels in the SMV and the FA. There was a significant (p < 0.05) correlation between cardiac index, stroke volume index, and TNF-alpha. The SvO(2) decreased significantly (p < 0.05) at a systemic blood flow of 30 and 20%. A rise in TNF-alpha occurred when the SvO(2) was less than 75%. The data demonstrate that a reduction in systemic blood flow causes an increase in plasma TNF-alpha. This can lead to the development of a sepsis-like syndrome in a group of patients who already are hemodynamically compromised. While weaning short-term LVAD support, rapid diminution of the cardiac output and the pump flow must be avoided. |
| Databáze: | OpenAIRE |
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