Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Blood Electrolytes and Metabolites—A Randomized Controlled Trial
| Autor: | Raluca Maltesen, Bodil Steen Rasmussen, Hanne Berg Ravn, Reinhard Wimmer, Munsoor Hanifa, Katrine B Buggeskov, Morten Asp Vonsild Lund |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
lung protection Isotonic hyponatremia lcsh:Medicine 030204 cardiovascular system & hematology Article ischemia-reperfusion law.invention 03 medical and health sciences 0302 clinical medicine law medicine.artery medicine Cardiopulmonary bypass COPD metabolites Lung business.industry lcsh:R CPB General Medicine medicine.disease pulmonary perfusion Cardiac surgery oxygenated blood medicine.anatomical_structure surgical procedures operative HTK 030228 respiratory system Anesthesia Pulmonary artery randomized controlled trial Arterial blood business Perfusion circulatory and respiratory physiology |
| Zdroj: | Buggeskov, K B, Maltesen, R G, Rasmussen, B S, Hanifa, M A, Lund, M A V, Wimmer, R & Ravn, H B 2018, ' Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Blood Electrolytes and Metabolites—A Randomized Controlled Trial ', Journal of Clinical Medicine, vol. 7, no. 11, 462, pp. 1-18 . https://doi.org/10.3390/jcm7110462 Buggeskov, K, Maltesen, R, Rasmussen, B S, Hanifa, M A, Lund, M A V, Wimmer, R & Ravn, H B 2018, ' Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Blood Electrolytes and Metabolites—A Randomized Controlled Trial ', Journal of Clinical Medicine, vol. 7, no. 11, 462, pp. 1-18 . Journal of Clinical Medicine, Vol 7, Iss 11, p 462 (2018) Aalborg University Journal of Clinical Medicine Volume 7 Issue 11 |
| DOI: | 10.3390/jcm7110462 |
| Popis: | Cardiac surgery with cardiopulmonary bypass (CPB) causes an acute lung ischemia-reperfusion injury, which can develop to pulmonary dysfunction postoperatively. This sub-study of the Pulmonary Protection Trial aimed to elucidate changes in arterial blood gas analyses, inflammatory protein interleukin-6, and metabolites of 90 chronic obstructive pulmonary disease patients following two lung protective regimens of pulmonary artery perfusion with either hypothermic histidine-tryptophan-ketoglutarate (HTK) solution or normothermic oxygenated blood during CPB, compared to the standard CPB with no pulmonary perfusion. Blood was collected at six time points before, during, and up to 20 h post-CPB. Blood gas analysis, enzyme-linked immunosorbent assay, and nuclear magnetic resonance spectroscopy were used, and multivariate and univariate statistical analyses were performed. All patients had decreased gas exchange, augmented inflammation, and metabolite alteration during and after CPB. While no difference was observed between patients receiving oxygenated blood and standard CPB, patients receiving HTK solution had an excess of metabolites involved in energy production and detoxification of reactive oxygen species. Also, patients receiving HTK suffered a transient isotonic hyponatremia that resolved within 20 h post-CPB. Additional studies are needed to further elucidate how to diminish lung ischemia-reperfusion injury during CPB, and thereby, reduce the risk of developing severe postoperative pulmonary dysfunction. |
| Databáze: | OpenAIRE |
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