The influence of gaseous microemboli on various biomarkers after minimized cardiopulmonary bypass
| Autor: | Meyke A Molenaar, Bastian A. de Mol, Frederik N Hofman, Wim van Oeveren, Roel de Vroege, Peter Bruins, Marco C. Stehouwer, Eline F. Bruggemans |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
inorganic chemicals medicine.medical_specialty minimally invasive extracorporeal technology Adverse outcomes Cardiopulmonary bypass circuit 030204 cardiovascular system & hematology adverse effects cardiopulmonary bypass law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Cardiopulmonary bypass minimized cardiopulmonary bypass Humans Radiology Nuclear Medicine and imaging Prospective Studies Aged Advanced and Specialized Nursing Cardiopulmonary Bypass business.industry biomarkers General Medicine Cardiac surgery respiratory tract diseases 030228 respiratory system Cardiology Female gaseous microemboli Gases Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. SAGE PUBLICATIONS LTD Perfusion |
| Popis: | Introduction: Gaseous microemboli that originate from the cardiopulmonary bypass circuit may contribute to adverse outcome after cardiac surgery. We prospectively evaluated the influence of gaseous microemboli on the release of various biomarkers after use of a minimally invasive extracorporeal technology system. Methods: In 70 patients undergoing coronary artery bypass grafting with minimized cardiopulmonary bypass, gaseous microemboli were measured intraoperatively with a bubble counter. Intra- and postoperative biomarker levels for inflammatory response (interleukin-6, C5b-9), endothelial damage (von Willebrand factor, soluble vascular cell adhesion molecule-1), oxidative stress (malondialdehyde, 8-isoprostane, neuroketal), and neurological injury (neuron-specific enolase, brain-type fatty acid-binding protein) were analyzed using immune assay techniques. The relationship between gaseous microemboli number or volume and the incremental area under the curve (iAUC24h) or peak change for the biomarkers was calculated. Results: All biomarkers except for malondialdehyde increased at least temporarily after coronary artery bypass grafting with a minimally invasive extracorporeal technology system. The median total gaseous microemboli number was 6,174 (interquartile range: 3,507-10,531) and the median total gaseous microemboli volume was 4.31 µL (interquartile range: 2.71-8.50). There were no significant correlations between total gaseous microemboli number or volume and iAUC24h or peak change for any of the biomarkers. After controlling for the variance of possible other predictor variables, multiple linear regression analysis showed no association between gaseous microemboli parameters and release of biomarkers. Conclusion: This study showed no evidence that gaseous microemboli contribute to increased biomarker levels after coronary artery bypass grafting with cardiopulmonary bypass. A reason for the absence of damage by gaseous microemboli may be the relative and considerably small amount of gaseous microemboli entering the patients in this study. |
| Databáze: | OpenAIRE |
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