Microcirculatory perfusion disturbances following cardiac surgery with cardiopulmonary bypass are associated with in vitro endothelial hyperpermeability and increased angiopoietin-2 levels

Autor: Nicole A. M. Dekker, Anoek L. I. van Leeuwen, Willem W. J. van Strien, Jisca Majolée, Robert Szulcek, Alexander B. A. Vonk, Peter L. Hordijk, Christa Boer, Charissa E. van den Brom
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Critical Care, Vol 23, Iss 1, Pp 1-10 (2019)
Druh dokumentu: article
ISSN: 1364-8535
81447272
DOI: 10.1186/s13054-019-2418-5
Popis: Abstract Background Endothelial hyperpermeability following cardiopulmonary bypass (CPB) contributes to microcirculatory perfusion disturbances and postoperative complications after cardiac surgery. We investigated the postoperative course of renal and pulmonary endothelial barrier function and the association with microcirculatory perfusion and angiopoietin-2 levels in patients after CPB. Methods Clinical data, sublingual microcirculatory data, and plasma samples were collected from patients undergoing coronary artery bypass graft surgery with CPB (n = 17) before and at several time points up to 72 h after CPB. Renal and pulmonary microvascular endothelial cells were incubated with patient plasma, and in vitro endothelial barrier function was assessed using electric cell–substrate impedance sensing. Plasma levels of angiopoietin-1,-2, and soluble Tie2 were measured, and the association with in vitro endothelial barrier function and in vivo microcirculatory perfusion was determined. Results A plasma-induced reduction of renal and pulmonary endothelial barrier function was observed in all samples taken within the first three postoperative days (P
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