Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Bronchoalveolar Fluid and Lung Tissue in Cardiac Surgery Patients

Metabolites
Raluca G MaltesenBodil S Rasmussen

Abstract

Pulmonary dysfunction is among the most frequent complications to cardiac surgeries. Exposure of blood to the cardiopulmonary bypass (CPB) circuit with subsequent lung ischemia-reperfusion leads to the production of inflammatory mediators and increases in microvascular permeability. The study aimed to elucidate histological, cellular, and metabolite changes following two lung protective regimens during CPB with Histidine-Tryptophan-Ketoglutarate (HTK) enriched or warm oxygenated blood pulmonary perfusion compared to standard regimen with no pulmonary perfusion. A total of 90 patients undergoing CPB were randomized to receiving HTK, oxygenated blood or standard regimen. Of these, bronchoalveolar lavage fluid (BALF) and lung tissue biopsies were obtained before and after CPB from 47 and 25 patients, respectively. Histopathological scores, BALF cell counts and metabolite screening were assessed. Multivariate and univariate analyses were performed. Profound histological, cellular, and metabolic changes were identified in all patients after CPB. Histological and cellular changes were similar in the three groups; however, some metabolite profiles were different in the HTK patients. While all patients presented an increase in inflamma...Continue Reading

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Citations

Aug 14, 2020·Journal of Cardiac Surgery·Edward GologorskyTomas A Salerno
Jan 1, 2021·Oxidative Medicine and Cellular Longevity·Marwan AlmoiliqyYuan Lin
May 6, 2021·Journal of Cellular and Molecular Medicine·Carsten SimonsenRaluca Georgiana Maltesen
Sep 24, 2021·Metabolomics : Official Journal of the Metabolomic Society·Sean J CooneyJesse A Davidson

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Methods Mentioned

BETA
biopsies
bronchoalveolar
coronary artery bypass
biopsy
lavage
nuclear magnetic resonance
NMR
light microscopy

Clinical Trials Mentioned

NCT01614951

Software Mentioned

PLS Toolbox
SPSS Statistics
AMIX ( Analysis of MIXtures
TopSpin
MATLAB
MNOVA Mestrelab Research
MathWork

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