Endothelial Progenitor Cell Homing Decreases Postoperative Complications in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass

Du, Lei; Meng, Wen-Tong; Zhang, Yujing; Zhang, Jie; Zhou, Jing; Yu, Jerry; Gong, Ling; Lin, Ke; Lin, Bo; Zhao, Liang; Liu, Jin

doi:10.24015/japm.2014.0004

Cited by 5 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They demonstrated that the migratory effect of EPC was compromised in on-pump CPB patients [32]. Further, Lei Du et al have reported that EPCs start homing to the injured site after 4 hours from the end of the surgery, reporting a drop in the counts of circulating EPCs after 4 hours accompanied by a corresponding increase in their numbers in lung and kidney tissues [39].…”

Section: Discussionmentioning

confidence: 99%

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Nandi

Kumari

Potunuru

et al. 2020

Preprint

View full text Add to dashboard Cite

Vasoplegia observed post-cardiopulmonary bypass (CPB), is associated with substantial morbidity, multiple organ failure and mortality. Circulating counts of hematopoietic stem cells (HSCs) and endothelial progenitor cells (EPC) are potential markers of neovascularization and vascular repair. However, changes in the circulating levels of these progenitors in perioperative CPB and their association with post-CPB vasoplegia remains to be determined. HSC and EPC counts were enumerated at different timepoints during CPB in 19 individuals who underwent elective cardiac surgery via flow cytometry. These 19 individuals were categorized into two groups based on severity of post-operative vasoplegia as: clinically insignificant vasoplegic Group 1 (G1) and clinically significant vasoplegic Group 2 (G2). The differential changes in progenitor cell counts during different stages of surgery were compared across these two groups.Machine-learning classifiers (logistic regression and gradient boosting) were employed to determine if differential changes in progenitor counts could differentiate and group subjects based on the severity of vasoplegia. Enumeration of progenitor cells revealed an early and significant increase in the circulating counts of CD34 + and CD34 + CD133 + hematopoietic stem cells (HSC) in G1 subjects which was attenuated in G2 individuals.Additionally, EPCs (CD34 + VEGFR2 + ) were lower in G2 individuals compared to G1.Gradient boosting outperformed logistic regression in assessing the vasoplegia grouping based on fold change in circulating CD 34 + levels. Our findings indicate that a lack of early response of CD34 + cells and CD34 + CD133 + HSCs might serve as an early marker for development of clinically significant vasoplegia after CPB.

show abstract

Section: Discussionmentioning

confidence: 99%

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Nandi

Kumari

Potunuru

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…They demonstrated that the migratory effect of EPC was compromised in on-pump CPB patients [ 32 ]. Further, Lei Du et al have reported that EPCs start homing to the injured site after 4 hours from the end of the surgery, reporting a drop in the counts of circulating EPCs after 4 hours accompanied by a corresponding increase in their numbers in lung and kidney tissues [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

et al. 2020

View full text Add to dashboard Cite

Vasoplegia observed post cardiopulmonary bypass (CPB) is associated with substantial morbidity, multiple organ failure and mortality. Circulating counts of hematopoietic stem cells (HSCs) and endothelial progenitor cells (EPC) are potential markers of neo-vascularization and vascular repair. However, the significance of changes in the circulating levels of these progenitors in perioperative CPB, and their association with post-CPB vasoplegia, are currently unexplored. We enumerated HSC and EPC counts, via flow cytometry, at different time-points during CPB in 19 individuals who underwent elective cardiac surgery. These 19 individuals were categorized into two groups based on severity of post-operative vasoplegia, a clinically insignificant vasoplegic Group 1 (G1) and a clinically significant vasoplegic Group 2 (G2). Differential changes in progenitor cell counts during different stages of surgery were compared across these two groups. Machine-learning classifiers (logistic regression and gradient boosting) were employed to determine if differential changes in progenitor counts could aid the classification of individuals into these groups. Enumerating progenitor cells revealed an early and significant increase in the circulating counts of CD34+ and CD34+CD133+ hematopoietic stem cells (HSC) in G1 individuals, while these counts were attenuated in G2 individuals. Additionally, EPCs (CD34+VEGFR2+) were lower in G2 individuals compared to G1. Gradient boosting outperformed logistic regression in assessing the vasoplegia grouping based on the fold change in circulating CD 34+ levels. Our findings indicate that a lack of early response of CD34+ cells and CD34+CD133+ HSCs might serve as an early marker for development of clinically significant vasoplegia after CPB.

show abstract

“…Organ dysfunction was defined as described previously. 22 Briefly, respiratory failure was defined as PaO 2 /FiO 2 ≤ 100 mm Hg with PEEP ≥ 5 cm H 2 O in the absence of cardiac dysfunction. Renal dysfunction was defined as postoperative serum creatinine level >177 μM and an increase >62 μM from preoperative baseline.…”

Section: Methodsmentioning

confidence: 99%

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

et al. 2016

Self Cite

View full text Add to dashboard Cite

Patients undergoing cardiac surgery often experience abnormal bleeding, due primarily to cardiopulmonary bypass (CPB)-induced activation of platelets. Sevoflurane may inhibit platelet activation, raising the possibility that administering it during CPB may reduce blood loss.Patients between 18 and 65 years old who were scheduled for cardiac surgery under CPB at our hospital were prospectively enrolled and randomized to receive intravenous anesthetics alone (control group, n = 77) or together with sevoflurane (0.5–1.0 vol/%) from an oxygenator (sevoflurane group, n = 76). The primary outcome was postoperative blood loss, the secondary outcome was postoperative need for blood products.Volume of blood loss was 48% lower in the sevoflurane group than the control group at 4 hours after surgery, and 33% lower at 12 hours after surgery. Significantly fewer patients in the sevoflurane group lost >700 mL blood within 24 hours (9 of 76 vs 28 of 77, P < 0.001). As a result, the sevoflurane group received significantly smaller volumes of packed red blood cells (1.25 ± 2.36 vs 2.23 ± 3.75 units, P = 0.011) and fresh frozen plasma (97 ± 237 vs 236 ± 344 mL, P = 0.004). Thus the sevoflurane group was at significantly lower risk of requiring complex blood products after surgery (adjusted odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17–0.68, P = 0.002).Sevoflurane inhalation from an oxygenator during CPB may reduce blood loss and need for blood products after cardiac surgery.

show abstract

Endothelial Progenitor Cell Homing Decreases Postoperative Complications in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass

Cited by 5 publications

References 22 publications

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Altered kinetics of circulating progenitor cells in cardiopulmonary bypass (CPB) associated vasoplegic patients: A pilot study

Low-Dose Sevoflurane May Reduce Blood Loss and Need for Blood Products After Cardiac Surgery

Contact Info

Product

Resources

About