Tumor Necrosis Factor-Alpha in Plasma During Cardiopulmonary Bypass in a Pig Model Correlation With Marginated Neutrophils and Cerebral Edema by Magnetic Resonance Imaging

Dewanjee, Mrinal K.; Wu, Shu; Burke, George W.; Hsu, Li Chien

doi:10.1097/00002480-199805000-00017

Cited by 12 publications

(9 citation statements)

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“…In a few studies, TNF‐α was detectable preoperatively (18, 28–30) but without further changes in TNF‐α plasma concentration during or after CPB (18, 29, 30). A similar inconsistency in TNF‐α response was found in pigs subjected to CPB (31, 32). Animal studies have further revealed that administration of small amounts of TNF‐α decrease myocardial performance (33), suggesting that even small TNF‐α levels may contribute to myocardial dysfunction in humans also.…”

Section: Cytokinessupporting

confidence: 60%

“…Moreover, children below 2 years of age showed still marked ventricular enlargement 2–4 weeks after CPB surgery. Analogous cerebral changes have also been described in animal studies of CPB (32). Cellular accumulation in the brain tissue has not been described, suggesting that the blood–brain barrier (BBB) is intact for cellular transmigration.…”

Section: Inflammatory Events At the Organ Levelmentioning

confidence: 53%

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The systemic inflammatory response after cardiac surgery with cardiopulmonary bypass in children

Christensen¹

2001

Acta Anaesthesiol Scand

141

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Paediatric cardiac surgery often requires cardiopulmonary bypass (CPB) during the surgical intervention. CPB is known to elicit a systemic inflammatory response with activation of the complement and coagulation systems, stimulation of cytokine production, cellular entrapment in organs, neutrophil activation with degranulation, platelet activation, and endothelial dysfunction. These changes are associated with a risk of postoperative organ dysfunction and increased morbidity and mortality in the postoperative period. Clinical studies have concentrated on measurement of inflammatory markers and mediators in peripheral blood, where the systemic inflammatory response in the paediatric cardiac patient seems to be different from the adult case. Looking at the organ level, experimental studies have the advantage of providing information contributing to a better understanding of the pathological events that may lead to the deteriorated organ function. This review focuses on the systemic inflammatory response after cardiac surgery with CPB in children and experimental CPB models.

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Section: Cytokinessupporting

confidence: 60%

Section: Inflammatory Events At the Organ Levelmentioning

confidence: 53%

The systemic inflammatory response after cardiac surgery with cardiopulmonary bypass in children

Christensen¹

2001

Acta Anaesthesiol Scand

141

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“…1,2 These insults activate the microcirculation throughout the body, [3][4][5][6][7][8][9][10][11] and this results in organ dysfunction in the immediate postoperative period. [12][13][14] Microvascular activation may cause organ dysfunction due to microvascular thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Dixon

Santamaria

Campbell

2005

Chest

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“…26 Furthermore, inflammatory mediators are suspected of causing damage to the blood-brain barrier in association with CPB. 15 Dewanjee et al 15 reported brain edema on the basis of descriptive magnetic resonance imaging without a semiquantitative analysis. TNF-␣ concentrations were determined during CPB and 90 minutes thereafter, which peaked 30 minutes after termination of CPB.…”

Section: Discussionmentioning

confidence: 99%

“…15 In OPCAB, reduced inflammatory mediator levels compared with those during CPB have been detected.…”

mentioning

confidence: 99%

Emboli Formation Rather Than Inflammatory Mediators Are Responsible for Increased Cerebral Water Content After Conventional and Assisted Beating-Heart Myocardial Revascularization in a Porcine Model

Bierbach¹,

Meier²,

Kasper-König³

et al. 2008

Stroke

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Background and Purpose-Emboli and proinflammatory mediators are suspected of generating cerebral edema after coronary surgery. In contrast to cardiopulmonary bypass (CPB), off-pump coronary artery bypass surgery (OPCAB) reduces microemboli count and proinflammatory mediator release but carries the risk of hemodynamic instability. A microaxial blood pump can augment cardiac output. Methods-Coronary bypasses were constructed in pigs with CPB and cardioplegia (nϭ9), OPCAB (nϭ9), or blood-pump support CAB (nϭ9). Nine animals underwent sham operation. Embolus count was monitored and regional cerebral blood flow was assessed with microspheres in 21 brain specimens per animal (nϭ189 per group). Interleukins 6 and 8 and tumor necrosis factor-␣ concentrations were determined. These variables were studied before, during, and for 4 hours after surgery. Finally, cerebral water content was determined. Results-During CPB and blood-pump CAB, a significant number of emboli were counted in contrast to OPCAB and controls (PϽ0.05). During CPB, regional cerebral blood flow was affected (32 of 189) and showed reactive hyperemia except in 10 specimens after aortic cross-clamp release. This impairment persisted in 20 specimens. During and after OPCAB, regional cerebral blood flow remained nearly unchanged but showed low flow during (58 of 189) and after (35 of 189) the blood-pump run. A significant increase in proinflammatory mediators was observed only in the CPB group. CPB and blood-pump CAB significantly increased cerebral water content (PϽ0.05). A strong correlation between embolic load and cerebral water content was observed in all groups. No correlation between proinflammatory mediator release and cerebral water content was detected. Conclusions-Emboli formation rather than inflammatory mediators are responsible for increased cerebral water content after conventional and assisted beating-heart myocardial revascularization. (Stroke. 2008;39:213-219.)

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Tumor Necrosis Factor-Alpha in Plasma During Cardiopulmonary Bypass in a Pig Model Correlation With Marginated Neutrophils and Cerebral Edema by Magnetic Resonance Imaging

Cited by 12 publications

References 0 publications

The systemic inflammatory response after cardiac surgery with cardiopulmonary bypass in children

The systemic inflammatory response after cardiac surgery with cardiopulmonary bypass in children

Coagulation Activation and Organ Dysfunction Following Cardiac Surgery

Emboli Formation Rather Than Inflammatory Mediators Are Responsible for Increased Cerebral Water Content After Conventional and Assisted Beating-Heart Myocardial Revascularization in a Porcine Model

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