Continuous ultrafiltration attenuates the pulmonary injury that follows open heart surgery with cardiopulmonary bypass

Huang, Huimin; Yao, Tingjun; Wang, Wei; Zhang, Deming; Zhang, Wei; Chen, Hong; Fu, Weiding

doi:10.1016/s0003-4975(03)00264-9

Cited by 103 publications

(74 citation statements)

References 9 publications

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“…CPB may be responsible for changes in the StaC. Pulmonary compliance decreases after CPB due to the accumulation of liquids in the pulmonary interstice and to the inflammatory response [9,12]. Auler Junior et al [13] and Nozawa et al [14] also reported reductions in the StaC in the immediate postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Ambrozin¹,

Catâneo²

2005

Rev Bras Cir Cardiovasc

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“…Cardiac support can be achieved by the optimization of fluid balance, the reduction of organ edema, and the restoration of desirable levels of preload and afterload. By optimizing the patient's volume state and offering the ability to remove interstitial fluid, extracorporeal therapy may provide additional support to the failing lung (102,103). Blood purification may improve the encephalopathy of sepsis by removing uremic toxins and amino acid derivatives and correcting acidemia.…”

Section: Organ Supportmentioning

confidence: 99%

Potential Interventions in Sepsis-Related Acute Kidney Injury

Ronco¹,

Kellum²,

Bellomo³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Sepsis is an important cause of morbidity and mortality. Acute kidney injury often complicates sepsis, leading to greater complexity, cost of care, and worsening prognosis. In recent years, a consensus definition of acute kidney injury has been developed, facilitating research into the pathophysiology and epidemiology of this disorder. New and emerging biomarkers to recognize kidney injury before functional abnormalities are manifest may allow early recognition and facilitate prevention or treatment. Furthermore, advances in the clinical management of sepsis may have secondary benefits with respect to renal outcomes. Existing and hybrid extracorporeal therapies are being investigated not only as means to replace lost kidney function but also to modulate the immune response to sepsis. For those who have more advanced forms of kidney injury, strategies to promote renal recovery are being sought to minimize the long-term consequences of impaired kidney function. This review provides an update on the current state of the science and a glimpse toward the future of intervention in sepsis-related acute kidney injury.

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“…In particular, ET-1 levels are significantly increased in humans and animals during a variety of models of ischemia-reperfusion injury, including hypothermic CPB (35)(36)(37)(38)(39). In ischemia reperfusion, it has been shown that ET-1 becomes dominant whereas the production of NO becomes impaired and this imbalance contributes to ischemia reperfusion injury.…”

Section: Et-1 After Cardiac Surgery For Congenital Heart Diseasementioning

confidence: 99%

Endothelin-1 in Congenital Heart Disease

Beghetti¹,

Black

Fineman

2005

Pediatr Res

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Endothelin-1 (ET-1) is a 21-amino acid polypeptide produced primarily by vascular endothelial cells. First discovered in 1988 as a potent vasoconstrictor, it has subsequently been appreciated to participate in several biologic activities, including vascular smooth muscle proliferation, fibrosis, cardiac and vascular hypertrophy, and inflammation. Increasing data demonstrate alterations in ET-1 signaling in newborns, infants, and children with congenital heart defects that are associated with alterations in pulmonary blood flow. This review outlines the pathophysiologic role of the ET-1 cascade in the development of altered pulmonary vascular tone and reactivity that occurs with congenital heart disease and its repair, following the use of cardiopulmonary bypass. In addition, therapeutic implications for the use of novel ET receptor antagonists will be emphasized. Abbreviations CPB, cardiopulmonary bypass CHD, congenital heart defect ET-1, endothelin 1, PVR, pulmonary vascular resistance ET-1 was originally isolated in 1988 as a 21-amino acid polypeptide produced by pulmonary and systemic vascular endothelial cells, and was described as the most potent endogenous vasoconstrictor discovered to date (1). Subsequently it has been appreciated that ET-1 may be produced by a variety of cell types, and has numerous biologic properties within the cardiovascular, respiratory, renal, endocrine, gastrointestinal, and neurologic systems. These biologic properties include the regulation of vasomotor tone, vascular smooth muscle proliferation, fibrosis, cardiac and vascular hypertrophy, and inflammation (Fig. 1). In addition, alterations in the ET-1 cascade have been implicated in the pathophysiology of a variety of disease states, including congestive heart failure, bronchoconstriction, fibrotic disorders, and pulmonary hypertension (2-5). Increasing data demonstrate alterations in ET-1 signaling in newborns, infants, and children with congenital heart defects (CHD) that are associated with alterations in pulmonary blood flow (6 -10). This review outlines the pathophysiologic role of the ET-1 cascade in the development of altered pulmonary vascular tone and reactivity that occurs with congenital heart disease and its repair, following the use of cardiopulmonary bypass (CPB). In addition, therapeutic implications for the use of novel ET receptor antagonists will be emphasized. THE ENDOTHELIN CASCADEThe gene for human ET-1 is located on chromosome 6 and is translated to a 203-amino acid peptide precursor (preproET-1), which is then cleaved to form proendothelin-1. Proendothelin, big ET-1, is then cleaved by a membrane-bound metalloprotein converting enzyme (Endothelin Converting Enzyme-1, ECE-1) into its functional form (2,3,5,11). The biologic effects of ET-1 are mediated by at least two distinctive receptor populations, ET A and ET B , the densities of which are different depending on age, species, pathologic state, and vascular bed studied. The ET A receptors are located on vascular smooth muscle cells and mediate vasoconstr...

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Continuous ultrafiltration attenuates the pulmonary injury that follows open heart surgery with cardiopulmonary bypass

Cited by 103 publications

References 9 publications

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

Potential Interventions in Sepsis-Related Acute Kidney Injury

Endothelin-1 in Congenital Heart Disease

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