Histological Changes in Neonatal Kidneys after Cardiopulmonary Bypass and Deep Hypothermic Circulatory Arrest

Tirilomis, Theodor; Tempes, T; Waldmann-Beushausen, Regina; Ballat, C; Bensch, M; Schoendube, Friedrich A.

doi:10.1055/s-2008-1039061

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…Compared to control animals, a significant increase in renal tubular damage and loss of tubular function was observed. Previous work by Tirilomis et al [ 20 ] showed similar results after MHCA using a similar histological scoring system for kidney damage in neonatal piglets. Furthermore, an association between hemolysis, renal hypoxia, and acute kidney damage has been postulated [ 21 – 23 ].…”

Section: Discussionsupporting

confidence: 64%

Blood cytokine expression correlates with early multi-organ damage in a mouse model of moderate hypothermia with circulatory arrest using cardiopulmonary bypass

et al. 2018

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Cardiopulmonary bypass (CPB) with moderate hypothermic cardiac arrest (MHCA) is essential for prolonged complex procedures in cardiac surgery and is associated with postoperative complications. Although cytokine release provoked through MHCA under CPB plays a pivotal role in postoperative organ damage, the pathomechanisms are unclear. Here, we investigated the cytokine release pattern and histological organ damage after MHCA using a recently described mouse CPB model. Eight BALB/c mice underwent 60 minutes of circulatory arrest under CPB, were successively rewarmed and reperfused. Blood cytokine concentrations and liver and kidney function parameters were measured and histological changes to these organs were compared to control animals. Our results showed a marked increase in proinflammatory cytokines and histological changes in the kidney, lung, and liver after CPB. Furthermore, clinical chemistry showed signs of hemolysis and acute kidney injury. These results suggest early onset of solid organ injury which correlates with increased leukocyte infiltration. A better understanding of the interplay between pro-inflammatory cytokine activation and solid organ injury in this model of CBP with MHCA will inform strategies to reduce organ damage during cardiac surgeries in the clinic.

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Section: Discussionsupporting

confidence: 64%

Blood cytokine expression correlates with early multi-organ damage in a mouse model of moderate hypothermia with circulatory arrest using cardiopulmonary bypass

et al. 2018

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“…However, there is some evidence that a more physiological pulsatile flow might be superior over the commonly used non-pulsatile flow during CPB (Kusch et al, 2001 ). Other organs like kidney, liver, and intestine are less tightly autoregulated, and thus also possibly affected by CPB, especially in young organisms (Tirilomis et al, 2009 , 2013 ; Doguet et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Strategies for Pharmacological Organoprotection during Extracorporeal Circulation Targeting Ischemia-Reperfusion Injury

Salameh

Dhein

2015

Front. Pharmacol.

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Surgical correction of congenital cardiac malformations or aortocoronary bypass surgery in many cases implies the use of cardiopulmonary-bypass (CPB). However, a possible negative impact of CPB on internal organs such as brain, kidney, lung and liver cannot be neglected. In general, CPB initiates a systemic inflammatory response (SIRS) which is presumably caused by contact of blood components with the surface of CPB tubing. Moreover, during CPB the heart typically undergoes a period of cold ischemia, and the other peripheral organs a global low flow hypoperfusion. As a result, a plethora of pro-inflammatory mediators and cytokines is released activating different biochemical pathways, which finally may result in the occurrence of microthrombosis, microemboli, in depletion of coagulation factors and haemorrhagic diathesis besides typical ischemia-reperfusion injuries. In our review we will focus on possible pharmacological interventions in patients to decrease negative effects of CPB and to improve post-operative outcome with regard to heart and other organs like brain, kidney, or lung.

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“…In experimental animal models of hypoxia, only minor histological changes, including mild brush border loss and vacuolization of tubular cells, are present in the kidney at 22 h post-peritonitis-induced septic shock in pigs [17] . Piglets subjected to mild hypothermic cardiopulmonary bypass exhibit tubular dilatation, vacuoles, leukocyte infiltration, epithelial destruction and interstitial oedema [18] . In cultured glomerular endothelial cells, hypoxia has been shown to induce apoptosis [19] .…”

Section: Introductionmentioning

confidence: 99%

Histopathology of renal asphyxia in newborn piglets: Individual susceptibility to tubular changes

Gerosa

Iacovidou

Argyri

et al. 2015

WJN

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Histological Changes in Neonatal Kidneys after Cardiopulmonary Bypass and Deep Hypothermic Circulatory Arrest

Abstract: Although changes in the kidney tissue of newborn piglets are detectable after any cardiac procedure, changes are more profound after cardiopulmonary bypass with mild hypothermia.

Cited by 9 publications

References 6 publications

Blood cytokine expression correlates with early multi-organ damage in a mouse model of moderate hypothermia with circulatory arrest using cardiopulmonary bypass

Blood cytokine expression correlates with early multi-organ damage in a mouse model of moderate hypothermia with circulatory arrest using cardiopulmonary bypass

Strategies for Pharmacological Organoprotection during Extracorporeal Circulation Targeting Ischemia-Reperfusion Injury

Histopathology of renal asphyxia in newborn piglets: Individual susceptibility to tubular changes

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