Pulmonary endothelial dysfunction after cardiopulmonary bypass in neonatal pigs

Abstract

CPB seems to induce pulmonary endothelial dysfunction in pulmonary but not peripheral resistance arteries in neonatal piglets.

Neutrophil and platelet dynamics at organ level after cardiopulmonary bypass: An in vivo study in neonatal pigs

“…The lungs are together with the kidneys organs at high risk for postoperative complication after CPB. We have previously reported impaired oxygenation in the present CPB pigs 139 compared to the sham pigs (8) together with endothelial dysfunction of the pulmonary resistance arteries (18). In this study, however, we did not find cell accumulation in the pulmonary tissue, contrary to our expectations.…”

Oral sildenafil for persistent pulmonary hypertension early after congenital cardiac surgery in children☆

“…The resultant elevated vascular resistance may lead to pulmonary hypertension (PH), which is a major cause of postoperative morbidity [1,2]. Endothelial dysfunction during and following cardiopulmonary bypass [3,4] may have deleterious effects on the pulmonary circulation, which may explain the limited efficacy for this type of PH of endothelium-dependent intravenous vasodilator therapy with nitroglycerine or prostaglandins. Therefore, endothelium-independent pulmonary vasodilators may be indicated to treat persistent PH early after congenital surgery.…”

Anestesia para o recém-nascido submetido a cirurgia cardíaca com circulação extracorpórea

“…As membranas alvéo-lo-capilares e o endotélio capilar são alvos das citocinas pró-inflamatórias e dos produtos da ativação do sistema complemento 53 . A disfunção endotelial é parte da resposta inflamatória sistêmica exagerada e manifesta-se como edema intersticial pela alteração na função de barreira do endotélio 54 . O endotélio vascular não tem, no entanto, apenas a função de barreira; ele produz substâncias que controlam o próprio tônus vascular como o óxido nítrico (NO), a endotelina e a prostaciclina 55 .…”

“…A tolazolina, a prostaglandina E1 e a prostaciclina, todas drogas vasodilatadoras pulmonares, são também dilatadores da circulação sistêmica e a hipotensão arterial decorrente de seu uso anula os possíveis efeitos benéfi-cos sobre a circulação pulmonar 7 . A descoberta do óxido ní-trico (NO), um vasodilatador produzido no endotélio, trouxe novas perspectivas para o tratamento da hipertensão pulmonar 54 . Sendo um gás e tendo metabolização instantânea no sangue pela hemoglobina, dilata os vasos adjacentes aos alvéolos sem exercer ação sobre a circulação sistêmica.…”

“…Tolatozine, prostaglandin E1 and prostacyclin, all pulmonary vasodilating drugs, also dilate systemic circulation and hypotension induce by them cancel possible beneficial effects on pulmonary circulation 7 . The introduction of nitric oxide (NO), endothelium-produced vasodilator, has opened new perspectives for pulmonary hypertension management 54 . For being a gas instantaneously metabolized in blood by hemoglobin, it dilates vessels adjacent to alveoli without acting on systemic circulation.…”