Renal and Cerebral Hypoxia and Inflammation During Cardiopulmonary Bypass

Jufar, Alemayehu H; Lankadeva, Yugeesh R.; May, Clive N.; Cochrane, Andrew; Marino, Bruno; Bellomo, Rinaldo; Evans, Roger G.

doi:10.1002/cphy.c210019

Cited by 23 publications

(42 citation statements)

References 398 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Major organ dysfunction after cardiac surgery requiring cardiopulmonary bypass (CPB), particularly in the kidneys and brain, is relatively common 1 . For example, post‐operative acute kidney injury (AKI) occurs in ~30% of patients undergoing cardiac surgery requiring CPB 2 .…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiological mechanisms leading to cardiac surgery‐associated AKI and brain injury are not completely understood. However, tissue hypoxia during CPB is considered important 1 . Indeed, renal medullary hypoxia during CPB is predicted from computational models of renal oxygenation 4 and was observed in porcine, 5 rodents, 6 and ovine 7–10 experimental models of CPB.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of moderate hypothermia on renal and cerebral haemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep

et al. 2022

Self Cite

View full text Add to dashboard Cite

Aim Cardiac surgery requiring cardiopulmonary bypass (CPB) can result in renal and cerebral injury. Intraoperative tissue hypoxia could contribute to such organ injury. Hypothermia, however, may alleviate organ hypoxia. Therefore, we tested whether moderate hypothermia (30°C) improves cerebral and renal tissue perfusion and oxygenation during ovine CPB. Methods Ten sheep were studied while conscious, under stable anesthesia, and during 3 h of CPB. In a randomized within‐animal cross‐over design, five sheep commenced CPB at a target body temperature of 30°C (moderate hypothermia). After 90 min, the body temperature was increased to 36°C (standard procedure). The remaining five sheep were randomized to the opposite order of target body temperature. Results Compared with the standard procedure, moderately hypothermic CPB reduced renal oxygen delivery (−34.8% ± 19.6%, P = 0.003) and renal oxygen consumption (−42.7% ± 35.2%, P = 0.04). Nevertheless, moderately hypothermic CPB did not significantly alter either renal cortical or medullary tissue PO2. Moderately hypothermic CPB also did not significantly alter cerebral perfusion, cerebral tissue PO2, or cerebral oxygen saturation compared with the standard procedure. Compared with the anesthetized state, the standard procedure reduced renal medullary PO2 (−21.0 ± 13.8 mmHg, P = 0.014) and cerebral oxygen saturation (65.0% ± 7.0% to 55.4% ± 9.6%, P = 0.022) but did not significantly alter either renal cortical or cerebral PO2. Conclusion Ovine experimental CPB leads to renal medullary tissue hypoxia. Moderately hypothermic CPB did not improve cerebral or renal tissue oxygenation. In the kidney, this is probably because renal tissue oxygen consumption is matched by reduced renal oxygen delivery.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of moderate hypothermia on renal and cerebral haemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…With only three sutures needed to anchor the valve, rapid-deployment valve replacement can shorten cardiopulmonary bypass time, thus reducing the risk for complications associated with cardiopulmonary bypass. 6,7 Major differences in TAVR and RDV are the use of cardiopulmonary bypass and the need for decalcification. Although the effect of cardiopulmonary bypass on physiology are well known, [6][7][8] the effect of decalcification after AVR is not well studied.…”

Section: Resultsmentioning

confidence: 99%

“…6,7 Major differences in TAVR and RDV are the use of cardiopulmonary bypass and the need for decalcification. Although the effect of cardiopulmonary bypass on physiology are well known, [6][7][8] the effect of decalcification after AVR is not well studied.…”

Section: Resultsmentioning

confidence: 99%

“…For surgical AVR, rapid‐deployment valve replacement, which uses stent technology similar to TAVR to anchor the valves at the aortic annulus, is another evolving technology used today. With only three sutures needed to anchor the valve, rapid‐deployment valve replacement can shorten cardiopulmonary bypass time, thus reducing the risk for complications associated with cardiopulmonary bypass 6,7 . Major differences in TAVR and RDV are the use of cardiopulmonary bypass and the need for decalcification.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of stent and decalcification on mitral annular motion after aortic valve replacement

Hori

Nomura

Taniguchi

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Objective: The purpose of this study was to evaluate the changes in mitral annular motion after surgery in patients with aortic stenosis.Methods: Patients receiving Edwards (Edwards) valves were included in the study.Echocardiographic findings were compared among the three treatments postoperatively, at discharge, and at 1 year after the surgery. Mitral annular motion was evaluated by e prime, using tissue doppler imaging.Results: There were 111 patients receiving Inspiris, 30 patients receiving Intuity and 241 patients receiving Sapien 3. The patients receiving Sapien 3 were significantly older, (Inspiris: 71 ± 6.7 years vs. Intuity: 75 ± 5.2 years vs. Sapien 3: 84 ± 5.1 years, p < .001), and prevalence of hemodialysis were significantly higher in patients receiving Intuity (Inspiris: 11.7% vs. Intuity: 46.7% vs. Sapien 3: 0.0%, p < .001).

show abstract

Perioperative acute kidney injury: The renoprotective effect and mechanism of dexmedetomidine

Gao,

2024

Biochemical and Biophysical Research Communications

View full text Add to dashboard Cite

Renal and Cerebral Hypoxia and Inflammation During Cardiopulmonary Bypass

Cited by 23 publications

References 398 publications

Influence of moderate hypothermia on renal and cerebral haemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep

Influence of moderate hypothermia on renal and cerebral haemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep

The effect of stent and decalcification on mitral annular motion after aortic valve replacement

Perioperative acute kidney injury: The renoprotective effect and mechanism of dexmedetomidine

Contact Info

Product

Resources

About