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https://www.readbyqxmd.com/read/29724540/glycocalyx-degradation-and-inflammation-in-cardiac-surgery
#1
Eero Pesonen, Arie Passov, Sture Andersson, Raili Suojaranta, Tomi Niemi, Peter Raivio, Markku Salmenperä, Alexey Schramko
OBJECTIVE: Experimental inflammation induces degradation of glycocalyx. The authors hypothesized that inflammation is an important determinant of glycocalyx degradation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). DESIGN: A prospective observational study. SETTING: Operation theater and intensive care unit of a university hospital. PARTICIPANTS: Two separate prospective patient cohorts. INTERVENTIONS: Blood samples were collected at 5 perioperative time points in the trial cohort (30 patients) and only preoperatively in the preoperative cohort (35 patients)...
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29696581/potential-biomarkers-of-tissue-hypoxia-during-acute-hemodilutional-anemia-in-cardiac-surgery-a-prospective-study-to-assess-tissue-hypoxia-as-a-mechanism-of-organ-injury
#2
Gregory M T Hare, Kaho Han, Yevheniy Leshchyshyn, Nikhil Mistry, Tiffanie Kei, Si Yuan Dai, Albert K Y Tsui, Razak A Pirani, Jaideep Honavar, Rakesh P Patel, Sanjay Yagnik, Shelley L Welker, Tessa Tam, Alexander Romaschin, Philip W Connelly, W Scott Beattie, C David Mazer
PURPOSE: Hemodilutional anemia is associated with acute kidney injury (AKI) and mortality in patients undergoing cardiac surgery by mechanisms that may include tissue hypoxia. Our hypothesis was to assess if changes in the potential hypoxic biomarkers, including methemoglobin and erythropoietin, correlated with a decrease in hemoglobin (Hb) concentration following hemodilution on cardiopulmonary bypass (CPB). METHODS: Arterial blood samples were taken from patients (n = 64) undergoing heart surgery and CPB at baseline, during CPB, following CPB, and in the intensive care unit (ICU)...
April 25, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29667173/efficacy-of-corticosteroids-in-prevention-of-acute-kidney-injury-in-neonates-undergoing-cardiac-surgery-a-randomized-controlled-trial
#3
T Jahnukainen, J Keski-Nisula, J Tainio, H Valkonen, T Pätilä, H Jalanko, P Suominen
BACKGROUND: Heart surgery requiring cardiopulmonary bypass (CPB) causes an inflammatory response which may further induce acute kidney injury (AKI). In the present randomized controlled study we evaluated whether corticosteroids can prevent CPB related AKI in neonates undergoing heart surgery. METHODS: Forty neonates were randomized to receive 2 mg/kg methylprednisolone followed by hydrocortisone infusion 0.2 mg/kg/h perioperatively with tapering doses for 5 days, or placebo administered in a similar fashion...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29452878/combining-novel-renal-injury-markers-with-delta-serum-creatinine-early-after-cardiac-surgery-and-risk-stratification-for-serious-adverse-outcomes-an-exploratory-analysis
#4
David R McIlroy, David Farkas, Kun Pan, John W Pickering, H Thomas Lee
OBJECTIVE: To evaluate the prognostic utility of multiple novel urinary biomarkers of renal injury when used alone, in pair-wise combination with an early delta serum creatinine (ΔSCr ) term, and combined as a broad biomarker panel for the prediction of serious adverse outcomes that may reflect AKI in patients undergoing cardiac surgery. DESIGN: Post-hoc analysis of prospective observational study. SETTING: Academic medical center. PARTICIPANTS: 603 adults undergoing cardiac surgery...
December 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29399365/urinary-hepcidin-25-is-elevated-in-patients-that-avoid-acute-kidney-injury-following-cardiac-surgery
#5
Nora Choi, Claudio Rigatto, Michael Zappitelli, Ang Gao, Simon Christie, Brett Hiebert, Rakesh C Arora, Julie Ho
Background: Acute kidney injury (AKI) following cardiac surgery leads to increased morbidity and mortality. Characterization and validation of early biomarkers of AKI may ultimately facilitate early therapeutic intervention. We have previously identified that elevated urinary hepcidin-25 is inversely and independently associated with the development of AKI in adult cardiac surgery patients. Hepcidin-25 is an antimicrobial peptide that sequesters iron intracellularly, and its elevation following human ischemia reperfusion injury may represent a renoprotective response to minimize renal injury...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29282039/plasma-levels-of-alarmin-hnps-1-3-associate-with-lung-dysfunction-after-cardiac-surgery-in-children
#6
XiWang Liu, QiXing Chen, YuJia Luo, YaoQin Hu, DengMing Lai, XiaoLe Zhang, XiangHong Zhang, JianGen Yu, XiangMing Fang, Qiang Shu
BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether elevated plasma levels of human neutrophil peptides (HNPs) 1-3 herald impaired lung function in infants and young children after cardiac surgery necessitating cardiopulmonary bypass (CPB). METHODS: Consecutive children younger than 3 years old who underwent cardiac surgery were prospectively enrolled...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29216946/-diagnostic-significance-of-urinary-neutrophil-gelatin-enzyme-related-lipid-delivery-protein-and-kidney-injury-molecule-1-in-acute-kidney-injury-after-cardiac-operation-with-cardiopulmonary-bypass-operation-in-children
#7
Yupeng Wen, Zongxiao Li, Cheng Chang, Peng Zhang, Yang Lyu
OBJECTIVE: To investigate the diagnostic value of urinary neutrophil gelatin enzyme-related lipid delivery protein (NGAL) and kidney injury molecule-1 (KIM-1) in the acute kidney injury (AKI) after cardiopulmonary bypass (CPB) operation in children with non-cyanotic congenital heart disease (CHD). METHODS: A retrospective analysis was conducted. 200 CPB undergoing cardiac surgery in children with non-cyanotic CHD admitted to Tianjin Children's Hospital from June 2015 to May 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29174262/perioperative-plasma-mitochondrial-dna-dynamics-and-correlation-with-inflammation-during-infantile-cardiopulmonary-bypass
#8
Fei Xu, Rui-Qi Liu, Rong Cao, Lang-Tao Guo, Ning Zhang, Ke Huang, Yu Cui, Wei-Na Li, Lei Li, Zheng-Hua Huang
OBJECTIVE: Numerous studies in animals and humans have demonstrated that inflammatory mediators such as tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8 play a role in cardiopulmonary bypass (CPB), which might affect surgical outcomes. Plasma mitochondrial DNA (mtDNA), a recently discovered pro-inflammatory agent, is released by cells upon insult. This study aimed to detect changes in plasma mtDNA levels at different time points after infantile CPB and explore its potential association with inflammatory mediators...
November 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29119086/can-acute-phase-response-biomarkers-differentiate-infection-from-inflammation-postpediatric-cardiac-surgery
#9
Bana Agha Nasser, Abdu Rahman Mesned, Mohamad Tageldein, Mohamed S Kabbani, Nada Siddig Sayed
Background: Infection is a common serious complication postpediatric cardiac surgery. Diagnosis of infection after cardiopulmonary bypass (CPB) is difficult in the presence of surgical stress, hemodynamic instability, and inflammatory reaction. Aim: The purpose of this study is to investigate the value of available inflammatory biomarkers and its validity to differentiate infection from inflammation postpediatric cardiac surgery and to find the trend and the change in the level of these biomarkers shortly after cardiac surgery...
October 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29102258/copeptin-release-in-cardiac-surgery-a-new-biomarker-to-identify-risk-patients
#10
Jonas Holm, Zoltán Szabó, Urban Alehagen, Tomas L Lindahl, Ingemar Cederholm
OBJECTIVE: To describe the dynamics of copeptin in open cardiac surgery during the perioperative course. DESIGN: Prospective cohort study. SETTING: Single tertiary hospital. PARTICIPANTS: Twenty patients scheduled for open cardiac surgery procedures with cardiopulmonary bypass (CPB). INTERVENTIONS: No intervention. MEASUREMENTS AND MAIN RESULTS: Copeptin concentrations were measured pre-, peri-, and postoperatively until day 6 after surgery...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29058155/preoperative-levels-of-urinary-uromodulin-predict-acute-kidney-injury-after-pediatric-cardiopulmonary-bypass-surgery
#11
Michael R Bennett, Olivia Pyles, Qing Ma, Prasad Devarajan
BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass surgery (CPB) in children. Several promising postoperative AKI biomarkers have been identified, but no preoperative biomarkers are available. We evaluated the association of urinary uromodulin (uUMOD) with postoperative AKI. METHODS: One hundred and one children undergoing CPB were enrolled. Urine was collected prior to CPB, and AKI was defined as ≧50% increase in serum creatinine from preoperative baseline within 48 h of surgery...
March 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28992285/remote-ischaemic-preconditioning-for-renal-and-cardiac-protection-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Giacomo Deferrari, Alice Bonanni, Maurizio Bruschi, Cristiano Alicino, Alessio Signori
Background: The main aim of this systematic review was to assess whether remote ischaemic preconditioning (RIPC) protects kidneys and the heart in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate a possible role of anaesthetic agents. Methods: Randomized clinical trials (RCTs) on the effects of RIPC through limb ischaemia in adult patients undergoing cardiac surgery with CPB were searched (1965-October 2016) in PubMed, Cochrane Library and article reference lists...
May 1, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28937313/shed-blood-separation-and-cell-saver-an-integral-part-of-miecc-shed-blood-separation-and-its-influence-on-the-perioperative-inflammatory-response-during-coronary-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-a-randomized-controlled
#13
Adrian Bauer, Harald Hausmann, Jan Schaarschmidt, Martin Scharpenberg, Dirk Troitzsch, Peter Johansen, Hans Nygaard, Thomas Eberle, J Michael Hasenkam
OBJECTIVE: The postoperative systemic inflammatory response after cardiopulmonary bypass (CPB) is still an undesirable side-effect after cardiac surgery. It is most likely caused by blood contact with foreign surfaces and by the surgical trauma itself. However, the recirculation of activated shed mediastinal blood is another main cause of blood cell activation and cytokine release. Minimal invasive extracorporeal circulation (MiECC) comprises a completely closed circuit, coated surfaces and the separation of suction blood...
March 2018: Perfusion
https://www.readbyqxmd.com/read/28862938/microstructural-alterations-and-oligodendrocyte-dysmaturation-in-white-matter-after-cardiopulmonary-bypass-in-a-juvenile-porcine-model
#14
Gary R Stinnett, Stephen Lin, Alexandru V Korotcov, Ludmila Korotcova, Paul D Morton, Shruti D Ramachandra, Angeline Pham, Sonali Kumar, Kota Agematsu, David Zurakowski, Paul C Wang, Richard A Jonas, Nobuyuki Ishibashi
BACKGROUND: Newly developed white matter (WM) injury is common after cardiopulmonary bypass (CPB) in severe/complex congenital heart disease. Fractional anisotropy (FA) allows measurement of macroscopic organization of WM pathology but has rarely been applied after CPB. The aims of our animal study were to define CPB-induced FA alterations and to determine correlations between these changes and cellular events after congenital heart disease surgery. METHODS AND RESULTS: Normal porcine WM development was first assessed between 3 and 7 weeks of age: 3-week-old piglets were randomly assigned to 1 of 3 CPB-induced insults...
August 15, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28803769/urine-biomarkers-of-tubular-renal-cell-damage-for-the-prediction-of-acute-kidney-injury-after-cardiac-surgery-a-pilot-study
#15
Tanja Mayer, Daniel Bolliger, Markus Scholz, Oliver Reuthebuch, Michael Gregor, Patrick Meier, Martin Grapow, Manfred D Seeberger, Jens Fassl
OBJECTIVE: To evaluate the perioperative course of urine levels of the renal damage biomarkers tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) and to evaluate the predictive value of elevated TIMP-2 × IGFBP7 concentrations to predict acute kidney injury (AKI) early after cardiac on-pump surgery. DESIGN: Prospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: The study comprised 110 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) between January and March 2014...
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28755073/urinary-biomarkers-of-cell-cycle-arrest-are-delayed-predictors-of-acute-kidney-injury-after-pediatric-cardiopulmonary-bypass
#16
Liqun Dong, Qing Ma, Michael Bennett, Prasad Devarajan
BACKGROUND: Several novel biomarkers that predict acute kidney injury (AKI) have recently been proposed. We have evaluated the sequential patterns of biomarker elevation after pediatric cardiopulmonary bypass (CPB) and determined their diagnostic accuracy. METHODS: We measured the ability of neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver type fatty-acid binding protein (L-FABP), kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinase-2 (TIMP-2), and insulin-like growth factor binding protein 7 (IGFBP7), to predict AKI (≥50% increase in serum creatinine from baseline)...
December 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28748536/renal-tubular-injury-during-cardiopulmonary-bypass-as-assessed-by-urinary-release-of-n-acetyl-%C3%A3-d-glucosaminidase
#17
L Lannemyr, E Lundin, B Reinsfelt, G Bragadottir, B Redfors, J Oras, S-E Ricksten
BACKGROUND: Acute kidney injury (AKI) is a common complication with a major impact on morbidity and mortality after cardiac surgery with cardiopulmonary bypass (CPB). The aim of the present study was to perform a detailed analysis on the release of the tubular injury biomarker N-acetyl-b-D-glucosaminidase (NAG) during and early after CPB and to describe independent predictors of maximal tubular injury. We hypothesized that renal tubular injury occurs early after the onset of CPB. METHODS: In this prospective observational study, we included 61 patients undergoing open cardiac surgery with an expected CPB duration exceeding 60 min...
October 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28729908/aki-after-pediatric-cardiac-surgery-for-congenital-heart-diseases-recent-developments-in-diagnostic-criteria-and-early-diagnosis-by-biomarkers
#18
REVIEW
Yuichiro Toda, Kentaro Sugimoto
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery in children with congenital heart disease is a common complication. AKI is also associated with high morbidity and mortality. The Kidney Diseases Improving Global Outcomes (KDIGO) criteria for AKI classification are now widely used for the definition of AKI. It is noteworthy that a statement about children was added to the criteria. Many studies aimed at finding useful biomarkers are now being performed by using these criteria...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28693509/biomarkers-allow-detection-of-nutrient-limitations-and-respective-supplementation-for-elimination-in-pichia-pastoris-fed-batch-cultures
#19
Jonas Burgard, Minoska Valli, Alexandra B Graf, Brigitte Gasser, Diethard Mattanovich
BACKGROUND: Industrial processes for recombinant protein production challenge production hosts, such as the yeast Pichia pastoris, on multiple levels. During a common P. pastoris fed-batch process, cells experience strong adaptations to different metabolic states or suffer from environmental stresses due to high cell density cultivation. Additionally, recombinant protein production and nutrient limitations are challenging in these processes. RESULTS: Pichia pastoris producing porcine carboxypeptidase B (CpB) was cultivated in glucose or methanol-limited fed-batch mode, and the cellular response was analyzed using microarrays...
July 11, 2017: Microbial Cell Factories
https://www.readbyqxmd.com/read/28683994/the-effects-of-steroids-on-coagulation-dysfunction-induced-by-cardiopulmonary-bypass-a-steroids-in-cardiac-surgery-sirs-trial-substudy
#20
RANDOMIZED CONTROLLED TRIAL
Domenico Paparella, Alessandro Parolari, Crescenzia Rotunno, Jessica Vincent, Veronica Myasoedova, Pietro Guida, Micaela De Palo, Vito Margari, Philip J Devereaux, Andre Lamy, Francesco Alamanni, Salim Yusuf, Richard Whitlock
Cardiopulmonary bypass (CPB) surgery, despite heparin administration, elicits activation of coagulation system resulting in coagulopathy. Anti-inflammatory effects of steroid treatment have been demonstrated, but its effects on coagulation system are unknown. The primary objective of this study is to assess the effects of methylprednisolone on coagulation function by evaluating thrombin generation, fibrinolysis, and platelet activation in high-risk patients undergoing cardiac surgery with CPB. The Steroids In caRdiac Surgery study is a double-blind, randomized, controlled trial performed on 7507 patients worldwide who were randomized to receive either intravenous methylprednisolone, 250 mg at anesthetic induction and 250 mg at initiation of CPB (n = 3755), or placebo (n = 3752)...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
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