Efficiency of Minimized Circuits of a Heart Roller Pump on Systemic Inflammatory Response Syndrome and Multiorgan Effects in a Rat Model

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DOI:

https://doi.org/10.1532/hsf.2825

Abstract

Background: The aim of this study is to compare the effects of tubing length on systemic inflammatory response syndrome and myocardial protection in a rat model of cardiopulmonary bypass (CPB) from a
histological standpoint.

Methods: Twelve adult male Wistar Albino rats weighing >180 g were randomly selected and divided into 2 groups. In 1 group, the pump lines were kept 1 m shorter than standard. The right jugular vein and tail artery were cannulated using a 16-gauge catheter. Animals received 500 IU/kg intravenous heparin. Cardiac index and rectal temperature were set at 2.4 mL and 36°C, respectively. Total line volume was maintained at 8 mL. A roller pump was adjusted to supply a blood flow of 6 to 28 mL/min (mean 10 mL/min), similar to the typical cardiac output of rats. CPB duration was 15 minutes throughout the experiment. After sacrifice, tissue samples were collected from heart, liver, and kidney for
histomorphologic examination.

Results: All histochemical and histomorphologic analyses, performed by 2 blinded researchers, revealed band loss in cardiomyocytes, mononuclear (MNL) cell infiltration, and impaired fibrillar organization in the standard-line group. Additionally in that group, sinusoidal dilatation in the liver, low-level congestion, focal necrosis, and periportal MNL infiltration were noted. In the shorter-line group, on the other hand, MNL cell infiltration, band loss in myofibrils, and cardiomyocyte degeneration were rarely observed. Higher liver congestion and lower MNL cell infiltration were observed in the shorter-line group. No significant differences were found in kidney samples.

Conclusion: In a shorter-line roller pump test model, less multiorgan damage and fewer systemic inflammatory responses were observed. It may be applicable to keep CPB lines as close to the table as possible, especially in pediatric cardiac surgery cases.

References

Anastasiadis K, Fragoulakis V, Antonitsis P, et al. Coronary artery bypass grafting with minimal versus conventional extracorporeal circulation; an economic analysis. Int J Cardiol 2013;168:5336-5343.

Engels M, Bilgic E, Pinto A, et al. A cardiopulmonary bypass with deep hypothermic circulatory arrest rat model for the investigation of the systemic inflammation response and induced organ damage. J Inflamm (Lond) 2014;11:26.

Engels M, Bilgic E, Pinto A, et al. A cardiopulmonary bypass with deep hypothermic circulatory arrest rat model for the investigation of the systemic inflammation response and induced organ damage. J Inflamm 2014;11:26.

Fujii Y, Shirai M, Inamori S, et al. A novel small animal extracorporeal circulation model for studying pathophysiology of cardiopulmonary bypass. J Artif Organs 2015;18:35-39.

Fujii Y, Shirai M, Takewa Y et al. Cardiopulmonary bypass with low- versus high-priming volume: Comparison of infammatory responses in a rat model. ASAIO J 2016;62:289-290.

Ganushchak Y, Körver E, Yamamoto Y, et al. Versatile minimized system: A step towards safe perfusion. Perfusion 2016;31:295-299.

Immer FF, Pirovino C, Gygax E, et al. Minimal versus conventional cardiopulmonary bypass: Assessment of intraoperative myocardial damage in coronary bypass surgery. Eur J Cardiothorac Surg 2005;28:701-704.

Kim J, Lampe JW, Yin T, et al. Phospholipid alterations in the brain and heart in a rat model of asphyxia-induced cardiac arrest and cardiopulmonary bypass resuscitation. Mol Cell Biochem 2015;408:273-281.

Koster A. A new miniaturised cardiopulmonary bypass circuit reduces transfusion requirements during neonatal surgery. Initial experiences in 13 consecutive patients. J Thorac Cardiovasc Surg 2009;137:1565-1568.

Mackensen GB, Sato Y, Nellgard B, et al. Cardiopulmonary bypass induces neurologic and neurocognitive dysfunction in the rat. Anesthesiol 2001;95:1485-1491.

Modine T, Azzaoui R, Fayad G, et al. A recovery model of minimally invasive cardiopulmonary bypass in the rat. Perfusion 2006;21:87-92.

Peterss S, Guenther S, Kellermann K, et al. An experimental model of myocardial infarction and controlled reperfusion using a miniaturized cardiopulmonary bypass in rats. Interact Cardiovasc Thorac Surg 2014;19:561-566.

Rahman A, Martens S, Risteski P, et al. The use of minimized extracorporeal circulation system has a beneficial effect on hemostasis: A randomized clinical study. Heart Surg Forum 2005;9:1110.

Redlin M. Minimizing intraoperative hemodilution by use of a very low priming volume cardiopulmonary bypass neonates with transposition of the great arteries. J Thorac Cardiovasc Surg 2011;142:875-881.

Schnoering H, Arens J, Detering SM, et al. Development of a rabbit animal model for miniaturized heart-lung machines. ASAIO J 2013;59:152-156.

Schnoering H, Arens J, Detering SM, et al. Expression of inflammation in myocardial tissue of rabbits: Comparison of two miniaturized heart-lung machines. Artif Organs 2013;37:541-548.

Shen L, Wang J, Liu K, et al. Hydrogen-rich saline is cerebroprotective in a rat model of deep hypothermic circulatory arrest. Neurochem Res 2011;36:1501-1511.

Shinozaki K, Lampe JW, Wang CH, et al. Developing dual hemofiltration plus cardiopulmonary bypass in rodents. J Surg Res 2015;195:196-203.

Silistreli E, Ugurlu B, Catalyurek H, et al. The effects of pulsatile flow characteristics on hemolysis, transfusion requirement, and hemostasis in open heart surgeries. Turk Gogus Kalp Dama 2012;20:217-222.

Walker G, Liddell M, Davis C: Extracorporeal life support: State of the art. Paediatr Respir Rev 2003;4:147-152.

Wang Y, Gu T, Shi E, et al. Inhibition of microRNA-29c protects the brain in a rat model of prolonged hypothermic circulatory arrest. J Thorac Cardiovasc Surg 2015;150:675-684.

Zhang K, Li M, Peng XC, et al. The protective effects of sufentanil pretreatment on rat brains under the state of cardiopulmonary bypass. Iran J Pharm Res 2015;14:559-566.

Zhou J, Zhou N, Wu XN, et al. Role of the Toll‑like receptor 3 signaling pathway in the neuroprotective effect of sevoflurane pre‑conditioning during cardiopulmonary bypass in rats. Mol Med Rep 2015;12:7859-7868.

Published

2020-04-02

How to Cite

Bayrak, S., Gencpinar, T., Akkaya, G., Bilen, Çağatay, Akokay, P., Dereli, N., Yılmaz, O., & Metin, K. (2020). Efficiency of Minimized Circuits of a Heart Roller Pump on Systemic Inflammatory Response Syndrome and Multiorgan Effects in a Rat Model. The Heart Surgery Forum, 23(2), E187-E192. https://doi.org/10.1532/hsf.2825

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