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Inflammatory Effects of Blood–Air Interface in a Porcine Cardiopulmonary Bypass Model

2018; Lippincott Williams & Wilkins; Volume: 66; Issue: 1 Linguagem: Inglês

10.1097/mat.0000000000000938

1538-943X

Benjamin D. Carr, Thomas J. Johnson, Amalia Gomez-Rexrode, Azmath Mohammed, Megan A. Coughlin, John M. Toomasian, Álvaro Rojas-Peña, Robert H. Bartlett, Jonathan W. Haft,

Cardiac Arrest and Resuscitation

Cardiopulmonary bypass (CPB) causes a systemic inflammatory response syndrome (SIRS) associated with multiorgan injury. A model was developed to test whether a blood-air interface (BAI) in the CPB circuit causes blood element activation and inflammation. Ten healthy swine were placed on partial CPB for 2 hours via the cervical vessels and monitored for 96 hours postoperatively. Five pigs (control group) had minimal air exposure in the circuit, while five were exposed to a BAI simulating cardiotomy suction. There were no significant differences in bypass flow or hemodynamics between the groups. In the BAI group, there was an increase in hemolysis after bypass (plasma-free hemoglobin 5.27 ± 1.2 vs. 0.94 ± 0.8 mg/dl; p = 0.01), more aggressive platelet consumption (28% vs. 83% of baseline; p = 0.009), leukocyte consumption (71% vs. 107% of baseline; p = 0.02), and increased granulocyte CD11b expression (409% vs. 106% of baseline; p = 0.009). These data suggest the inflammatory pattern responsible for the CPB-SIRS phenomenon may be driven by blood-air interaction. Future efforts should focus on BAI-associated mechanisms for minimizing blood trauma and inflammation during CPB.