Inflammatory response to cardiac bypass in ewe fetuses

Effects of steroid administration or continuous hemodiafiltration

Adriano Carotti, Francesco Emma, Stefano Picca, Enrico Iannace, Sonia B. Albanese, Mauro Grigioni, Francesco Meo, Mario Sciarra, Roberto M. Di Donato, Mohan Reddy, Renato S. Assad, Frank L. Hanley

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: We sought to investigate the effectiveness of glucocorticoid administration or continuous venovenous hemodiafiltration on endothelin and corticotropin-releasing factor release or clearance during prolonged fetal cardiac bypass and on the overall performance of fetuses. Methods: Circulating endothelin 1, 2, and 3 and corticotropin-releasing factor levels were measured in fetal ewes during a 60-minute cardiac bypass period performed with an inline axial flow pump. Blood samples were collected before, during, and 90 minutes after cardiac bypass. Animals were divided into 4 groups. The betamethasone group (n = 6) received maternal treatment with 12 mg of betamethasone 1 and 2 days before the experiment. The methylprednisolone group (n = 5) received fetal treatment with 40 mg/kg intravenous methylprednisolone at the beginning of cardiac bypass. The continuous venovenous hemodiafiltration group (n = 4) underwent continuous venovenous hemodiafiltration with a 0.3-m2 polysulfone filter during cardiac bypass. The final group was the control group (n = 4). Results: Maternal steroid pretreatment failed to decrease endothelin or corticotropin-releasing factor production when compared with levels in the control animals. Fetal treatment with methylprednisolone produced a significant decrease in endothelin 2 production during cardiac bypass (P <.02) and endothelin 1 production at the end of the experiment (P <.02). Continuous venovenous hemodiafiltration blocked completely the increase of endothelin and corticotropin-releasing factor levels during cardiac bypass (P <.02), which was maintained 90 minutes after cardiac bypass. Acid-base balance was preserved during cardiac bypass by the continuous venovenous hemodiafiltration but worsened after disconnection of the extracorporeal circuit, whereas animals treated with methylprednisolone had better pH, Paco2, and bicarbonate levels by the end of the experiment. The overall tolerance of the procedure was better in the continuous venovenous hemodiafiltration group during cardiac bypass and in the methylprednisolone group at the end of the experiment. Conclusions: Continuous venovenous hemodiafiltration provides sustained stability of endothelin levels during fetal cardiac bypass. This technique might help, in association with fetal steroid treatment, to contain the inflammatory response leading to postbypass placental dysfunction.

Original languageEnglish
Pages (from-to)1839-1850
Number of pages12
JournalJournal of Thoracic and Cardiovascular Surgery
Volume126
Issue number6
DOIs
Publication statusPublished - Dec 2003

Fingerprint

Hemodiafiltration
Fetus
Methylprednisolone
Steroids
Corticotropin-Releasing Hormone
Endothelins
Endothelin-2
Betamethasone
Endothelin-1
Mothers
Endothelin-3
Acid-Base Equilibrium
Therapeutics
Bicarbonates
Glucocorticoids
Control Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Inflammatory response to cardiac bypass in ewe fetuses : Effects of steroid administration or continuous hemodiafiltration. / Carotti, Adriano; Emma, Francesco; Picca, Stefano; Iannace, Enrico; Albanese, Sonia B.; Grigioni, Mauro; Meo, Francesco; Sciarra, Mario; Di Donato, Roberto M.; Reddy, Mohan; Assad, Renato S.; Hanley, Frank L.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 6, 12.2003, p. 1839-1850.

Research output: Contribution to journalArticle

Carotti, A, Emma, F, Picca, S, Iannace, E, Albanese, SB, Grigioni, M, Meo, F, Sciarra, M, Di Donato, RM, Reddy, M, Assad, RS & Hanley, FL 2003, 'Inflammatory response to cardiac bypass in ewe fetuses: Effects of steroid administration or continuous hemodiafiltration', Journal of Thoracic and Cardiovascular Surgery, vol. 126, no. 6, pp. 1839-1850. https://doi.org/10.1016/S0022-5223(03)01293-5
Carotti, Adriano ; Emma, Francesco ; Picca, Stefano ; Iannace, Enrico ; Albanese, Sonia B. ; Grigioni, Mauro ; Meo, Francesco ; Sciarra, Mario ; Di Donato, Roberto M. ; Reddy, Mohan ; Assad, Renato S. ; Hanley, Frank L. / Inflammatory response to cardiac bypass in ewe fetuses : Effects of steroid administration or continuous hemodiafiltration. In: Journal of Thoracic and Cardiovascular Surgery. 2003 ; Vol. 126, No. 6. pp. 1839-1850.
@article{afe3dafac92d451791cd7e80093b567c,
title = "Inflammatory response to cardiac bypass in ewe fetuses: Effects of steroid administration or continuous hemodiafiltration",
abstract = "Objectives: We sought to investigate the effectiveness of glucocorticoid administration or continuous venovenous hemodiafiltration on endothelin and corticotropin-releasing factor release or clearance during prolonged fetal cardiac bypass and on the overall performance of fetuses. Methods: Circulating endothelin 1, 2, and 3 and corticotropin-releasing factor levels were measured in fetal ewes during a 60-minute cardiac bypass period performed with an inline axial flow pump. Blood samples were collected before, during, and 90 minutes after cardiac bypass. Animals were divided into 4 groups. The betamethasone group (n = 6) received maternal treatment with 12 mg of betamethasone 1 and 2 days before the experiment. The methylprednisolone group (n = 5) received fetal treatment with 40 mg/kg intravenous methylprednisolone at the beginning of cardiac bypass. The continuous venovenous hemodiafiltration group (n = 4) underwent continuous venovenous hemodiafiltration with a 0.3-m2 polysulfone filter during cardiac bypass. The final group was the control group (n = 4). Results: Maternal steroid pretreatment failed to decrease endothelin or corticotropin-releasing factor production when compared with levels in the control animals. Fetal treatment with methylprednisolone produced a significant decrease in endothelin 2 production during cardiac bypass (P <.02) and endothelin 1 production at the end of the experiment (P <.02). Continuous venovenous hemodiafiltration blocked completely the increase of endothelin and corticotropin-releasing factor levels during cardiac bypass (P <.02), which was maintained 90 minutes after cardiac bypass. Acid-base balance was preserved during cardiac bypass by the continuous venovenous hemodiafiltration but worsened after disconnection of the extracorporeal circuit, whereas animals treated with methylprednisolone had better pH, Paco2, and bicarbonate levels by the end of the experiment. The overall tolerance of the procedure was better in the continuous venovenous hemodiafiltration group during cardiac bypass and in the methylprednisolone group at the end of the experiment. Conclusions: Continuous venovenous hemodiafiltration provides sustained stability of endothelin levels during fetal cardiac bypass. This technique might help, in association with fetal steroid treatment, to contain the inflammatory response leading to postbypass placental dysfunction.",
author = "Adriano Carotti and Francesco Emma and Stefano Picca and Enrico Iannace and Albanese, {Sonia B.} and Mauro Grigioni and Francesco Meo and Mario Sciarra and {Di Donato}, {Roberto M.} and Mohan Reddy and Assad, {Renato S.} and Hanley, {Frank L.}",
year = "2003",
month = "12",
doi = "10.1016/S0022-5223(03)01293-5",
language = "English",
volume = "126",
pages = "1839--1850",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Inflammatory response to cardiac bypass in ewe fetuses

T2 - Effects of steroid administration or continuous hemodiafiltration

AU - Carotti, Adriano

AU - Emma, Francesco

AU - Picca, Stefano

AU - Iannace, Enrico

AU - Albanese, Sonia B.

AU - Grigioni, Mauro

AU - Meo, Francesco

AU - Sciarra, Mario

AU - Di Donato, Roberto M.

AU - Reddy, Mohan

AU - Assad, Renato S.

AU - Hanley, Frank L.

PY - 2003/12

Y1 - 2003/12

N2 - Objectives: We sought to investigate the effectiveness of glucocorticoid administration or continuous venovenous hemodiafiltration on endothelin and corticotropin-releasing factor release or clearance during prolonged fetal cardiac bypass and on the overall performance of fetuses. Methods: Circulating endothelin 1, 2, and 3 and corticotropin-releasing factor levels were measured in fetal ewes during a 60-minute cardiac bypass period performed with an inline axial flow pump. Blood samples were collected before, during, and 90 minutes after cardiac bypass. Animals were divided into 4 groups. The betamethasone group (n = 6) received maternal treatment with 12 mg of betamethasone 1 and 2 days before the experiment. The methylprednisolone group (n = 5) received fetal treatment with 40 mg/kg intravenous methylprednisolone at the beginning of cardiac bypass. The continuous venovenous hemodiafiltration group (n = 4) underwent continuous venovenous hemodiafiltration with a 0.3-m2 polysulfone filter during cardiac bypass. The final group was the control group (n = 4). Results: Maternal steroid pretreatment failed to decrease endothelin or corticotropin-releasing factor production when compared with levels in the control animals. Fetal treatment with methylprednisolone produced a significant decrease in endothelin 2 production during cardiac bypass (P <.02) and endothelin 1 production at the end of the experiment (P <.02). Continuous venovenous hemodiafiltration blocked completely the increase of endothelin and corticotropin-releasing factor levels during cardiac bypass (P <.02), which was maintained 90 minutes after cardiac bypass. Acid-base balance was preserved during cardiac bypass by the continuous venovenous hemodiafiltration but worsened after disconnection of the extracorporeal circuit, whereas animals treated with methylprednisolone had better pH, Paco2, and bicarbonate levels by the end of the experiment. The overall tolerance of the procedure was better in the continuous venovenous hemodiafiltration group during cardiac bypass and in the methylprednisolone group at the end of the experiment. Conclusions: Continuous venovenous hemodiafiltration provides sustained stability of endothelin levels during fetal cardiac bypass. This technique might help, in association with fetal steroid treatment, to contain the inflammatory response leading to postbypass placental dysfunction.

AB - Objectives: We sought to investigate the effectiveness of glucocorticoid administration or continuous venovenous hemodiafiltration on endothelin and corticotropin-releasing factor release or clearance during prolonged fetal cardiac bypass and on the overall performance of fetuses. Methods: Circulating endothelin 1, 2, and 3 and corticotropin-releasing factor levels were measured in fetal ewes during a 60-minute cardiac bypass period performed with an inline axial flow pump. Blood samples were collected before, during, and 90 minutes after cardiac bypass. Animals were divided into 4 groups. The betamethasone group (n = 6) received maternal treatment with 12 mg of betamethasone 1 and 2 days before the experiment. The methylprednisolone group (n = 5) received fetal treatment with 40 mg/kg intravenous methylprednisolone at the beginning of cardiac bypass. The continuous venovenous hemodiafiltration group (n = 4) underwent continuous venovenous hemodiafiltration with a 0.3-m2 polysulfone filter during cardiac bypass. The final group was the control group (n = 4). Results: Maternal steroid pretreatment failed to decrease endothelin or corticotropin-releasing factor production when compared with levels in the control animals. Fetal treatment with methylprednisolone produced a significant decrease in endothelin 2 production during cardiac bypass (P <.02) and endothelin 1 production at the end of the experiment (P <.02). Continuous venovenous hemodiafiltration blocked completely the increase of endothelin and corticotropin-releasing factor levels during cardiac bypass (P <.02), which was maintained 90 minutes after cardiac bypass. Acid-base balance was preserved during cardiac bypass by the continuous venovenous hemodiafiltration but worsened after disconnection of the extracorporeal circuit, whereas animals treated with methylprednisolone had better pH, Paco2, and bicarbonate levels by the end of the experiment. The overall tolerance of the procedure was better in the continuous venovenous hemodiafiltration group during cardiac bypass and in the methylprednisolone group at the end of the experiment. Conclusions: Continuous venovenous hemodiafiltration provides sustained stability of endothelin levels during fetal cardiac bypass. This technique might help, in association with fetal steroid treatment, to contain the inflammatory response leading to postbypass placental dysfunction.

UR - http://www.scopus.com/inward/record.url?scp=9144219736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9144219736&partnerID=8YFLogxK

U2 - 10.1016/S0022-5223(03)01293-5

DO - 10.1016/S0022-5223(03)01293-5

M3 - Article

VL - 126

SP - 1839

EP - 1850

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 6

ER -