Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation
Abstract Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB r...
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SpringerOpen
2024-11-01
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| Series: | Intensive Care Medicine Experimental |
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| Online Access: | https://doi.org/10.1186/s40635-024-00669-w |
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| author | Varun Karnik Sebastiano Maria Colombo Leah Rickards Silver Heinsar Louise E. See Hoe Karin Wildi Margaret R. Passmore Mahe Bouquet Kei Sato Carmen Ainola Nicole Bartnikowski Emily S. Wilson Kieran Hyslop Kris Skeggs Nchafatso G. Obonyo Charles McDonald Samantha Livingstone Gabriella Abbate Andrew Haymet Jae-Seung Jung Noriko Sato Lynnette James Benjamin Lloyd Nicole White Chiara Palmieri Mark Buckland Jacky Y. Suen David C. McGiffin John F. Fraser Gianluigi Li Bassi |
| author_facet | Varun Karnik Sebastiano Maria Colombo Leah Rickards Silver Heinsar Louise E. See Hoe Karin Wildi Margaret R. Passmore Mahe Bouquet Kei Sato Carmen Ainola Nicole Bartnikowski Emily S. Wilson Kieran Hyslop Kris Skeggs Nchafatso G. Obonyo Charles McDonald Samantha Livingstone Gabriella Abbate Andrew Haymet Jae-Seung Jung Noriko Sato Lynnette James Benjamin Lloyd Nicole White Chiara Palmieri Mark Buckland Jacky Y. Suen David C. McGiffin John F. Fraser Gianluigi Li Bassi |
| author_sort | Varun Karnik |
| collection | DOAJ |
| description | Abstract Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB reduces postoperative lung damage and complications. Eighteen sheep from an ovine HTx model were included, with ventilatory interventions randomly assigned during CPB: the OPENVENT group received low tidal volume (VT) of 3 mL/kg and positive end-expiratory pressure (PEEP) of 8 cm H20, while no ventilation was provided in the NOVENT group as per standard of care. The recipient sheep were monitored for 6 h post-surgery. The primary outcome was histological lung damage, scored at the end of the study. Secondary outcomes included pulmonary shunt, driving pressure, hemodynamics and inflammatory lung infiltration. All animals completed the study. The OPENVENT group showed significantly lower histological lung damage versus the NOVENT group (0.22 vs 0.27, p = 0.042) and lower pulmonary shunt (19.2 vs 32.1%, p = 0.001). In addition, the OPENVENT group exhibited a reduced driving pressure (9.6 cm H2O vs. 12.8 cm H2O, p = 0.039), lower neutrophil (5.25% vs 7.97%, p ≤ 0.001) and macrophage infiltrations (11.1% vs 19.6%, p < 0.001). No significant differences were observed in hemodynamic parameters. In an ovine model of HTx, open-lung ventilation during CPB significantly reduced lung histological injury and inflammatory infiltration. This highlights the value of an open-lung approach during CPB and emphasizes the need for further clinical evidence to decrease risks of lung injury in HTx patients. |
| format | Article |
| id | doaj-art-5ec2089cb8ca435584c95f51876bc537 |
| institution | Kabale University |
| issn | 2197-425X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj-art-5ec2089cb8ca435584c95f51876bc5372024-12-01T12:06:09ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2024-11-0112111810.1186/s40635-024-00669-wOpen-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantationVarun Karnik0Sebastiano Maria Colombo1Leah Rickards2Silver Heinsar3Louise E. See Hoe4Karin Wildi5Margaret R. Passmore6Mahe Bouquet7Kei Sato8Carmen Ainola9Nicole Bartnikowski10Emily S. Wilson11Kieran Hyslop12Kris Skeggs13Nchafatso G. Obonyo14Charles McDonald15Samantha Livingstone16Gabriella Abbate17Andrew Haymet18Jae-Seung Jung19Noriko Sato20Lynnette James21Benjamin Lloyd22Nicole White23Chiara Palmieri24Mark Buckland25Jacky Y. Suen26David C. McGiffin27John F. Fraser28Gianluigi Li Bassi29Critical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalDepartment of Anaesthesia and Perioperative Medicine, Sunshine Coast University HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalSchool of Veterinary Science, The University of QueenslandDepartment of Anesthesia, The Alfred HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalCritical Care Research Group, The Prince Charles HospitalAbstract Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB reduces postoperative lung damage and complications. Eighteen sheep from an ovine HTx model were included, with ventilatory interventions randomly assigned during CPB: the OPENVENT group received low tidal volume (VT) of 3 mL/kg and positive end-expiratory pressure (PEEP) of 8 cm H20, while no ventilation was provided in the NOVENT group as per standard of care. The recipient sheep were monitored for 6 h post-surgery. The primary outcome was histological lung damage, scored at the end of the study. Secondary outcomes included pulmonary shunt, driving pressure, hemodynamics and inflammatory lung infiltration. All animals completed the study. The OPENVENT group showed significantly lower histological lung damage versus the NOVENT group (0.22 vs 0.27, p = 0.042) and lower pulmonary shunt (19.2 vs 32.1%, p = 0.001). In addition, the OPENVENT group exhibited a reduced driving pressure (9.6 cm H2O vs. 12.8 cm H2O, p = 0.039), lower neutrophil (5.25% vs 7.97%, p ≤ 0.001) and macrophage infiltrations (11.1% vs 19.6%, p < 0.001). No significant differences were observed in hemodynamic parameters. In an ovine model of HTx, open-lung ventilation during CPB significantly reduced lung histological injury and inflammatory infiltration. This highlights the value of an open-lung approach during CPB and emphasizes the need for further clinical evidence to decrease risks of lung injury in HTx patients.https://doi.org/10.1186/s40635-024-00669-wVentilationCardiopulmonary bypassHeart transplant |
| spellingShingle | Varun Karnik Sebastiano Maria Colombo Leah Rickards Silver Heinsar Louise E. See Hoe Karin Wildi Margaret R. Passmore Mahe Bouquet Kei Sato Carmen Ainola Nicole Bartnikowski Emily S. Wilson Kieran Hyslop Kris Skeggs Nchafatso G. Obonyo Charles McDonald Samantha Livingstone Gabriella Abbate Andrew Haymet Jae-Seung Jung Noriko Sato Lynnette James Benjamin Lloyd Nicole White Chiara Palmieri Mark Buckland Jacky Y. Suen David C. McGiffin John F. Fraser Gianluigi Li Bassi Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation Intensive Care Medicine Experimental Ventilation Cardiopulmonary bypass Heart transplant |
| title | Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| title_full | Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| title_fullStr | Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| title_full_unstemmed | Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| title_short | Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| title_sort | open lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation |
| topic | Ventilation Cardiopulmonary bypass Heart transplant |
| url | https://doi.org/10.1186/s40635-024-00669-w |
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