Microcirculatory perfusion disturbances following cardiac surgery with cardiopulmonary bypass are associated with in vitro endothelial hyperpermeability and increased angiopoietin-2 levels.

Abstract:

BACKGROUND:Endothelial hyperpermeability following cardiopulmonary bypass (CPB) contributes to microcirculatory perfusion disturbances and postoperative complications after cardiac surgery. We investigated the postoperative course of renal and pulmonary endothelial barrier function and the association with microcirculatory perfusion and angiopoietin-2 levels in patients after CPB. METHODS:Clinical data, sublingual microcirculatory data, and plasma samples were collected from patients undergoing coronary artery bypass graft surgery with CPB (n = 17) before and at several time points up to 72 h after CPB. Renal and pulmonary microvascular endothelial cells were incubated with patient plasma, and in vitro endothelial barrier function was assessed using electric cell-substrate impedance sensing. Plasma levels of angiopoietin-1,-2, and soluble Tie2 were measured, and the association with in vitro endothelial barrier function and in vivo microcirculatory perfusion was determined. RESULTS:A plasma-induced reduction of renal and pulmonary endothelial barrier function was observed in all samples taken within the first three postoperative days (P < 0.001 for all time points vs. pre-CPB). Angiopoietin-2 and soluble Tie2 levels increased within 72 h after CPB (5.7 ± 4.4 vs. 1.7 ± 0.4 ng/ml, P < 0.0001; 16.3 ± 4.7 vs. 11.9 ± 1.9 ng/ml, P = 0.018, vs. pre-CPB), whereas angiopoietin-1 remained stable. Interestingly, reduced in vitro renal and pulmonary endothelial barrier moderately correlated with reduced in vivo microcirculatory perfusion after CPB (r = 0.47, P = 0.005; r = 0.79, P < 0.001). In addition, increased angiopoietin-2 levels moderately correlated with reduced in vitro renal and pulmonary endothelial barrier (r = - 0.46, P < 0.001; r = - 0.40, P = 0.005) and reduced in vivo microcirculatory perfusion (r = - 0.43, P = 0.01; r = - 0.41, P = 0.03). CONCLUSIONS:CPB is associated with an impairment of in vitro endothelial barrier function that continues in the first postoperative days and correlates with reduced postoperative microcirculatory perfusion and increased circulating angiopoietin-2 levels. These results suggest that angiopoietin-2 is a biomarker for postoperative endothelial hyperpermeability, which may contribute to delayed recovery of microcirculatory perfusion after CPB. TRIAL REGISTRATION:NTR4212 .

journal_name

Crit Care

authors

Dekker NAM,van Leeuwen ALI,van Strien WWJ,Majolée J,Szulcek R,Vonk ABA,Hordijk PL,Boer C,van den Brom CE

doi

10.1186/s13054-019-2418-5

subject

Has Abstract

pub_date

2019-04-11 00:00:00

pages

117

issue

1

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-019-2418-5

journal_volume

23

pub_type

杂志文章
  • Open the intensive care unit doors to HIV-infected patients with sepsis.

    abstract::Severe sepsis is more and more frequent, especially because of an increased rate of immunocompromised patients. Despite the improvement in the overall prognosis of HIV/AIDS patients and the improvement of global ICU care, the prognosis of HIV/ADS patients hospitalized in ICU with severe sepsis remained poor. This situ...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc3923

    authors: Timsit JF

    更新日期:2005-01-01 00:00:00

  • Influence of different electrode belt positions on electrical impedance tomography imaging of regional ventilation: a prospective observational study.

    abstract:BACKGROUND:Electrical impedance tomography (EIT) is a non-invasive bedside tool which allows an individualized ventilator strategy by monitoring tidal ventilation and lung aeration. EIT can be performed at different cranio-caudal thoracic levels, but data are missing about the optimal belt position. The main goal of th...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1161-9

    authors: Karsten J,Stueber T,Voigt N,Teschner E,Heinze H

    更新日期:2016-01-08 00:00:00

  • A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

    abstract:INTRODUCTION:Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strateg...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s13054-015-0886-9

    authors: Trogrlić Z,van der Jagt M,Bakker J,Balas MC,Ely EW,van der Voort PH,Ista E

    更新日期:2015-04-09 00:00:00

  • Mild hypoglycemia is independently associated with increased mortality in the critically ill.

    abstract:INTRODUCTION:Severe hypoglycemia (blood glucose concentration (BG) < 40 mg/dL) is independently associated with an increased risk of mortality in critically ill patients. The association of milder hypoglycemia (BG < 70 mg/dL) with mortality is less clear. METHODS:Prospectively collected data from two observational coh...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc10322

    authors: Krinsley JS,Schultz MJ,Spronk PE,Harmsen RE,van Braam Houckgeest F,van der Sluijs JP,Mélot C,Preiser JC

    更新日期:2011-07-25 00:00:00

  • Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM)-guided administration of fibrinogen concentrate and prothrombin complex concentrate.

    abstract:INTRODUCTION:The appropriate strategy for trauma-induced coagulopathy management is under debate. We report the treatment of major trauma using mainly coagulation factor concentrates. METHODS:This retrospective analysis included trauma patients who received >or= 5 units of red blood cell concentrate within 24 hours. C...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc8948

    authors: Schöchl H,Nienaber U,Hofer G,Voelckel W,Jambor C,Scharbert G,Kozek-Langenecker S,Solomon C

    更新日期:2010-01-01 00:00:00

  • The race against the "septic shark".

    abstract::Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the curren...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc14729

    authors: Westphal M,Kampmeier T

    更新日期:2015-01-01 00:00:00

  • Endothelial dysfunction is a potential contributor to multiple organ failure and mortality in aged mice subjected to septic shock: preclinical studies in a murine model of cecal ligation and puncture.

    abstract:INTRODUCTION:The goal of the current study was to investigate the effect of aging on the development of endothelial dysfunction in a murine model of sepsis, and to compare it with the effect of genetic deficiency of the endothelial isoform of nitric oxide synthase (eNOS). METHODS:Cecal ligation and puncture (CLP) was ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-014-0511-3

    authors: Coletta C,Módis K,Oláh G,Brunyánszki A,Herzig DS,Sherwood ER,Ungvári Z,Szabo C

    更新日期:2014-09-16 00:00:00

  • Antibiotics or probiotics as preventive measures against ventilator-associated pneumonia: a literature review.

    abstract:INTRODUCTION:Mechanically ventilated critically ill patients frequently develop ventilator-associated pneumonia (VAP), a life-threatening complication. Proposed preventive measures against VAP include, but are not restricted to, selective decontamination of the digestive tract (SDD), selective oropharyngeal decontamina...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc9963

    authors: Schultz MJ,Haas LE

    更新日期:2011-01-01 00:00:00

  • Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials.

    abstract:INTRODUCTION:It has been hypothesized that hyperoncotic colloids might contribute to acute kidney injury (AKI). However, the validity of this hypothesis remains unclear. METHODS:A meta-analysis was conducted of randomized controlled trials evaluating AKI after infusion of hyperoncotic albumin and hydroxyethyl starch (...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析

    doi:10.1186/cc9308

    authors: Wiedermann CJ,Dunzendorfer S,Gaioni LU,Zaraca F,Joannidis M

    更新日期:2010-01-01 00:00:00

  • So much to teach, so little time: a prospective cohort study evaluating a tool to select content for a critical care curriculum.

    abstract:INTRODUCTION:Curricular content is often based on the personal opinions of a small number of individuals. Although convenient, such curricula may not meet the needs of the target learner, the program or the institution. Using an objective method to ensure content validity of a curriculum can alleviate this issue. METH...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7087

    authors: Peets AD,McLaughlin K,Lockyer J,Donnon T

    更新日期:2008-01-01 00:00:00

  • Effects of selective β1-adrenoceptor blockade on cardiovascular and renal function and circulating cytokines in ovine hyperdynamic sepsis.

    abstract:INTRODUCTION:Activation of the sympathetic nervous system has beneficial cardiovascular effects in sepsis, but there is also evidence that sympatholytics have beneficial actions in sepsis. We therefore determined the effect of selective β1-adrenoceptor blockade on cardiac and renal function and cytokine release in ovin...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-014-0610-1

    authors: Calzavacca P,Lankadeva YR,Bailey SR,Bailey M,Bellomo R,May CN

    更新日期:2014-11-21 00:00:00

  • Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure.

    abstract:INTRODUCTION:Patients with acute-on-chronic liver failure show an aggravated hyperdynamic circulation. We evaluated, in a controlled manner, potential changes in systemic haemodynamics induced by the molecular adsorbent recirculating system (MARS) and the Prometheus system liver detoxification devices in a group of pat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc4985

    authors: Laleman W,Wilmer A,Evenepoel P,Elst IV,Zeegers M,Zaman Z,Verslype C,Fevery J,Nevens F

    更新日期:2006-01-01 00:00:00

  • Longitudinal changes of inflammatory parameters and their correlation with disease severity and outcomes in patients with COVID-19 from Wuhan, China.

    abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease and rapidly escalating epidemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogenesis of COVID-19 remains to be elucidated. We aimed to clarify correlation of systemic inflammation with disease s...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03255-0

    authors: Zeng Z,Yu H,Chen H,Qi W,Chen L,Chen G,Yan W,Chen T,Ning Q,Han M,Wu D

    更新日期:2020-08-27 00:00:00

  • National survey and point prevalence study of sedation practice in UK critical care.

    abstract:BACKGROUND:The present study was designed to (1) establish current sedation practice in UK critical care to inform evidence synthesis and potential future primary research and (2) to compare practice reported via a survey with actual practice assessed in a point prevalence study (PPS). METHODS:UK adult general critica...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1532-x

    authors: Richards-Belle A,Canter RR,Power GS,Robinson EJ,Reschreiter H,Wunsch H,Harvey SE

    更新日期:2016-10-27 00:00:00

  • Effect of sepsis therapies on health-related quality of life.

    abstract::Sepsis is one of the most common conditions encountered in the intensive care unit and is the 10th leading cause of death overall in the United States. Both long-term survival and health-related quality of life are reduced in survivors of sepsis, yet there is little knowledge of the effect of sepsis-specific intervent...

    journal_title:Critical care (London, England)

    pub_type: 评论,社论

    doi:10.1186/cc6215

    authors: Erickson SE,Martin GS

    更新日期:2008-01-01 00:00:00

  • Relationship between acid-base status and inflammation in the critically ill.

    abstract:INTRODUCTION:There is a complex interplay between changes in acid-base components and inflammation. This manuscript aims to explore associations between plasma cytokines and chemokines and acid-base status on admission to intensive care. METHODS:We conducted a prospective cohort study in a 13-bed ICU in a tertiary-car...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13993

    authors: Zampieri FG,Kellum JA,Park M,Ranzani OT,Barbeiro HV,de Souza HP,da Cruz Neto LM,da Silva FP

    更新日期:2014-07-17 00:00:00

  • Inhaled nitric oxide and the risk of renal dysfunction in patients with acute respiratory distress syndrome: a propensity-matched cohort study.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1566-0

    authors: Ruan SY,Wu HY,Lin HH,Wu HD,Yu CJ,Lai MS

    更新日期:2016-11-30 00:00:00

  • Prevalence of iron deficiency on ICU discharge and its relation with fatigue: a multicenter prospective study.

    abstract:INTRODUCTION:Prevalence of iron deficiency (ID) at intensive care (ICU) admission is around 25 to 40%. Blood losses are important during ICU stay, leading to iron losses, but prevalence of ID at ICU discharge is unknown. ID has been associated with fatigue and muscular weakness, and may thus impair post-ICU rehabilitat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-014-0542-9

    authors: Lasocki S,Chudeau N,Papet T,Tartiere D,Roquilly A,Carlier L,Mimoz O,Seguin P,Malledant Y,Asehnoune K,Hamel JF,AtlanREA group.

    更新日期:2014-09-30 00:00:00

  • Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review.

    abstract:INTRODUCTION:To systematically review studies evaluating the performance of Sequential Organ Failure Assessment (SOFA)-based models for predicting mortality in patients in the intensive care unit (ICU). METHODS:Medline, EMBASE and other databases were searched for English-language articles with the major objective of ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc7160

    authors: Minne L,Abu-Hanna A,de Jonge E

    更新日期:2008-01-01 00:00:00

  • Pre-existing atrial fibrillation and risk of arterial thromboembolism and death in intensive care unit patients: a population-based cohort study.

    abstract:INTRODUCTION:Pre-existing atrial fibrillation (AF) may worsen prognosis in patients admitted to the intensive care unit (ICU). METHODS:In a cohort study (2005-2011) including all patients with first-time ICU admissions in Denmark (n=57,110), we compared patients with and without pre-existing AF and estimated absolute ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-1007-5

    authors: Gamst J,Christiansen CF,Rasmussen BS,Rasmussen LH,Thomsen RW

    更新日期:2015-08-19 00:00:00

  • Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study.

    abstract:INTRODUCTION:Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7760

    authors: Dahl MK,Vistisen ST,Koefoed-Nielsen J,Larsson A

    更新日期:2009-01-01 00:00:00

  • Effects of reduced rebreathing time, in spontaneously breathing patients, on respiratory effort and accuracy in cardiac output measurement when using a partial carbon dioxide rebreathing technique: a prospective observational study.

    abstract:INTRODUCTION:New technology using partial carbon dioxide rebreathing has been developed to measure cardiac output. Because rebreathing increases respiratory effort, we investigated whether a newly developed system with 35 s rebreathing causes a lesser increase in respiratory effort under partial ventilatory support tha...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc3801

    authors: Tachibana K,Imanaka H,Takeuchi M,Nishida T,Takauchi Y,Nishimura M

    更新日期:2005-10-05 00:00:00

  • Rapid diagnosis of sepsis using biomarker signatures.

    abstract::Diagnosis of sepsis is complicated by non-specific clinical definitions and delays in laboratory analysis using tests which may have very poor predictive values. The use of host biomarker signature sets, which when measured in combination have high predictive values, offers a paradigm shift forwards for rapid, near-pa...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13137

    authors: Silman NJ

    更新日期:2013-12-04 00:00:00

  • Compartmentalization of lipid peroxidation in sepsis by multidrug-resistant gram-negative bacteria: experimental and clinical evidence.

    abstract:INTRODUCTION:Recent evidence suggests a link between excess lipid peroxidation and specific organ failures in sepsis. No study has been performed in sepsis by multidrug-resistant (MDR) Gram-negative bacteria. METHODS:Lethal sepsis was induced in rats by the intraperitoneal injection of one MDR isolate of Pseudomonas a...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc11930

    authors: Toufekoula C,Papadakis V,Tsaganos T,Routsi C,Orfanos SE,Kotanidou A,Carrer DP,Raftogiannis M,Baziaka F,Giamarellos-Bourboulis EJ

    更新日期:2013-01-16 00:00:00

  • Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study.

    abstract:INTRODUCTION:Prophylactic steroid therapy to reduce the occurrence of postextubation laryngeal edema is controversial. Only a limited number of prospective trials involve adults in an intensive care unit. The purpose of this study was to ascertain whether administration of multiple doses of dexamethasone to critically ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc5957

    authors: Lee CH,Peng MJ,Wu CL

    更新日期:2007-01-01 00:00:00

  • Extracorporeal membrane oxygenation for severe acute respiratory failure.

    abstract::Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems. ECMO technique was an adaptation of conventional cardiopulmonary bypass techniques and introduced into treatment...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc689

    authors: Lewandowski K

    更新日期:2000-01-01 00:00:00

  • Immune derangement occurs in patients with H7N9 avian influenza.

    abstract:INTRODUCTION:Currently, little is known about the immunological characteristics of patients with avian influenza A (H7N9) virus infection. METHODS:The numbers and percentages of peripheral blood immune cells were measured in 27 patients with laboratory-confirmed H7N9 virus infection and 30 healthy controls (HCs). The ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc13788

    authors: Wu W,Shi Y,Gao H,Liang W,Sheng J,Li L

    更新日期:2014-03-24 00:00:00

  • Incidence and outcomes of acute respiratory distress syndrome in intensive care units of mainland China: a multicentre prospective longitudinal study.

    abstract:OBJECTIVES:To evaluate the incidence and mortality of acute respiratory distress syndrome (ARDS) in medical/respiratory intensive care units (MICUs/RICUs) to assess ventilation management and the use of adjunct therapy in routine clinical practice for patients fulfilling the Berlin definition of ARDS in mainland China....

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03112-0

    authors: Huang X,Zhang R,Fan G,Wu D,Lu H,Wang D,Deng W,Sun T,Xing L,Liu S,Wang S,Cai Y,Tian Y,Zhang Y,Xia J,Zhan Q,CHARDSnet group.

    更新日期:2020-08-20 00:00:00

  • Science review: redox and oxygen-sensitive transcription factors in the regulation of oxidant-mediated lung injury: role for hypoxia-inducible factor-1alpha.

    abstract::A progressive rise of oxidative stress due to altered reduction-oxidation (redox) homeostasis appears to be one of the hallmarks of the processes that regulate gene transcription in physiology and pathophysiology. Reactive oxygen species and reactive nitrogen species serve as signaling messengers for the evolution and...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc1840

    authors: Haddad JJ

    更新日期:2003-02-01 00:00:00

  • High-molecular-weight hyaluronan--a possible new treatment for sepsis-induced lung injury: a preclinical study in mechanically ventilated rats.

    abstract:INTRODUCTION:Mechanical ventilation with even moderate-sized tidal volumes synergistically increases lung injury in sepsis and has been associated with proinflammatory low-molecular-weight hyaluronan production. High-molecular-weight hyaluronan (HMW HA), in contrast, has been found to be anti-inflammatory. We hypothesi...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6982

    authors: Liu YY,Lee CH,Dedaj R,Zhao H,Mrabat H,Sheidlin A,Syrkina O,Huang PM,Garg HG,Hales CA,Quinn DA

    更新日期:2008-01-01 00:00:00