Peripheral bypass-induced pulmonary and coronary vascular injury: Association with increased levels of tumor necrosis factor

Ira M. Dauber, Polly E. Parsons, Carolyn H. Welsh, Patsy C. Giclas, Glenn Whitman, Gretchen S. Wheeler, Lawrence D. Horwitz, John V. Weil

Research output: Contribution to journalArticle

Abstract

Background. Although cardiopulmonary bypass is associated with systemic complement activation and neutrophil sequestration, it is unclear whether bypass-induced vascular injury is localized and dependent on organ ischemia. We hypothesized that other factors perhaps related to placement of a bypass circuit or to blood perfusion of a pump-oxygenator system may produce vascular injury caused by systemically circulating mediators. In dogs, we determined whether application of a systemic venoarterial bypass circuit with pump-oxygenator perfusion but without pulmonary or cardiac flow diversion (peripheral bypass) leads to vascular injury. Since several features of the postperfusion syndrome after bypass resemble sequelae of endotoxin exposure, we also measured circulating endotoxin and tumor necrosis factor levels. Methods and Results. Anesthetized dogs underwent 2 hours of exposure to a pump-oxygenator with peripheral venoarterial bypass. We used a double indicator measurement of pulmonary and coronary vascular permeability (protein leak index [PLI])as indexes of vascular injury. Compared with controls (n=7), the pulmonary PLI of dogs undergoing bypass (n=11) increased more than threefold (18.8±2.3 vs 63.3±7.6×10-4 min-1; P1/2, 241±35 vs 84±15 minutes, control vs bypass; P

Original languageEnglish (US)
Pages (from-to)726-735
Number of pages10
JournalCirculation
Volume88
Issue number2
Publication statusPublished - Aug 1993
Externally publishedYes

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Keywords

  • Arteries
  • Bypass surgery
  • Edema
  • Ischemia
  • Vessels

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Dauber, I. M., Parsons, P. E., Welsh, C. H., Giclas, P. C., Whitman, G., Wheeler, G. S., ... Weil, J. V. (1993). Peripheral bypass-induced pulmonary and coronary vascular injury: Association with increased levels of tumor necrosis factor. Circulation, 88(2), 726-735.