Abstract | BACKGROUND: Patients undergoing open heart surgery with cardiopulmonary bypass (CPB) often develop a systemic immune reaction, characterized by an increase of proinflammatory and anti-inflammatory mediators. We previously demonstrated that continued mechanical ventilation during CPB reduces this response. We hypothesized that this strategy may also impact on matrix metalloproteinase ( MMP) release. MATERIAL AND METHODS: Thirty consecutive patients undergoing coronary artery bypass grafting with CPB were randomized into a ventilated (VG) (n = 15) and a standard non-ventilated group (NVG) (n = 15). Blood was collected at the beginning, at the end of surgery, and on the five consecutive days. MMPs, tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), and lipocalin 2 (LCN2) were measured by enzyme-linked immunosorbent assay. Parameters of transpulmonary oxygen transport were assessed at different time points. RESULTS: MMP-8, MMP-9, and LCN2 were significantly lower at the end of surgery in VG compared with those in NVG patients ( MMP-8 [ng/mL]: 7.1 [3.5] versus 12.5 [7.7], P = 0.02; MMP-9 [ng/mL]: 108 [42] versus 171 [98], P = 0.029; LCN2 [ng/mL]: 109 [42] versus 171 [98], P = 0.03). TIMP-1 concentrations were lower on postoperative day one, (TIMP-1 [ng/mL]: 174 [55] versus 273 [104], P = 0.003), whereas MMP-3 levels were lower on postoperative days four and five ( MMP-3 [ng/mL]: 44 [17] versus 67 [35], P = 0.026). The arterial partial pressure of oxygen/fraction of inspired oxygen ratio was significantly higher in VG patients throughout the postoperative observation period, which did not affect the length of postoperative ventilatory support. CONCLUSIONS:
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Authors | Lucian Beer, Joanna Maria Warszawska, Peter Schenk, Tamás Debreceni, Martin Dworschak, Georg A Roth, Tamás Szerafin, Hendrik Jan Ankersmit |
Journal | The Journal of surgical research
(J Surg Res)
Vol. 195
Issue 1
Pg. 294-302
(May 01 2015)
ISSN: 1095-8673 [Electronic] United States |
PMID | 25577145
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Chemical References |
- Acute-Phase Proteins
- LCN2 protein, human
- Lipocalin-2
- Lipocalins
- Proto-Oncogene Proteins
- TIMP1 protein, human
- Tissue Inhibitor of Metalloproteinase-1
- Matrix Metalloproteinases
- Oxygen
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Topics |
- Acute-Phase Proteins
- Aged
- Aged, 80 and over
- Cardiopulmonary Bypass
- Female
- Humans
- Lipocalin-2
- Lipocalins
(blood)
- Male
- Matrix Metalloproteinases
(blood)
- Middle Aged
- Oxygen
(blood)
- Proto-Oncogene Proteins
(blood)
- Respiration, Artificial
- Tissue Inhibitor of Metalloproteinase-1
(blood)
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