Walski Tomasz, Drohomirecka Anna, Bujok Jolanta, Czerski Albert, Wąż Grzegorz, Trochanowska-Pauk Natalia, Gorczykowski Michał, Cichoń Romuald, Komorowska Małgorzata
Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, Wrocław, Poland.
Regional Specialist Hospital in Wrocław, Research and Development Centre, Wrocław, Poland.
Front Physiol. 2018 May 31;9:647. doi: 10.3389/fphys.2018.00647. eCollection 2018.
An activation of non-specific inflammatory response, coagulation disorder, and blood morphotic elements damage are the main side effects of the extracorporeal circulation (ECC). Red-to-near-infrared radiation (R/NIR) is thought to be capable of stabilizing red blood cell (RBC) membrane through increasing its resistance to destructive factors. We focused on the development of a method using low-level light therapy (LLLT) in the spectral range of R/NIR which could reduce blood trauma caused by the heart-lung machine during surgery. R/NIR emitter was adjusted in terms of geometry and optics to ECC circuit. The method of extracorporeal blood photobiomodulation was tested during experiments in an animal, porcine model (1 h of ECC plus 23 h of animal observation). A total of 24 sows weighing 90-100 kg were divided into two equal groups: control one and LLLT. Blood samples were taken during the experiment to determine changes in blood morphology [RBC and white blood cell (WBC) counts, hemoglobin (Hgb)], indicators of hemolysis [plasma-free hemoglobin (PFHgb), serum bilirubin concentration, serum lactate dehydrogenase (LDH) activity], and oxidative stress markers [thiobarbituric acid reactive substances (TBARS) concentration, total antioxidant capacity (TAC)]. In the control group, a rapid systemic decrease in WBC count during ECC was accompanied by a significant increase in RBC membrane lipids peroxidation, while in the LLLT group the number of WBC and TBARS concentration both remained relatively constant, indicating limitation of the inflammatory process. These results were consistent with the change in the hemolysis markers like PFHgb, LDH, and serum bilirubin concentration, which were significantly reduced in LLLT group. No differences in TAC, RBC count, and Hgb concentration were detected. We presented the applicability of the LLLT with R/NIR radiation to blood trauma reduction during ECC.
非特异性炎症反应激活、凝血障碍和血液形态学成分损伤是体外循环(ECC)的主要副作用。红到近红外辐射(R/NIR)被认为能够通过增加红细胞(RBC)膜对破坏因素的抵抗力来稳定其膜结构。我们专注于开发一种在R/NIR光谱范围内使用低强度光疗法(LLLT)的方法,该方法可以减少手术期间心肺机引起的血液损伤。根据ECC回路对R/NIR发射器的几何形状和光学特性进行了调整。在动物猪模型实验(1小时ECC加23小时动物观察)中测试了体外血液光生物调节方法。总共24头体重90-100公斤的母猪被分为两组,每组数量相等:对照组和LLLT组。在实验过程中采集血样,以确定血液形态学变化[红细胞和白细胞(WBC)计数、血红蛋白(Hgb)]、溶血指标[血浆游离血红蛋白(PFHgb)、血清胆红素浓度、血清乳酸脱氢酶(LDH)活性]和氧化应激标志物[硫代巴比妥酸反应性物质(TBARS)浓度、总抗氧化能力(TAC)]。在对照组中,ECC期间白细胞计数迅速全身性下降,同时红细胞膜脂质过氧化显著增加,而在LLLT组中,白细胞数量和TBARS浓度均保持相对恒定,表明炎症过程受到限制。这些结果与溶血标志物如PFHgb、LDH和血清胆红素浓度的变化一致,LLLT组中这些指标显著降低。未检测到TAC、红细胞计数和Hgb浓度的差异。我们展示了R/NIR辐射的LLLT在减少ECC期间血液损伤方面的适用性。