Department of Cardiac Surgery, University of Szeged, Szeged, Hungary.
Institute for Surgical Research, University of Szeged, Szeged, Hungary.
Eur J Cardiothorac Surg. 2019 Jul 1;56(1):135-142. doi: 10.1093/ejcts/ezy453.
Extracorporeal circulation induces cellular and humoral inflammatory reactions, thus possibly leading to detrimental secondary inflammatory responses. Previous data have demonstrated the bioactive potential of methane and confirmed its anti-inflammatory effects in model experiments. Our goal was to investigate the in vivo consequences of exogenous methane administration on extracorporeal circulation-induced inflammation.
Two groups of anaesthetized Vietnamese minipigs (non-treated and methane treated, n = 5 each) were included. Standard central cannulation was performed, and extracorporeal circulation was maintained for 120 min without cardiac arrest or ischaemia, followed by an additional 120-min observation period with haemodynamic monitoring. In the methane-treated group, 2.5% v/v methane-normoxic air mixture was added to the oxygenator sweep gas. Blood samples through the central venous line and tissue biopsies from the heart, ileum and kidney were taken at the end point to determine the whole blood superoxide production (chemiluminometry) and the activity of xanthine-oxidoreductase and myeloperoxidase, with substrate-specific reactions.
Methane treatment resulted in significantly higher renal blood flow during the extracorporeal circulation period compared to the non-treated group (63.9 ± 16.4 vs 29.0 ± 9.3 ml/min). Whole blood superoxide production (548 ± 179 vs 1283 ± 193 Relative Light Unit (RLU)), ileal myeloperoxidase (2.23 ± 0.2 vs 3.26 ± 0.6 mU/(mg protein)) and cardiac (1.5 ± 0.6 vs 4.7 ± 2.5 pmol/min/mg), ileal (2.2 ± 0.6 vs 7.0 ± 3.4 pmol/min/mg) and renal (1.2 ± 0.8 vs 13.3 ± 8.0 pmol/min/mg) xanthine-oxidoreductase activity were significantly lower in the treated group.
The addition of bioactive gases, such as methane, through the oxygenator of the extracorporeal circuit represents a novel strategy to influence the inflammatory effects of extracorporeal perfusion in cardiac surgical procedures.
体外循环会引起细胞和体液的炎症反应,从而可能导致有害的二次炎症反应。先前的数据已经证明了甲烷的生物活性潜力,并在模型实验中证实了其抗炎作用。我们的目标是研究外源性甲烷给药对体外循环引起的炎症的体内后果。
纳入两组麻醉的越南小型猪(未治疗组和甲烷治疗组,每组 5 只)。进行标准的中央插管,在无心脏骤停或缺血的情况下维持体外循环 120 分钟,然后进行另外 120 分钟的血流动力学监测。在甲烷治疗组中,将 2.5%v/v 的甲烷-常氧空气混合物添加到体外循环机的扫气气体中。通过中央静脉线采血,并从心脏、回肠和肾脏采集组织活检,以确定全血中超氧化物的产生(化学发光法)以及黄嘌呤氧化还原酶和髓过氧化物酶的活性,采用底物特异性反应。
与未治疗组相比,甲烷治疗组在体外循环期间的肾血流量显著升高(63.9±16.4 比 29.0±9.3ml/min)。全血中超氧化物的产生(548±179 比 1283±193 相对光单位(RLU))、回肠髓过氧化物酶(2.23±0.2 比 3.26±0.6 mU/(mg 蛋白))和心脏(1.5±0.6 比 4.7±2.5 pmol/min/mg)、回肠(2.2±0.6 比 7.0±3.4 pmol/min/mg)和肾脏(1.2±0.8 比 13.3±8.0 pmol/min/mg)黄嘌呤氧化还原酶的活性明显降低。
通过体外循环机的氧气浓缩器添加生物活性气体(如甲烷)是一种影响心脏手术体外灌注炎症作用的新策略。