In:
European Surgical Research, S. Karger AG, Vol. 51, No. 1-2 ( 2013), p. 1-13
Abstract:
〈 b 〉 〈 i 〉 Background/Purpose: 〈 /i 〉 〈 /b 〉 Cardiac tamponade is a medical emergency situation associated with a high rate of life-threatening complications, even after immediate interventions. Our aim was to characterize the acute inflammatory consequences of this event in a clinically relevant large animal model. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Cardiac tamponade was induced for 60 min in anesthetized, ventilated and thoracotomized minipigs by intrapericardial fluid administration, the mean arterial pressure (MAP) being maintained in the interval of 40-45 mm Hg (n = 8). A further group (n = 7) served as sham-operated control. The global macrohemodynamics, including the right- and left-heart end-diastolic volumes (RHEDV and LHEDV), the pulmonary vascular resistance index (PVRI) and the superior mesenteric artery (SMA) flow, were monitored for 240 min, and the intestinal microcirculatory changes (pCO 〈 sub 〉 2 〈 /sub 〉 gap) were evaluated by indirect tonometry. Blood samples were taken for the determination of cardiac troponin T and vasoactive inflammatory mediators, including histamine, nitrite/nitrate, big-endothelin, superoxide and high-mobility group box protein-1 levels in association with intestinal leukocyte and complement activation. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The cardiac tamponade induced significant decreases in MAP, cardiac output, LHEDV and SMA flow, while the PVRI and the pCO 〈 sub 〉 2 〈 /sub 〉 gap increased significantly. After the removal of fluid from the pericardial sac, the MAP and the LHEDV were decreased, while the PVRI and the pCO 〈 sub 〉 2 〈 /sub 〉 gap remained elevated when compared with those in the sham-operated group. In the posttamponade period, the abrupt release of inflammatory mediators was accompanied by a significant splanchnic leukocyte accumulation and complement activation. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The macrocirculatory and splanchnic microcirculatory disturbances were accompanied by a significant proinflammatory reaction; endothelin and the complement system may be significant components of the inflammatory cascade that is activated in this porcine model of pericardial tamponade.
Type of Medium:
Online Resource
ISSN:
0014-312X
,
1421-9921
Language:
English
Publisher:
S. Karger AG
Publication Date:
2013
detail.hit.zdb_id:
1468505-X
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