Effects of Nitric Oxide on the Systemic Inflammatory Response Induced During Cardiopulmonary Bypass

Sydney Kelly

Pronouns: she/her/hers

Research Mentor(s): Alvaro Rojas Pena
Co-Presenter:
Research Mentor School/College/Department: Department of Surgery-Transplantation / Medicine
Presentation Date: April 20
Presentation Type: Oral5
Session: Session 4 – 2:40pm – 3:30 pm
Room: Breakout room 5
Authors: Sydney Kelly, Brianna Spencer, Mark Langley, Joshua Anapoell, John Toomasian, Daniel Drake, Robert Bartlett, Alvaro Rojas-Peña
Presenter: 3

Abstract

Cardiopulmonary bypass (CPB) provides a motion- and bloodless surgical field by bypassing blood from the lungs and heart through an extracorporeal circuit and systemic circulation. CPB is an inherently invasive procedure that results in interaction of the blood with air, tubing, and other artificial surfaces of the extracorporeal circuit which causes trauma to the blood. The resulting inflammatory response can be quantified by looking at the inflammatory markers present in the blood during and following the procedure. Increased levels of inflammatory markers such as cytokines and exotoxins can cause injury to the kidney along with other organs that can result in hindered recovery and higher instances of complications during and after the procedure. The efficacy of blending nitric oxide (NO) gas into the artificial lung of the extracorporeal circuit to attenuate systemic inflammation and improve recovery was studied in porcine models. 10 swine underwent 2 hours of CPB with 500 ppm NO continuously delivered. 11 control swine underwent 2 hours of CPB without the blending of NO into the artificial lungs. Animals were kept alive for 2 days following the procedure. Data was collected at baseline 1 (post central and arterial line), baseline 2 (post thoracotomy and pre bypass), every 30 minutes after initiation of bypass until conclusion of bypass at 180 minutes, 6 hr (post initiation of bypass), 24 hr, and 48 hour (pre-necropsy). Mortality was higher among swine that did not receive NO. Troponin-I levels were significantly higher in the treatment group at 6 hr. White blood cell count and neutrophil count were slightly higher in the control group. Lung compliance was slightly higher in the treatment group. Preliminary data suggests that delivering NO during CPB reduces the presence of inflammatory markers and consequently curbs the systemic inflammatory response (SIR).

Presentation link

Interdisciplinary, Natural/Life Sciences