Preservation of endothelium nitric oxide release by pulsatile flow cardiopulmonary bypass when compared with continuous flow.
The aim of this work is to analyze endothelium nitric oxide (NO) release in patients undergoing continuous or pulsatile flow cardiopulmonary bypass (CPB). Nine patients operated under continuous flow CPB, and nine patients on pulsatile flow CPB were enrolled. Plasma samples were withdrawn for the chemiluminescence detection of nitrite and nitrate. Moreover the cellular component was withdrawn for the detection of nitric oxide synthase (NOS) activity in the erythrocytes, and an estimation of systemic inflammatory response was carried out. Significant reduction in the intraoperative concentration with respect to the preoperative was observed only under continuous flow CPB for both nitrite and NO(x) (nitrite + nitrate) concentration (P = 0.010 and P = 0.016, respectively). Significant difference in intraoperative nitrite concentration was also observed between the groups (P = 0.012). Finally, erythrocytes showed a certain endothelial NOS activity, which did not differ between the groups, and no differences in the inflammatory response were pointed out. The significant reduction of NO(2)(-) concentration under continuous perfusion revealed the strong connection among perfusion modality, endothelial NO release, and plasmatic nitrite concentration. The similar erythrocyte eNOS activity between the groups revealed that the differences in blood NO metabolites are mainly ascribable to the endothelium release.
Laboratory of Mechanical Biological Structures, Department of Structural Engineering, Politecnico di Milano, Milan, Italy. ettore.lanzarone@polimi.it
Ettore
E
Lanzarone
Fabrizio
F
Gelmini
Maddalena
M
Tessari
Tiziano
T
Menon
Hisanori
H
Suzuki
Marina
M
Carini
Maria Laura
ML
Costantino
Roberto
R
Fumero
Giovanni Battista
GB
Luciani
Giuseppe
G
Faggian
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D004727:Endothelium / Q000378:metabolism*; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009569:Nitric Oxide / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D009573:Nitrites / Q000097:blood; D011673:Pulsatile Flow
D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase