title: Minimized and conventional cardiopulmonary bypass damage intestinal mucosal integrity.
abstract: OBJECTIVE
  Previous studies have suggested that gastrointestinal integrity is compromised after cardiopulmonary bypass (CPB). We compared the effects of prolonged minimized (MCPB) and conventional CPB (CCPB) on intestinal mucosal integrity by determining mucosal damage, epithelial cell proliferation rate and distribution of tight junction proteins in a porcine model.
  
  
  METHODS
  Fourteen animals were randomly assigned to undergo 240 minutes of mild hypothermic MCPB or CCPB. Ileal and colonic biopsies were obtained prior and at the end of CPB. Mucosal damage was determined under light microscopic evaluation. Immunohistochemistry was used to investigate epithelial expression of Ki-67 as a measure of cell proliferation rate and claudin-1, 2, 3, 4, 5, and 7 as elements of tight junctions.
  
  
  RESULTS
  In colonic biopsies, independent of the circuit type used, moderate mucosal damage was observed as indicated by focal epithelial damage, increased epithelial cell proliferation and decreased expression of tight junction protein claudin-4.
  
  
  CONCLUSIONS
  Colonic mucosal damage was observed similarly in MCPB and CCPB. Based on these results, the effects of MCPB on intestinal mucosal stability are similar to those of CCPB.
authors.affiliation: Department of Anesthesiology, Oulu University Hospital, Finland. riikka.rimpilainen@oulu.fi
authors.forename: Riikka
authors.initials: R
authors.lastname: Rimpiläinen
authors.forename: Merja
authors.initials: M
authors.lastname: Vakkala
authors.forename: Eija
authors.initials: E
authors.lastname: Rimpiläinen
authors.forename: Hanna
authors.initials: H
authors.lastname: Jensen
authors.forename: Jussi
authors.initials: J
authors.lastname: Rimpiläinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Erkinaro
authors.forename: Kai
authors.initials: K
authors.lastname: Kiviluoma
authors.forename: Sanna
authors.initials: S
authors.lastname: Meriläinen
authors.forename: Matti
authors.initials: M
authors.lastname: Pokela
authors.forename: Tuomo
authors.initials: T
authors.lastname: Karttunen
authors.forename: Tatu
authors.initials: T
authors.lastname: Juvonen
mesh_terms: D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D049109:Cell Proliferation; D003108:Colonic Diseases / Q000209:etiology* / Q000378:metabolism; D005260:Female; D007077:Ileal Diseases / Q000209:etiology* / Q000378:metabolism; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology*; D008565:Membrane Proteins / Q000378:metabolism; D019060:Minimally Invasive Surgical Procedures; D013152:Splanchnic Circulation / Q000502:physiology; D013552:Swine; D019108:Tight Junctions / Q000378:metabolism
chemical_list: D008565:Membrane Proteins