Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest

Minimal protection of pump prime methylprednisolone

Dominique Shum-Tim, Christo I. Tchervenkov, Eric Laliberté, Al Maleek Jamal, Toni Nimeh, Chwan-Yau Luo, Bindu Bittira, Anie Philip

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objectives: The contact of cardiopulmonary bypass surface and patient's blood activates systemic inflammatory response which aggravates ischemia-reperfusion injury. This study evaluates the effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral protection using different steroid administration protocols. Methods: Eighteen (n=6/group) 4 week-old piglets were divided in three groups. Methylprednisolone (30 mg/kg) was administered intravenously 4 h prior to CPB in Group I, or added in pump prime in group II. Group III received no steroid. All animals were cooled to 15°C followed by 100 min of DHCA, then rewarmed over 40 min and sacrificed 6 h after CPB. Post-operative weight gain, bioelectrical impedance, colloid oncotic pressure (COP) and interleukin-6 (IL-6) were evaluated. Determination of cerebral trypan blue and immunohistochemical assays of transforming growth factor (TGF)-β1 and caspase-3 activities were performed. Results: Post-operative % weight gain (13.0±3.8 (I) versus 26.4±9.9 (II) versus 22.6±6.4 (III), P=0.02); % bioimpedance reduction (14.5±8.0 (I) versus 38.3±13.3 (II) versus 30.5±8.0 (III), P=0.003); mean COP (mmHg) (14.9±1.8 (I) versus 10.9±2.0 (II) versus 6.5±1.8 (III), P=0.0001) and systemic IL-6 levels (pg/ml) (208.2±353.0 (I) versus 1562.1±1111.4 (II) versus 1712.3±533.2 (III), P=0.01) were significantly different between the groups. Spectrophotometric analysis of cerebral trypan blue (ng/g dry weight) was significantly different between the groups (0.0053±0.0010 (I) versus 0.0096±0.0026 (II) versus 0.0090±0.0019 (III), P=0.004). TGF-β1 scores were 3.3±0.8 (I) versus 1.5±0.8 (II) versus 1.5±0.5 (III), P<0.05, groups I versus II and I versus III. Remarkable perivascular caspase-3 activity was observed in groups II and III. Conclusion: Different timing of steroid administration results in different inflammatory mediator response. Steroid in CPB prime is not significantly better than no steroid treatment, while systemic steroid pre-treatment significantly decreases systemic manifestation of inflammatory response and brain damage.

Original languageEnglish
Pages (from-to)125-132
Number of pages8
JournalEuropean Journal of Cardio-thoracic Surgery
Volume24
Issue number1
DOIs
Publication statusPublished - 2003 Jul 1

Fingerprint

Methylprednisolone
Cardiopulmonary Bypass
Steroids
Deep Hypothermia Induced Circulatory Arrest
Trypan Blue
Colloids
Transforming Growth Factors
Caspase 3
Weight Gain
Interleukin-6
Therapeutics
Pressure
Reperfusion Injury
Electric Impedance
Weights and Measures
Brain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Shum-Tim, Dominique ; Tchervenkov, Christo I. ; Laliberté, Eric ; Jamal, Al Maleek ; Nimeh, Toni ; Luo, Chwan-Yau ; Bittira, Bindu ; Philip, Anie. / Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest : Minimal protection of pump prime methylprednisolone. In: European Journal of Cardio-thoracic Surgery. 2003 ; Vol. 24, No. 1. pp. 125-132.
@article{f074dde1feae4f42953b977ee051e42a,
title = "Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest: Minimal protection of pump prime methylprednisolone",
abstract = "Objectives: The contact of cardiopulmonary bypass surface and patient's blood activates systemic inflammatory response which aggravates ischemia-reperfusion injury. This study evaluates the effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral protection using different steroid administration protocols. Methods: Eighteen (n=6/group) 4 week-old piglets were divided in three groups. Methylprednisolone (30 mg/kg) was administered intravenously 4 h prior to CPB in Group I, or added in pump prime in group II. Group III received no steroid. All animals were cooled to 15°C followed by 100 min of DHCA, then rewarmed over 40 min and sacrificed 6 h after CPB. Post-operative weight gain, bioelectrical impedance, colloid oncotic pressure (COP) and interleukin-6 (IL-6) were evaluated. Determination of cerebral trypan blue and immunohistochemical assays of transforming growth factor (TGF)-β1 and caspase-3 activities were performed. Results: Post-operative {\%} weight gain (13.0±3.8 (I) versus 26.4±9.9 (II) versus 22.6±6.4 (III), P=0.02); {\%} bioimpedance reduction (14.5±8.0 (I) versus 38.3±13.3 (II) versus 30.5±8.0 (III), P=0.003); mean COP (mmHg) (14.9±1.8 (I) versus 10.9±2.0 (II) versus 6.5±1.8 (III), P=0.0001) and systemic IL-6 levels (pg/ml) (208.2±353.0 (I) versus 1562.1±1111.4 (II) versus 1712.3±533.2 (III), P=0.01) were significantly different between the groups. Spectrophotometric analysis of cerebral trypan blue (ng/g dry weight) was significantly different between the groups (0.0053±0.0010 (I) versus 0.0096±0.0026 (II) versus 0.0090±0.0019 (III), P=0.004). TGF-β1 scores were 3.3±0.8 (I) versus 1.5±0.8 (II) versus 1.5±0.5 (III), P<0.05, groups I versus II and I versus III. Remarkable perivascular caspase-3 activity was observed in groups II and III. Conclusion: Different timing of steroid administration results in different inflammatory mediator response. Steroid in CPB prime is not significantly better than no steroid treatment, while systemic steroid pre-treatment significantly decreases systemic manifestation of inflammatory response and brain damage.",
author = "Dominique Shum-Tim and Tchervenkov, {Christo I.} and Eric Lalibert{\'e} and Jamal, {Al Maleek} and Toni Nimeh and Chwan-Yau Luo and Bindu Bittira and Anie Philip",
year = "2003",
month = "7",
day = "1",
doi = "10.1016/S1010-7940(03)00164-7",
language = "English",
volume = "24",
pages = "125--132",
journal = "European Journal of Cardio-thoracic Surgery",
issn = "1010-7940",
publisher = "Elsevier",
number = "1",

}

Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest : Minimal protection of pump prime methylprednisolone. / Shum-Tim, Dominique; Tchervenkov, Christo I.; Laliberté, Eric; Jamal, Al Maleek; Nimeh, Toni; Luo, Chwan-Yau; Bittira, Bindu; Philip, Anie.

In: European Journal of Cardio-thoracic Surgery, Vol. 24, No. 1, 01.07.2003, p. 125-132.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest

T2 - Minimal protection of pump prime methylprednisolone

AU - Shum-Tim, Dominique

AU - Tchervenkov, Christo I.

AU - Laliberté, Eric

AU - Jamal, Al Maleek

AU - Nimeh, Toni

AU - Luo, Chwan-Yau

AU - Bittira, Bindu

AU - Philip, Anie

PY - 2003/7/1

Y1 - 2003/7/1

N2 - Objectives: The contact of cardiopulmonary bypass surface and patient's blood activates systemic inflammatory response which aggravates ischemia-reperfusion injury. This study evaluates the effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral protection using different steroid administration protocols. Methods: Eighteen (n=6/group) 4 week-old piglets were divided in three groups. Methylprednisolone (30 mg/kg) was administered intravenously 4 h prior to CPB in Group I, or added in pump prime in group II. Group III received no steroid. All animals were cooled to 15°C followed by 100 min of DHCA, then rewarmed over 40 min and sacrificed 6 h after CPB. Post-operative weight gain, bioelectrical impedance, colloid oncotic pressure (COP) and interleukin-6 (IL-6) were evaluated. Determination of cerebral trypan blue and immunohistochemical assays of transforming growth factor (TGF)-β1 and caspase-3 activities were performed. Results: Post-operative % weight gain (13.0±3.8 (I) versus 26.4±9.9 (II) versus 22.6±6.4 (III), P=0.02); % bioimpedance reduction (14.5±8.0 (I) versus 38.3±13.3 (II) versus 30.5±8.0 (III), P=0.003); mean COP (mmHg) (14.9±1.8 (I) versus 10.9±2.0 (II) versus 6.5±1.8 (III), P=0.0001) and systemic IL-6 levels (pg/ml) (208.2±353.0 (I) versus 1562.1±1111.4 (II) versus 1712.3±533.2 (III), P=0.01) were significantly different between the groups. Spectrophotometric analysis of cerebral trypan blue (ng/g dry weight) was significantly different between the groups (0.0053±0.0010 (I) versus 0.0096±0.0026 (II) versus 0.0090±0.0019 (III), P=0.004). TGF-β1 scores were 3.3±0.8 (I) versus 1.5±0.8 (II) versus 1.5±0.5 (III), P<0.05, groups I versus II and I versus III. Remarkable perivascular caspase-3 activity was observed in groups II and III. Conclusion: Different timing of steroid administration results in different inflammatory mediator response. Steroid in CPB prime is not significantly better than no steroid treatment, while systemic steroid pre-treatment significantly decreases systemic manifestation of inflammatory response and brain damage.

AB - Objectives: The contact of cardiopulmonary bypass surface and patient's blood activates systemic inflammatory response which aggravates ischemia-reperfusion injury. This study evaluates the effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral protection using different steroid administration protocols. Methods: Eighteen (n=6/group) 4 week-old piglets were divided in three groups. Methylprednisolone (30 mg/kg) was administered intravenously 4 h prior to CPB in Group I, or added in pump prime in group II. Group III received no steroid. All animals were cooled to 15°C followed by 100 min of DHCA, then rewarmed over 40 min and sacrificed 6 h after CPB. Post-operative weight gain, bioelectrical impedance, colloid oncotic pressure (COP) and interleukin-6 (IL-6) were evaluated. Determination of cerebral trypan blue and immunohistochemical assays of transforming growth factor (TGF)-β1 and caspase-3 activities were performed. Results: Post-operative % weight gain (13.0±3.8 (I) versus 26.4±9.9 (II) versus 22.6±6.4 (III), P=0.02); % bioimpedance reduction (14.5±8.0 (I) versus 38.3±13.3 (II) versus 30.5±8.0 (III), P=0.003); mean COP (mmHg) (14.9±1.8 (I) versus 10.9±2.0 (II) versus 6.5±1.8 (III), P=0.0001) and systemic IL-6 levels (pg/ml) (208.2±353.0 (I) versus 1562.1±1111.4 (II) versus 1712.3±533.2 (III), P=0.01) were significantly different between the groups. Spectrophotometric analysis of cerebral trypan blue (ng/g dry weight) was significantly different between the groups (0.0053±0.0010 (I) versus 0.0096±0.0026 (II) versus 0.0090±0.0019 (III), P=0.004). TGF-β1 scores were 3.3±0.8 (I) versus 1.5±0.8 (II) versus 1.5±0.5 (III), P<0.05, groups I versus II and I versus III. Remarkable perivascular caspase-3 activity was observed in groups II and III. Conclusion: Different timing of steroid administration results in different inflammatory mediator response. Steroid in CPB prime is not significantly better than no steroid treatment, while systemic steroid pre-treatment significantly decreases systemic manifestation of inflammatory response and brain damage.

UR - http://www.scopus.com/inward/record.url?scp=0038349666&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038349666&partnerID=8YFLogxK

U2 - 10.1016/S1010-7940(03)00164-7

DO - 10.1016/S1010-7940(03)00164-7

M3 - Article

VL - 24

SP - 125

EP - 132

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 1

ER -