Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation

Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB reduces postoperative lung damage and complications. Eighteen sheep from an ovine HTx model were included, with ventilatory interventions randomly assigned during CPB: the OPENVENT group received low tidal volume (V<sub>T</sub>) of 3 mL/kg and positive end-expiratory pressure (PEEP) of 8 cm H<sub>2</sub>0, while no ventilation was provided in the NOVENT group as per standard of care. The recipient sheep were monitored for 6 h post-surgery. The primary outcome was histological lung damage, scored at the end of the study. Secondary outcomes included pulmonary shunt, driving pressure, hemodynamics and inflammatory lung infiltration. All animals completed the study. The OPENVENT group showed significantly lower histological lung damage versus the NOVENT group (0.22 vs 0.27, p = 0.042) and lower pulmonary shunt (19.2 vs 32.1%, p = 0.001). In addition, the OPENVENT group exhibited a reduced driving pressure (9.6 cm H<sub>2</sub>O vs. 12.8 cm H<sub>2</sub>O, p = 0.039), lower neutrophil (5.25% vs 7.97%, p ≤ 0.001) and macrophage infiltrations (11.1% vs 19.6%, p < 0.001). No significant differences were observed in hemodynamic parameters. In an ovine model of HTx, open-lung ventilation during CPB significantly reduced lung histological injury and inflammatory infiltration. This highlights the value of an open-lung approach during CPB and emphasizes the need for further clinical evidence to decrease risks of lung injury in HTx patients.

Authors

Institutions

Publication Details

Journal
Intensive Care Medicine Experimental
Published
2024-11-27
DOI
https://doi.org/10.1186/s40635-024-00669-w
Primary Topic
Mechanical Circulatory Support Devices
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation

Jacky Yung Suen, Sebastiano Maria Colombo, Andrew B. Haymet, Charles McDonald et al.
Intensive Care Medicine Experimental
Mechanical Circulatory Support Devices
article

Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation

Jacky Yung Suen, Sebastiano Maria Colombo, Andrew B. Haymet, Charles McDonald, Margaret R. Passmore, Silver Heinsar, Jae Seung Jung, Emily Wilson, K. Skeggs, Samantha Livingstone, John Francis Fraser, Louise E. See Hoe, David C. McGiffin, Gabriella Abbate, Nchafatso G. Obonyo, Carmen Ainola, Karin S. Wildi, Gianluigi Li Bassi, Chiara Palmieri, Nicole Bartnikowski, Mahé Bouquet, Kieran Hyslop, Varun A. Karnik, Kei Sato, Noriko Sato, Nicole White, L. James, Mark Buckland, Benjamin Lloyd, Leah Rickards
article en

Abstract

Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB reduces postoperative lung damage and complications. Eighteen sheep from an ovine HTx model were included, with ventilatory interventions randomly assigned during CPB: the OPENVENT group received low tidal volume (V<sub>T</sub>) of 3 mL/kg and positive end-expiratory pressure (PEEP) of 8 cm H<sub>2</sub>0, while no ventilation was provided in the NOVENT group as per standard of care. The recipient sheep were monitored for 6 h post-surgery. The primary outcome was histological lung damage, scored at the end of the study. Secondary outcomes included pulmonary shunt, driving pressure, hemodynamics and inflammatory lung infiltration. All animals completed the study. The OPENVENT group showed significantly lower histological lung damage versus the NOVENT group (0.22 vs 0.27, p = 0.042) and lower pulmonary shunt (19.2 vs 32.1%, p = 0.001). In addition, the OPENVENT group exhibited a reduced driving pressure (9.6 cm H<sub>2</sub>O vs. 12.8 cm H<sub>2</sub>O, p = 0.039), lower neutrophil (5.25% vs 7.97%, p ≤ 0.001) and macrophage infiltrations (11.1% vs 19.6%, p < 0.001). No significant differences were observed in hemodynamic parameters. In an ovine model of HTx, open-lung ventilation during CPB significantly reduced lung histological injury and inflammatory infiltration. This highlights the value of an open-lung approach during CPB and emphasizes the need for further clinical evidence to decrease risks of lung injury in HTx patients.

Intensive Care Medicine ExperimentalVol. 12(1)
Griffith University (AU), Queensland University of Technology (AU), The University of Queensland (AU), Korea University (KR), Wesley Hospital (AU), Princess Alexandra Hospital (AU), The Alfred Hospital (AU), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), African Institute for Leaders and Leadership (KE), North Estonia Medical Centre (EE), Wesley Research Institute (AU), Sunshine Coast University Hospital (AU), Prince Charles Hospital (AU), St Andrew’s Hospital (AU), Princess Alexandra Hospital (GB), Imperial College London (GB), Monash University (AU), Wellcome Trust (GB)
Wilson Foundation, Queensland Health, Metro North Hospital and Health Service, Medical Research Council, National Health and Medical Research Council
Good health and well-being
Openalex Percentile: Top 80%
Mechanical Circulatory Support Devices
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.