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Endogenous morphine is produced in response to cardiopulmonary bypass in neonatal pigs
V Brix-Christensen1, Y Goumon, E Tønnesen
1Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Denmark. vbc@iekf.au.dk
Background:
Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. Endogenous morphine production has previously been demonstrated in humans after cardiac surgery with CPB. It has been hypothesized that morphine plays a role as an anti-inflammatory mediator in the systemic inflammatory response. The aim of this study was to investigate if the CPB procedure in itself elicits an endogenous morphine production in neonatal pigs.
Methods:
Endogenous morphine production was measured in arterial blood in piglets exposed to sternotomy alone (sham group, n=10) or sternotomy and CPB (n=10). Blood samples were obtained immediately after the induction of anaesthesia, at the end of CPB and 4 h later. Morphine in arterial blood was detected by radioimmunoassay and confirmed by gas chromatography mass spectrometry.
Results:
Animals undergoing CPB showed detectable endogenous morphine concentrations immediately after CPB, with increased concentrations postoperatively. There was no measurable morphine production in the sham operated pigs.
Conclusion:
The CPB procedures elicits an endogenous morphine production in neonatal pigs. This morphine response is analogous to the previously demonstrated response in patients subjected to cardiac surgery and CPB.
Insights
Cardiopulmonary bypass (CPB) triggers endogenous morphine production in neonatal pigs, similar to humans. This suggests morphine may act as an anti-inflammatory during CPB procedures.
Area of Science:
- Physiology
- Immunology
- Pharmacology
Background:
- Cardiopulmonary bypass (CPB) induces a systemic inflammatory response.
- Endogenous morphine production is observed in humans post-CPB cardiac surgery.
- Morphine is hypothesized to be an anti-inflammatory mediator during CPB.
Purpose of the Study:
- To investigate if CPB elicits endogenous morphine production in neonatal pigs.
- To determine if the CPB procedure itself, not just cardiac surgery, stimulates morphine release.
Main Methods:
- Neonatal piglets underwent either sternotomy alone (sham) or sternotomy with CPB.
- Arterial blood samples were collected pre-anesthesia, post-CPB, and 4 hours later.
- Endogenous morphine levels were measured using radioimmunoassay and confirmed by gas chromatography-mass spectrometry.
Main Results:
- Piglets exposed to CPB exhibited detectable endogenous morphine levels post-procedure.
- Morphine concentrations increased postoperatively in the CPB group.
- No measurable morphine production was observed in the sham-operated piglets.
Conclusions:
- CPB procedures stimulate endogenous morphine production in neonatal pigs.
- This morphine response in pigs mirrors that seen in humans after cardiac surgery with CPB.
- Neonatal pigs serve as a relevant model for studying CPB-induced endogenous morphine release.