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Ischemic preconditioning does not prevent placental dysfunction induced by fetal cardiac bypass
Renato S Assad1, Marcelo G A Guedes1, Vera D Aiello2
1Laboratory of Cardiovascular Research, Heart Institute University of São Paulo, São Paulo, Brazil.
Journal of Cardiac Surgery
|July 1, 2022
Summary
Remote ischemic preconditioning (rIPC) improved blood flow during fetal cardiac bypass (CB) and reduced inflammation markers. However, rIPC did not prevent placental dysfunction in fetal lambs undergoing CB.
Area of Science:
- Perinatal medicine
- Cardiovascular research
- Inflammation and immunology
Background:
- Remote ischemic preconditioning (rIPC) is a technique used to reduce tissue injury.
- Its application in fetal lambs undergoing cardiac bypass (CB) was investigated to assess its impact on systemic inflammation and placental function.
Purpose of the Study:
- To determine if rIPC can mitigate fetal systemic inflammation and placental dysfunction during CB.
- To evaluate the effects of rIPC on inflammatory markers, gas exchange, and tissue morphology in fetal lambs.
Main Methods:
- Eighteen fetal lambs were divided into sham, CB control, and CB rIPC groups.
- rIPC involved hindlimb occlusion and reperfusion cycles before 30 minutes of normothermic CB.
- Assessment included fetal inflammatory markers, gas exchange, and placental/lung morphology.
Main Results:
- The CB rIPC group showed higher CB flow rates.
- Both CB groups experienced decreased PaO2, acidosis, and increased lactate.
- Placental VCAM-1 expression was reduced in the rIPC group, with lower fetal IL-1 and TXA2 levels post-CB.
Conclusions:
- rIPC enhanced blood flow during fetal CB and reduced IL-1, TXA2, and placental VCAM-1.
- Despite these benefits, rIPC did not prevent placental dysfunction in fetal lambs undergoing CB.
