Cardiac transcriptional and metabolic changes following thoracotomy.
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ABSTRACT:
SUBMITTER: Heckmann MB
PROVIDER: S-EPMC7295769 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Publications
Cardiac transcriptional and metabolic changes following thoracotomy.
Heckmann Markus B MB Rangrez Ashraf Yusuf AY Finke Daniel D Jungmann Andreas A Kreußer Julia S JS Rosskopf Alexandra A Schmiedel Nesrin N Katus Hugo A HA Frey Norbert N Müller Oliver J OJ
Scientific reports 20200615 1
Non-cardiac surgery is associated with significant cardiovascular complications. Reported mortality rate ranges from 1.9% to 4% in unselected patients. A postoperative surge in pro-inflammatory cytokines is a well-known feature and putative contributor to these complications. Despite much clinical research, little is known about the biomolecular changes in cardiac tissue following non-cardiac surgery. In order to increase our understanding, we analyzed whole-transcriptional and metabolic profili ...[more]
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Project description:Emergency department thoracotomy (EDT) was incorporated into traumatic out-of-hospital cardiac arrest (t-OHCA) resuscitation. Although current guidelines recommend EDT with survival predictors, futility following EDT has been demonstrated and the potential risks have not been thoroughly investigated. This study aimed to elucidate the benefits and harms of EDT for persistent cardiac arrest following injury until hospital arrival. This retrospective cohort study used a nationwide trauma registry (2019-2021) and included adult patients with t-OHCA both at the scene and on hospital arrival. Survival to discharge, hemostatic procedure frequency, and transfusion amount were compared between patients treated with and without EDT. Inverse probability weighting using a propensity score was conducted to adjust age, sex, comorbidities, mechanism of injury, prehospital resuscitative procedure, prehospital physician presence, presence of signs of life, degree of thoracic injury, transportation time, and institutional characteristics. Among 1289 patients, 374 underwent EDT. The longest transportation time for survivors was 8 and 23 min in patients with and without EDT, respectively. EDT was associated with lower survival to discharge (4/374 [1.1%] vs. 22/915 [2.4%]; adjusted odds ratio [OR], 0.43 [95% CI 0.22-0.84]; p = 0.011), although patients with EDT underwent more frequent hemostatic surgeries (46.0% vs. 5.0%; adjusted OR, 16.39 [95% CI 12.50-21.74]) and received a higher amount of transfusion. Subgroup analyses revealed no association between EDT and lower survival in patients with severe chest injuries (1.0% vs. 1.4%; adjusted OR, 0.72 [95% CI 0.28-1.84]). EDT was associated with lower survival till discharge in trauma patients with persistent cardiac arrests after adjusting for various patient backgrounds, including known indications for EDT. The idea that EDT is the last resort for t-OHCA should be reconsidered and EDT indications need to be deliberately determined.Trial registration This study is retrospectively registered at University Hospital Medical Information Network (UMIN ID: UMIN000050840).
| S-EPMC10520031 | biostudies-literature
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Project description:Eight-week-old male mice (C57BL/6N) were randomly subjected to isolated thoracotomy (ITH) or transaortic banding (TAC). Healthy littermates were used as controls. Mice were sacrificed after 2 weeks, 4 weeks , and 6 weeks. All mice were assessed by echocardiography. Animals were fed ad libitum with Rod 16-A (LASvendi) and housed in a specific pathogen free environment as previously described. Microarray and metabolic panales were performed for all animals.
2020-06-01 | E-MTAB-8910 | biostudies-arrayexpress
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