Vascular reactivity in cardiopulmonary bypass

PhD ceremony: Ms. I. Samarska, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Vascular reactivity in cardiopulmonary bypass

Promotor(s): prof. R.H. Henning, prof. M.M.R.F. Struys

Faculty: Medical Sciences

Cardiopulmonary bypass (CPB) is a widely used technique invaluable to cardiothoracic surgery, but it is also associated with organ dysfunction and increased incidence of postoperative clinical complications. These may occur in vital organs including the heart, kidneys, lungs, intestines and brain. Utilisation of CPB induces changes in vasoreactivity of macro- and microcirculatory beds, which may be a pivotal component in the development of organ dysfunction. The aim of this thesis was to study the pathophysiology of vasomotor function in a rat model of CPB. Key physiological components of the blood vessels did not fully normalise after a prolonged recovery period, suggesting a continuing pathological process. The researchers suggest that these findings are an important explanation for the ongoing complaints of patients after surgery with CPB. It was also found that the choice of anaesthesia largely impacts the vascular changes. Lastly, it was demonstrated that the negative effects of CPB were attenuated when patients were treated with drugs that modulate the Sphingosine 1 Phosphate receptor prior to surgery.