Влияние оксида азота на степень повреждения ткани кишечника и структурной организации мембран эритроцитов при моделировании искусственного кровообращения и циркуляторного ареста: экспериментальное рандомизированное исследование

Abstract

INTRODUCTION: Ischemia-reperfusion injury during cardiopulmonary bypass (CPB) and circulatory arrest (CA) can lead to the damage of various body systems, including splanchnic. In turn, intestinal damage can lead to the development of multiple organ dysfunction. There is evidence of organ protective properties of nitric oxide (NO), but the effects on the intestine have not been studied. OBJECTIVE: To study the effect of exogenous nitric oxide on the degree of intestinal tissue damage and erythrocyte membranes when simulating cardiopulmonary bypass and circulatory arrest in an experiment. MATERIALS AND METHODS: The study was carried out on sheep, n = 24. The animals were divided into 4 equal groups of 6 in each: “CPB” and “CPB+NO”, “CPB+CA” and “CPB+CA+NO”. In the “CPB+NO”, “CPB+CA+NO” groups NO was delivered. In the “CPB” and “CPB+CA” groups, CPB and CA were performed without NO. During the experiment, we assessed the following: systemic hemodynamics, acid-base status, blood gas components, hematocrit, electrolyte, lactate, glucose, hemoglobin, free hemoglobin, concentrations, dynamics of coefficient of microviscosity and polarity in the areas of lipid-lipid and protein-lipid interactions (CMPLI; CPPLI) of erythrocyte membranes. One hour after CPB, tissues of the small intestine were collected for subsequent morphological and morphometric analyses. RESULTS: The main laboratory findings and systemic hemodynamics were within the reference values and indicated the adequacy of mechanical perfusion. In the “CPB” and “CPB+CA” groups, CMPLI and CPPLI after weaning from CPB were significantly reduced from the initial values, but in the “CPB+NO” and “CPB+CA+NO” groups there was no tendency towards a decrease in these indicators. The histological picture of intestinal tissue in the NO groups was with less pronounced structural damage. CONCLUSIONS: Perioperative delivery of exogenous NO during CPB and CA in the experiment reduces morphological signs of damage in intestinal tissue and has a positive effect on the structural organization of erythrocyte membranes.