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https://ahro.austin.org.au/austinjspui/handle/1/34099
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DC Field | Value | Language |
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dc.contributor.author | Jufar, A H | - |
dc.contributor.author | May, C N | - |
dc.contributor.author | Booth, L C | - |
dc.contributor.author | Evans, R G | - |
dc.contributor.author | Cochrane, A D | - |
dc.contributor.author | Marino, B | - |
dc.contributor.author | Birchall, I | - |
dc.contributor.author | Hood, S G | - |
dc.contributor.author | McCall, P R | - |
dc.contributor.author | Sanders, R D | - |
dc.contributor.author | Yao, S T | - |
dc.contributor.author | Ortega-Bernal, V | - |
dc.contributor.author | Skene, Alison | - |
dc.contributor.author | Bellomo, R | - |
dc.contributor.author | Miles, L F | - |
dc.contributor.author | Lankadeva, Y R | - |
dc.date | 2023 | - |
dc.date.accessioned | 2023-11-03T03:10:06Z | - |
dc.date.available | 2023-11-03T03:10:06Z | - |
dc.date.issued | 2023-12 | - |
dc.identifier.citation | Anaesthesia 2023-12; 78(12) | en_US |
dc.identifier.issn | 1365-2044 | - |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/34099 | - |
dc.description.abstract | Cardiac surgery requiring cardiopulmonary bypass is associated with postoperative acute kidney injury and neurocognitive disorders, including delirium. Intra-operative inflammation and/or impaired tissue perfusion/oxygenation are thought to be contributors to these outcomes. It has been hypothesised that these problems may be ameliorated by the highly selective α2 -agonist, dexmedetomidine. We tested the effects of dexmedetomidine on renal and cerebral microcirculatory tissue perfusion, oxygenation and histology in a clinically relevant ovine model. Sixteen sheep were studied while conscious, after induction of anaesthesia and during 2 h of cardiopulmonary bypass. Eight sheep were allocated randomly to receive an intravenous infusion of dexmedetomidine (0.4-0.8 μg.kg-1 .h-1 ) from induction of anaesthesia to the end of cardiopulmonary bypass, and eight to receive an equivalent volume of matched placebo (0.9% sodium chloride). Commencement of cardiopulmonary bypass decreased renal medullary tissue oxygenation in the placebo group (mean (95%CI) 5.96 (4.24-7.23) to 1.56 (0.84-2.09) kPa, p = 0.001), with similar hypoxic levels observed in the dexmedetomidine group (6.33 (5.33-7.07) to 1.51 (0.33-2.39) kPa, p = 0.002). While no differences in kidney function (i.e. reduced creatinine clearance) were evident, a greater incidence of histological renal tubular injury was observed in sheep receiving dexmedetomidine (7/8 sheep) compared with placebo (2/8 sheep), p = 0.041. Graded on a semi-quantitative scale (0-3), median (IQR [range]) severity of histological renal tubular injury was higher in the dexmedetomidine group compared with placebo (1.5 (1-2 [0-3]) vs. 0 (0-0.3 [0-1]) respectively, p = 0.013). There was no difference in cerebral tissue microglial activation (neuroinflammation) between the groups. Dexmedetomidine did not reduce renal medullary hypoxia or cerebral neuroinflammation in sheep undergoing cardiopulmonary bypass. | en_US |
dc.language.iso | eng | - |
dc.subject | acute kidney injury | en_US |
dc.subject | cardiopulmonary bypass | en_US |
dc.subject | dexmedetomidine | en_US |
dc.subject | neuroinflammation | en_US |
dc.subject | postoperative cognitive dysfunction | en_US |
dc.title | Effects of dexmedetomidine on kidney and brain tissue microcirculation and histology in ovine cardiopulmonary bypass: a randomised controlled trial. | en_US |
dc.type | Journal Article | en_US |
dc.identifier.journaltitle | Anaesthesia | en_US |
dc.identifier.affiliation | Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Department of Paediatrics, University of Melbourne, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Cell Saving and Perfusion Resources, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Neurohistology Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Department of Critical Care, University of Melbourne, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Central Clinical School and NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. | en_US |
dc.identifier.affiliation | Cardiovascular Neuroscience Laboratory, Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Anatomical Pathology | en_US |
dc.identifier.affiliation | Department of Critical Care, University of Melbourne, Melbourne, Australia. | en_US |
dc.identifier.affiliation | Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia. | en_US |
dc.identifier.doi | 10.1111/anae.16152 | en_US |
dc.type.content | Text | en_US |
dc.identifier.orcid | 0000-0002-3589-9111 | en_US |
dc.identifier.pubmedid | 37880924 | - |
item.grantfulltext | none | - |
item.openairetype | Journal Article | - |
item.fulltext | No Fulltext | - |
item.languageiso639-1 | en | - |
item.cerifentitytype | Publications | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
crisitem.author.dept | Ophthalmology | - |
crisitem.author.dept | Pathology | - |
Appears in Collections: | Journal articles |
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