Mette Bjerre

Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Standard

Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. / Vlasselaers, Dirk; Mesotten, Dieter; Langouche, Lies; Vanhorebeek, Ilse; van den Heuvel, Ingeborg; Milants, Ilse; Wouters, Pieter; Wouters, Patrick; Meyns, Bart; Bjerre, Mette; Hansen, Troels Krarup; Van den Berghe, Greet.

I: Annals of Thoracic Surgery, Bind 90, Nr. 1, 2010, s. 22-9.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Vlasselaers, D, Mesotten, D, Langouche, L, Vanhorebeek, I, van den Heuvel, I, Milants, I, Wouters, P, Wouters, P, Meyns, B, Bjerre, M, Hansen, TK & Van den Berghe, G 2010, 'Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery', Annals of Thoracic Surgery, bind 90, nr. 1, s. 22-9. https://doi.org/10.1016/j.athoracsur.2010.03.093

APA

Vlasselaers, D., Mesotten, D., Langouche, L., Vanhorebeek, I., van den Heuvel, I., Milants, I., Wouters, P., Wouters, P., Meyns, B., Bjerre, M., Hansen, T. K., & Van den Berghe, G. (2010). Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. Annals of Thoracic Surgery, 90(1), 22-9. https://doi.org/10.1016/j.athoracsur.2010.03.093

CBE

Vlasselaers D, Mesotten D, Langouche L, Vanhorebeek I, van den Heuvel I, Milants I, Wouters P, Wouters P, Meyns B, Bjerre M, Hansen TK, Van den Berghe G. 2010. Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. Annals of Thoracic Surgery. 90(1):22-9. https://doi.org/10.1016/j.athoracsur.2010.03.093

MLA

Vancouver

Vlasselaers D, Mesotten D, Langouche L, Vanhorebeek I, van den Heuvel I, Milants I o.a. Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. Annals of Thoracic Surgery. 2010;90(1):22-9. https://doi.org/10.1016/j.athoracsur.2010.03.093

Author

Vlasselaers, Dirk ; Mesotten, Dieter ; Langouche, Lies ; Vanhorebeek, Ilse ; van den Heuvel, Ingeborg ; Milants, Ilse ; Wouters, Pieter ; Wouters, Patrick ; Meyns, Bart ; Bjerre, Mette ; Hansen, Troels Krarup ; Van den Berghe, Greet. / Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. I: Annals of Thoracic Surgery. 2010 ; Bind 90, Nr. 1. s. 22-9.

Bibtex

@article{faa16e808d8311df8c1a000ea68e967b,
title = "Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery",
abstract = "BACKGROUND: Neonatal cardiac surgery evokes hyperglycemia and a systemic inflammatory response. Hyperglycemia is associated with intensified inflammation and adverse outcome in critically ill children and in pediatric cardiac surgery. Recently we demonstrated that tight glycemic control (TGC) reduced morbidity and mortality of critically ill children. Experimental data suggest that insulin protects the myocardium in the setting of ischemia-reperfusion injury, but this benefit could be blunted by coinciding hyperglycemia. We hypothesized that insulin-titrated TGC, initiated prior to myocardial ischemia and reperfusion, protects the myocardium and attenuates the inflammatory response after neonatal cardiac surgery. METHODS: This is a prospective randomized study at a university hospital. Fourteen neonates were randomized to intraoperative and postoperative conventional insulin therapy or TGC. Study endpoints were effects on myocardial damage and function; inflammation, endothelial activation, and clinical outcome parameters. RESULTS: Tight glycemic control significantly reduced circulating levels of cardiac troponin-I (p = 0.009), heart fatty acid-binding protein (p = 0.01), B-type natriuretic peptide (p = 0.002), and the need for vasoactive support (p = 0.008). The TGC suppressed the rise of the proinflammatory cytokines interleukin-6 (p = 0.02) and interleukin-8 (p = 0.05), and reduced the postoperative increase in C-reactive protein (p = 0.04). Myocardial concentrations of Akt, endothelial nitric-oxide synthase, and their phosphorylated forms were not different between groups. CONCLUSIONS: In neonates undergoing cardiac surgery, intraoperative and postoperative TGC protects the myocardium and reduces the inflammatory response. This appears not to be mediated by an early, direct insulin signaling effect, but may rather be due to independent effects of preventing hyperglycemia during reperfusion.",
author = "Dirk Vlasselaers and Dieter Mesotten and Lies Langouche and Ilse Vanhorebeek and {van den Heuvel}, Ingeborg and Ilse Milants and Pieter Wouters and Patrick Wouters and Bart Meyns and Mette Bjerre and Hansen, {Troels Krarup} and {Van den Berghe}, Greet",
note = "Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.",
year = "2010",
doi = "10.1016/j.athoracsur.2010.03.093",
language = "English",
volume = "90",
pages = "22--9",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier Inc.",
number = "1",

}

RIS

TY - JOUR

T1 - Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery

AU - Vlasselaers, Dirk

AU - Mesotten, Dieter

AU - Langouche, Lies

AU - Vanhorebeek, Ilse

AU - van den Heuvel, Ingeborg

AU - Milants, Ilse

AU - Wouters, Pieter

AU - Wouters, Patrick

AU - Meyns, Bart

AU - Bjerre, Mette

AU - Hansen, Troels Krarup

AU - Van den Berghe, Greet

N1 - Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

PY - 2010

Y1 - 2010

N2 - BACKGROUND: Neonatal cardiac surgery evokes hyperglycemia and a systemic inflammatory response. Hyperglycemia is associated with intensified inflammation and adverse outcome in critically ill children and in pediatric cardiac surgery. Recently we demonstrated that tight glycemic control (TGC) reduced morbidity and mortality of critically ill children. Experimental data suggest that insulin protects the myocardium in the setting of ischemia-reperfusion injury, but this benefit could be blunted by coinciding hyperglycemia. We hypothesized that insulin-titrated TGC, initiated prior to myocardial ischemia and reperfusion, protects the myocardium and attenuates the inflammatory response after neonatal cardiac surgery. METHODS: This is a prospective randomized study at a university hospital. Fourteen neonates were randomized to intraoperative and postoperative conventional insulin therapy or TGC. Study endpoints were effects on myocardial damage and function; inflammation, endothelial activation, and clinical outcome parameters. RESULTS: Tight glycemic control significantly reduced circulating levels of cardiac troponin-I (p = 0.009), heart fatty acid-binding protein (p = 0.01), B-type natriuretic peptide (p = 0.002), and the need for vasoactive support (p = 0.008). The TGC suppressed the rise of the proinflammatory cytokines interleukin-6 (p = 0.02) and interleukin-8 (p = 0.05), and reduced the postoperative increase in C-reactive protein (p = 0.04). Myocardial concentrations of Akt, endothelial nitric-oxide synthase, and their phosphorylated forms were not different between groups. CONCLUSIONS: In neonates undergoing cardiac surgery, intraoperative and postoperative TGC protects the myocardium and reduces the inflammatory response. This appears not to be mediated by an early, direct insulin signaling effect, but may rather be due to independent effects of preventing hyperglycemia during reperfusion.

AB - BACKGROUND: Neonatal cardiac surgery evokes hyperglycemia and a systemic inflammatory response. Hyperglycemia is associated with intensified inflammation and adverse outcome in critically ill children and in pediatric cardiac surgery. Recently we demonstrated that tight glycemic control (TGC) reduced morbidity and mortality of critically ill children. Experimental data suggest that insulin protects the myocardium in the setting of ischemia-reperfusion injury, but this benefit could be blunted by coinciding hyperglycemia. We hypothesized that insulin-titrated TGC, initiated prior to myocardial ischemia and reperfusion, protects the myocardium and attenuates the inflammatory response after neonatal cardiac surgery. METHODS: This is a prospective randomized study at a university hospital. Fourteen neonates were randomized to intraoperative and postoperative conventional insulin therapy or TGC. Study endpoints were effects on myocardial damage and function; inflammation, endothelial activation, and clinical outcome parameters. RESULTS: Tight glycemic control significantly reduced circulating levels of cardiac troponin-I (p = 0.009), heart fatty acid-binding protein (p = 0.01), B-type natriuretic peptide (p = 0.002), and the need for vasoactive support (p = 0.008). The TGC suppressed the rise of the proinflammatory cytokines interleukin-6 (p = 0.02) and interleukin-8 (p = 0.05), and reduced the postoperative increase in C-reactive protein (p = 0.04). Myocardial concentrations of Akt, endothelial nitric-oxide synthase, and their phosphorylated forms were not different between groups. CONCLUSIONS: In neonates undergoing cardiac surgery, intraoperative and postoperative TGC protects the myocardium and reduces the inflammatory response. This appears not to be mediated by an early, direct insulin signaling effect, but may rather be due to independent effects of preventing hyperglycemia during reperfusion.

U2 - 10.1016/j.athoracsur.2010.03.093

DO - 10.1016/j.athoracsur.2010.03.093

M3 - Journal article

C2 - 20609741

VL - 90

SP - 22

EP - 29

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 1

ER -