Full text

Turn on search term navigation

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Mechanical ventilation during cardiothoracic surgery is life-saving but can lead to ventilator-induced diaphragm dysfunction (VIDD) and prolong ventilator weaning and hospital length of stay. Intraoperative phrenic nerve stimulation may preserve diaphragm force production to offset VIDD; we also investigated changes in mitochondrial function after stimulation. During cardiothoracic surgeries (n = 21), supramaximal, unilateral phrenic nerve stimulation was performed every 30 min for 1 min. Diaphragm biopsies were collected after the last stimulation and analyzed for mitochondrial respiration in permeabilized fibers and protein expression and enzymatic activity of biomarkers of oxidative stress and mitophagy. Patients received, on average, 6.2 ± 1.9 stimulation bouts. Stimulated hemidiaphragms showed lower leak respiration, maximum electron transport system (ETS) capacities, oxidative phosphorylation (OXPHOS), and spare capacity compared with unstimulated sides. There were no significant differences between mitochondrial enzyme activities and oxidative stress and mitophagy protein expression levels. Intraoperative phrenic nerve electrical stimulation led to an acute decrease of mitochondrial respiration in the stimulated hemidiaphragm, without differences in biomarkers of mitophagy or oxidative stress. Future studies warrant investigating optimal stimulation doses and testing post-operative chronic stimulation effects on weaning from the ventilator and rehabilitation outcomes.

Details

Title
Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
Author
Mankowski, Robert T 1 ; Wohlgemuth, Stephanie E 1 ; Bresciani, Guilherme 2 ; Martin, A Daniel 3 ; Arnaoutakis, George 4 ; Martin, Tomas 4 ; Jeng, Eric 4 ; Ferreira, Leonardo 2   VIAFID ORCID Logo  ; Machuca, Tiago 4 ; Rackauskas, Mindaugas 4 ; Smuder, Ashley J 2 ; Beaver, Thomas 4 ; Leeuwenburgh, Christiaan 1   VIAFID ORCID Logo  ; Smith, Barbara K 5 

 Department of Physiology and Aging, University of Florida, Gainesville, FL 32611, USA 
 Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA 
 Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA; Department of Surgery, University of Florida, Gainesville, FL 32611, USA 
 Department of Surgery, University of Florida, Gainesville, FL 32611, USA 
 Department of Physical Therapy, University of Florida, Gainesville, FL 32611, USA 
First page
1009
Publication year
2023
Publication date
2023
Publisher
MDPI AG
e-ISSN
20763921
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2819266361
Copyright
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.