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Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients

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 inv...

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Autores principales: Mankowski, Robert T., Wohlgemuth, Stephanie E., Bresciani, Guilherme, Martin, A. Daniel, Arnaoutakis, George, Martin, Tomas, Jeng, Eric, Ferreira, Leonardo, Machuca, Tiago, Rackauskas, Mindaugas, Smuder, Ashley J., Beaver, Thomas, Leeuwenburgh, Christiaan, Smith, Barbara K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10215949/
https://www.ncbi.nlm.nih.gov/pubmed/37237876
http://dx.doi.org/10.3390/antiox12051009
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author Mankowski, Robert T.
Wohlgemuth, Stephanie E.
Bresciani, Guilherme
Martin, A. Daniel
Arnaoutakis, George
Martin, Tomas
Jeng, Eric
Ferreira, Leonardo
Machuca, Tiago
Rackauskas, Mindaugas
Smuder, Ashley J.
Beaver, Thomas
Leeuwenburgh, Christiaan
Smith, Barbara K.
author_facet Mankowski, Robert T.
Wohlgemuth, Stephanie E.
Bresciani, Guilherme
Martin, A. Daniel
Arnaoutakis, George
Martin, Tomas
Jeng, Eric
Ferreira, Leonardo
Machuca, Tiago
Rackauskas, Mindaugas
Smuder, Ashley J.
Beaver, Thomas
Leeuwenburgh, Christiaan
Smith, Barbara K.
author_sort Mankowski, Robert T.
collection PubMed
description 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.
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spelling pubmed-102159492023-05-27 Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients Mankowski, Robert T. Wohlgemuth, Stephanie E. Bresciani, Guilherme Martin, A. Daniel Arnaoutakis, George Martin, Tomas Jeng, Eric Ferreira, Leonardo Machuca, Tiago Rackauskas, Mindaugas Smuder, Ashley J. Beaver, Thomas Leeuwenburgh, Christiaan Smith, Barbara K. Antioxidants (Basel) Article 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. MDPI 2023-04-27 /pmc/articles/PMC10215949/ /pubmed/37237876 http://dx.doi.org/10.3390/antiox12051009 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/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/).
spellingShingle Article
Mankowski, Robert T.
Wohlgemuth, Stephanie E.
Bresciani, Guilherme
Martin, A. Daniel
Arnaoutakis, George
Martin, Tomas
Jeng, Eric
Ferreira, Leonardo
Machuca, Tiago
Rackauskas, Mindaugas
Smuder, Ashley J.
Beaver, Thomas
Leeuwenburgh, Christiaan
Smith, Barbara K.
Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title_full Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title_fullStr Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title_full_unstemmed Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title_short Intraoperative Hemi-Diaphragm Electrical Stimulation Demonstrates Attenuated Mitochondrial Function without Change in Oxidative Stress in Cardiothoracic Surgery Patients
title_sort intraoperative hemi-diaphragm electrical stimulation demonstrates attenuated mitochondrial function without change in oxidative stress in cardiothoracic surgery patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10215949/
https://www.ncbi.nlm.nih.gov/pubmed/37237876
http://dx.doi.org/10.3390/antiox12051009
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