Loss of microcirculatory perfusion during cardiopulmonary bypass
Cardiac surgery with cardiopulmonary bypass (CPB) is performed in about 14,000 patients per year in the Netherlands. Cardiac surgery is associated with inflammation and acute impairment of microcirculation perfusion, which may both contribute to postoperative organ failure. Recent studies by our group suggest that these microcirculatory derangements are paralleled by loss of endothelial barrier function, but the interdependency between inflammation, vascular leakage and disturbed microcirculation perfusion is poorly understood. An emerging molecular pathway that is thought to play a central role in this pathophysiological concept is the Angiopoietin (Ang)/Tie2 system. While there is evidence that Ang/Tie2 signaling is involved in vascular leakage and inflammation during sepsis, its role in CPB-induced microcirculatory alterations is unknown.
This research line combines clinical and preclinical research to elucidate whether the CPB-related proinflammatory stimulus leads to vascular leakage and microvascular perfusion disturbances through an Ang/Tie 2-dependent mechanism.
The research is performed in collaboration with the department of Physiology of VUmc (dr. Geerten van Nieuw Amerongen), department of Intensive Care of the UMCG (dr. Matijs van Meurs) and the department of Pathology & Medical Biology of the University Groningen (prof.dr. G. Molema).
Promovendi: Nick Koning en Nicole Dekker