L'utilisation prophylactique du sildénafil dans la dysfonction endothéliale des artères pulmonaires secondaire à la circulation extracorporelle dans un modèle porcin
Bibliographic record
Abstract
ABSTRA CT Cardiopulmo nary bypass (CPB) is used daily to perform cardiac surgery.This tecimique, however, can cause side effects for the patient, as it can cause a dysfunction of rnany organs, notably the lungs, by creating an endothelial dysfunction due to a decreased NO production.This can contribute to pulmonary hypertension , a condition associated with a higli postoperative mortality rate when associated with right heart failure.A few modalities have been used to prevent this endothelial dysfunction.In our laboratory, miirinone, a phosphodies terase inhibitor type III lias been used with interesting resuits.We are now interested in trying sildenafit, a phosphodies terase inhibitor type V with a vasodilator effect on the pulmonary vasculature by limiting the degradation ofcyclic guanosine monophosph ate (cGMP).a second messenger of the NO pathway.This strategy could prevent the endothelial dysfunction without systernic adverse events such as hypotension when administered by nebulisation.In a porcine modeÏ, five groups were compared: 1-Control; 2-CPB; 3-Inhaled sildenafil prior to CPB; 4-Inhaled sildenafil after CPB and 5-Intravenous sildenafil prior to CPB.Afler 90 minutes of CPB and 60 minutes of pulmonary reperfusion, 2nd degree pulrnonary arteries endothelicim -dependent relaxations to ACh and 3K were studied in organ chambers.CPB decreased the amplitude of the endotheliumdependent relaxation to ACh and to BK.This endothelial dysfunction was prevented hy administratio n of sildenafil, both intravenously and by inhalation and for the latter both prior and after CPB.Moreover, sildenafil prevented the increase in puÏmonary artery pressure caused by CPB witli a safe hernodynami c profile causing no systernic hypotension and decrease in cardiac output.When administered by inhalation affer CPB or intravenousty , sildenafil improved oxygenation.vi In conclusio n, the administ ration by nebulisat ion afier CPB gave better resuits regarding hemodyn amic and oxygena tion.Sildenafi l could be added to our therapeu tic arsenal for the preventio n and treatrnent of pulmona ry hyperten sion after CPB in cardiac surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".