Birte Weber1, Marc Robin Mendler2, Ina Lackner1, Jochen Pressmar1, Melanie Haffner-Luntzer3, Severin Höfler1, Christian Karl Braun4, Helmut Hummler2,5, Stephan Schwarz2, Miriam Kalbitz6. 1. Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, Ulm, Germany. 2. Department of Pediatrics and Adolescent Medicine, Division of Neonatology and Pediatric Critical Care, Ulm University, Ulm, Germany. 3. Institute of Orthopedic Research and Biomechanics, University Medical Center Ulm, Ulm, Germany. 4. Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, Ulm, Germany. 5. Department of Pediatrics, Division of Neonatology, Sidra Medicine, Doha, Qatar. 6. Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, Ulm, Germany. miriam.kalbitz@uniklinik-ulm.de.
Abstract
BACKGROUND: Asphyxia of newborns is a severe and frequent challenge of the peri- and postnatal period. METHODS: Forty-four neonatal piglets underwent asphyxia and hemorrhage (AH), followed by resuscitation with blood or crystalloid transfusion. In this study, 15 piglets (blood n = 9, NaCl n = 6, mean age 31 h) were randomly chosen. Four hours after return of spontaneous circulation, heart tissue and blood were collected. Analyses of heart fatty acid binding protein (HFABP), cardiac troponin I (TnI) levels, and activation of the complement system were performed. Histological staining for connexin 43 (Cx43) and complement C5a receptor 1 (C5aR1) was performed. RESULTS: Following AH, systemic elevation of cardiac TnI and HFABP revealed cardiac damage in both groups. Systemic activation of the complement system and the appearance of extracellular histones in plasma of the blood transfusion group were observed. The Cx43 was translocated from the intercalated discs to the cytosol after AH. Cardiac glycogen concentration was reduced in both groups. A significant reduction of C5aR1 in the left ventricle and a significant elevation of the heart injury score were investigated after blood transfusion. CONCLUSION: AH leads to alteration of the heart, particularly in Cx43 and glycogen reserves, as well as local inflammation.
BACKGROUND:Asphyxia of newborns is a severe and frequent challenge of the peri- and postnatal period. METHODS: Forty-four neonatal piglets underwent asphyxia and hemorrhage (AH), followed by resuscitation with blood or crystalloid transfusion. In this study, 15 piglets (blood n = 9, NaCl n = 6, mean age 31 h) were randomly chosen. Four hours after return of spontaneous circulation, heart tissue and blood were collected. Analyses of heart fatty acid binding protein (HFABP), cardiac troponin I (TnI) levels, and activation of the complement system were performed. Histological staining for connexin 43 (Cx43) and complement C5a receptor 1 (C5aR1) was performed. RESULTS: Following AH, systemic elevation of cardiac TnI and HFABP revealed cardiac damage in both groups. Systemic activation of the complement system and the appearance of extracellular histones in plasma of the blood transfusion group were observed. The Cx43 was translocated from the intercalated discs to the cytosol after AH. Cardiac glycogen concentration was reduced in both groups. A significant reduction of C5aR1 in the left ventricle and a significant elevation of the heart injury score were investigated after blood transfusion. CONCLUSION:AH leads to alteration of the heart, particularly in Cx43 and glycogen reserves, as well as local inflammation.