Experimental studies on the endothelium ultrastructure of heart capillaries under moderate (28-30 degrees) and deep (22-24 degrees) hypothermia without perfusion

Effect of mild hypothermia on the coagulation-fibrinolysis system and physiological anticoagulants after cardiopulmonary resuscitation in a porcine model

The aim of this study was to evaluate the effect of mild hypothermia on the coagulation-fibrinolysis system and physiological anticoagulants after cardiopulmonary resuscitation (CPR). A total of 20 male Wuzhishan miniature pigs underwent 8 min of untreated ventricular fibrillation and CPR. Of these, 16 were successfully resuscitated and were randomized into the mild hypothermia group (MH, n = 8) or the control normothermia group (CN, n = 8). Mild hypothermia (33°C) was induced intravascularly, and this temperature was maintained for 12 h before pigs were actively rewarmed. The CN group received normothermic post-cardiac arrest (CA) care for 72 h. Four animals were in the sham operation group (SO). Blood samples were taken at baseline, and 0.5, 6, 12, 24, and 72 h after ROSC. Whole-body mild hypothermia impaired blood coagulation during cooling, but attenuated blood coagulation impairment at 72 h after ROSC. Mild hypothermia also increased serum levels of physiological anticoagulants, such as PRO C and AT-III during cooling and after rewarming, decreased EPCR and TFPI levels during cooling but not after rewarming, and inhibited fibrinolysis and platelet activation during cooling and after rewarming. Finally, mild hypothermia did not affect coagulation-fibrinolysis, physiological anticoagulants, or platelet activation during rewarming. Thus, our findings indicate that mild hypothermia exerted an anticoagulant effect during cooling, which may have inhibitory effects on microthrombus formation. Furthermore, mild hypothermia inhibited fibrinolysis and platelet activation during cooling and attenuated blood coagulation impairment after rewarming. Slow rewarming had no obvious adverse effects on blood coagulation.

Ultrastructural organization of capillaries in various compartments of the dog heart in artificial immersion hypothermia

Similarity of the structural characteristics of perfusion capacity of right-atrial and left-ventricular capillaries of the dog heart in health were detected, the capillaries differing significantly by size and by the majority of the morphometrical values. Exposure of animals to hypothermia induces different ultrastructural responses of the capillaries in two compartments of the heart: the perfusion characteristics of the right atrium deteriorate and the morphometrical parameters of endotheliocytes change, while in the left ventricle the population composition of endothelial cells changes significantly (the percentage of cells of the main type reduces, while the share of dark cells increases).

Ultrastructure of myocardial capillary endothelium in children with congenital heart disease

Cardiosurgical stress initiates endothelial injury of the colliquation necrosis type (without activating coagulation necrosis) in coronary capillaries of infants aged under 1 year. The dark cells exhibited high tolerance to operation stress in the presence of labile ultrastructural response of endothelial cells of the main and light types. The percentage of dark cells does not change during surgical intervention, which is a sign predicting a favorable course of the postoperative period.