0000000000186563

AUTHOR

Robert Ruemmler

0000-0002-9265-6052

showing 13 related works from this author

Experimental lung injury induces cerebral cytokine mRNA production in pigs

2020

Background Acute respiratory distress syndrome (ARDS) is an important disease with a high incidence among patients admitted to intensive care units. Over the last decades, the survival of critically ill patients has improved; however, cognitive deficits are among the long-term sequelae. We hypothesize that acute lung injury leads to upregulation of cerebral cytokine synthesis. Methods After approval of the institutional and animal care committee, 20 male pigs were randomized to one of three groups: (1) Lung injury by oleic acid injection (OAI), (2) ventilation only (CTR) or (3) untreated. We compared neuronal numbers, proportion of neurons with markers for apoptosis, activation state of Ib…

ARDSmedicine.medical_specialtyEmergency and Critical Caremedicine.medical_treatmentLung injuryGeneral Biochemistry Genetics and Molecular Biology03 medical and health sciences0302 clinical medicineInternal medicineIntensive caremedicineCognitive declineCognitive DisordersRespiratory MedicineMicrogliaAcute respiratory distress syndromebusiness.industryGeneral Neuroscience030208 emergency & critical care medicineGeneral Medicinemedicine.diseaseLung injuryCritical careEndocrinologyCytokinemedicine.anatomical_structureCognitive impairmentNeurologyApoptosisCerebral inflammationCytokinesTumor necrosis factor alphaPigsGeneral Agricultural and Biological Sciencesbusiness030217 neurology & neurosurgeryPeerJ
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Bi-Level ventilation decreases pulmonary shunt and modulates neuroinflammation in a cardiopulmonary resuscitation model

2020

Background Optimal ventilation strategies during cardiopulmonary resuscitation are still heavily debated and poorly understood. So far, no convincing evidence could be presented in favour of outcome relevance and necessity of specific ventilation patterns. In recent years, alternative models to the guideline-based intermittent positive pressure ventilation (IPPV) have been proposed. In this randomized controlled trial, we evaluated a bi-level ventilation approach in a porcine model to assess possible physiological advantages for the pulmonary system as well as resulting changes in neuroinflammation compared to standard measures. Methods Sixteen male German landrace pigs were anesthetized a…

ResuscitationAnatomy and PhysiologyEmergency and Critical CareRespiratory rateResuscitationmedicine.medical_treatmentCardiologylcsh:Medicine030204 cardiovascular system & hematologyGeneral Biochemistry Genetics and Molecular Biology03 medical and health sciences0302 clinical medicineNeuroinflammationmedicineCardiopulmonary resuscitationRespiratory MedicinePositive end-expiratory pressureTidal volumePigMultiple inert gas elimination techniquebusiness.industryGeneral Neurosciencelcsh:R030208 emergency & critical care medicineGeneral MedicineGas ExchangeVentilationOxygenationAnesthesiaBreathingPulmonary shuntmedicine.symptomMIGETGeneral Agricultural and Biological SciencesbusinessTranslational MedicineBi-levelPeerJ
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Bronchoalveolar Lavage and Oleic Acid-Injection in Pigs as a Double-Hit Model for Acute Respiratory Distress Syndrome (ARDS).

2020

The treatment of ARDS continues to pose major challenges for intensive care physicians in the 21st century with mortality rates still reaching up to 50% in severe cases. Further research efforts are needed to better understand the complex pathophysiology of this disease. There are different well-established animal models to induce acute lung injury but none has been able to adequately mimic the complex pathomechanisms of ARDS. The most crucial factor for the development of this condition is the damage to the alveolar capillary unit. The combination of two well-established lung injury models allow us to mimic in more detail the underlying pathomechanism. Bronchoalveolar lavage (BAL) leads to…

Impaired gas exchangeARDSSwineGeneral Chemical EngineeringInflammationLung injuryBronchoalveolar LavageGeneral Biochemistry Genetics and Molecular BiologyHypoxemiaInjectionsIntensive careMedicineAnimalsHumansRespiratory Distress SyndromeGeneral Immunology and Microbiologymedicine.diagnostic_testbusiness.industryGeneral Neurosciencerespiratory systemmedicine.diseasePathophysiologyrespiratory tract diseasesDisease Models AnimalBronchoalveolar lavageAnesthesiamedicine.symptombusinessOleic AcidJournal of visualized experiments : JoVE
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Ultra-low tidal volume ventilation-A novel and effective ventilation strategy during experimental cardiopulmonary resuscitation.

2018

Abstract Background The effects of different ventilation strategies during CPR on patient outcomes and lung physiology are still poorly understood. This study compares positive pressure ventilation (IPPV) to passive oxygenation (CPAP) and a novel ultra-low tidal volume ventilation (ULTVV) regimen in an experimental ventricular fibrillation animal model. Study design Prospective randomized controlled trial. Animals 30 male German landrace pigs (16–20 weeks). Methods Ventricular fibrillation was induced in anesthetized and instrumented pigs and the animals were randomized into three groups. Mechanical CPR was initiated and ventilation was either provided by means of standard IPPV (RR: 10/min,…

MaleResuscitationSwinemedicine.medical_treatmentRespiratory physiology030204 cardiovascular system & hematologyEmergency NursingLung injuryAdvanced Cardiac Life SupportReal-Time Polymerase Chain ReactionIntermittent Positive-Pressure Ventilation03 medical and health sciencesRandom Allocation0302 clinical medicinemedicineTidal VolumeAnimalsHumansCardiopulmonary resuscitationTidal volumeAnalysis of VarianceContinuous Positive Airway Pressurebusiness.industryPulmonary Gas Exchange030208 emergency & critical care medicineOxygenationLung Injurymedicine.diseaserespiratory tract diseasesDisease Models AnimalTreatment OutcomeAnesthesiaVentricular fibrillationEmergency MedicineBreathingCardiology and Cardiovascular MedicinebusinessResuscitation
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CD11c+ Alveolar Macrophages are a Source of IL-23 During Lipopolysaccharide-Induced Acute Lung Injury

2013

Acute lung injury (ALI) is a severe pulmonary disease causing high numbers of fatalities worldwide. Innate immune responses are an integral part of the pathophysiologic events during ALI. Interleukin 23 (IL-23) is a proinflammatory mediator known to direct the inflammatory responses in various settings of infection, autoimmunity, and cancer. Interleukin 23 has been associated with proliferation and effector functions in T(H)17 cells. Surprisingly, little is known about production of IL-23 during ALI. In this study, we found expression of mRNA for IL-23p19 to be 10-fold elevated in lung homogenates of C57BL/6 mice after lipopolysaccharide (LPS)-induced ALI. Likewise, concentrations of IL-23 …

LipopolysaccharidesMaleLipopolysaccharideAcute Lung InjuryCD11cBiologyLung injuryCritical Care and Intensive Care MedicineInterleukin-23ArticleProinflammatory cytokineMicechemistry.chemical_compoundMacrophages AlveolarmedicineAnimalsInnate immune systemmedicine.diagnostic_testrespiratory systemCD11c Antigenrespiratory tract diseasesBronchoalveolar lavagechemistryImmunologyEmergency MedicineAlveolar macrophageInterleukin 17Shock
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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs.

2019

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an insufficient oxygen supply and irreversible organ failure. The brain exerts only limited compensation capacities and is particularly at high risk of severe hypoxic damage.This article demonstrates the reproducible induction of life-threatening hemorrhagic shock in a porcine model by means of calculated blood withdrawal. We titrate shock induction guided by near-infrared spectroscopy and extended hemodynamic monitoring to display systemic circulatory failure, as well as cerebral microcirculatory oxygen depletion. In comparison to similar models tha…

medicine.medical_specialtyCardiac outputSwineGeneral Chemical EngineeringHemodynamicsBlood withdrawalShock HemorrhagicGeneral Biochemistry Genetics and Molecular BiologyMicrocirculation03 medical and health sciences0302 clinical medicine030202 anesthesiologyInternal medicinemedicineAnimalsOximetryCardiac OutputCerebral oximetry030304 developmental biology0303 health sciencesSpectroscopy Near-InfraredGeneral Immunology and Microbiologybusiness.industryGeneral NeuroscienceHemodynamic MonitoringHemodynamicsBrainReference StandardsOxygenShock (circulatory)Hemorrhagic shockCirculatory systemCardiologymedicine.symptombusinessJournal of visualized experiments : JoVE
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Ferroelectricity and piezoelectricity in soft biological tissue: Porcine aortic walls revisited

2017

Recently reported piezoresponse force microscopy (PFM) measurements have proposed that porcine aortic walls are ferroelectric. This finding may have great implications for understanding biophysical properties of cardiovascular diseases such as arteriosclerosis. However, the complex anatomical structure of the aortic wall with different extracellular matrices appears unlikely to be ferroelectric. The reason is that a prerequisite for ferroelectricity, which is the spontaneous switching of the polarization, is a polar crystal structure of the material. Although the PFM measurements were performed locally, the phase-voltage hysteresis loops could be reproduced at different positions on the tis…

PermittivityMaterials sciencePhysics and Astronomy (miscellaneous)FerroelectricityPiezoresponse force microscopyPiezoelectricityHOL - HolstNanotechnology02 engineering and technologyDielectricPFM01 natural sciences0103 physical sciences010306 general physicsTS - Technical SciencesIndustrial InnovationElectrostrictionCondensed matter physics021001 nanoscience & nanotechnologyPiezoelectricityFerroelectricityHysteresisPorcine aortic wallsPiezoresponse force microscopyNano Technology0210 nano-technologyElectric displacement fieldBiological tissue
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Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

2020

Cardiopulmonary resuscitation after cardiac arrest, independent of its origin, is a regularly encountered medical emergency in hospitals as well as preclinical settings. Prospective randomized trials in human subjects are difficult to design and ethically ambiguous, which results in a lack of evidence-based therapies. The model presented in this report represents one of the most common causes of cardiac arrests, ventricular fibrillation, in a standardized setting in a large animal model. This allows for reproducible observations and various therapeutic interventions under clinically accurate conditions, hence facilitating the generation of better evidence and eventually the potential for im…

Malemedicine.medical_specialtyCardiac outputResuscitationSwineGeneral Chemical Engineeringmedicine.medical_treatmentPsychological interventionMEDLINEAdvanced Cardiac Life SupportDecarboxylationGeneral Biochemistry Genetics and Molecular Biologylaw.invention03 medical and health sciences0302 clinical medicineRandomized controlled triallawmedicineAnimals030212 general & internal medicineCardiopulmonary resuscitationCardiac OutputIntensive care medicineGeneral Immunology and Microbiologybusiness.industryGeneral NeuroscienceAdvanced cardiac life support030208 emergency & critical care medicinemedicine.diseaseCardiopulmonary ResuscitationOxygenDisease Models AnimalVentricular FibrillationVentricular fibrillationbusinessJournal of Visualized Experiments
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Responses of retinal arterioles and ciliary arteries in pigs with acute respiratory distress syndrome (ARDS)

2019

Abstract Acute respiratory distress syndrome (ARDS) is a clinical syndrome of acute lung failure in critically sick patients, which severely compromises the function of multiple organs, including the brain. Although, the optic nerve and the retina are a part of the central nervous system, the effects of ARDS on these ocular structures are completely unknown. Thus, the major goal of this study was to test the hypothesis that ARDS affects vascular function in the eye. ARDS was induced in anesthetized pigs by intratracheal injection of lipopolysaccharide (LPS). Sham-treated animals served as controls. Pigs were monitored for 8 h and then sacrificed. Subsequently, retinal arterioles and short p…

LipopolysaccharidesMalePathologymedicine.medical_specialtyARDSEndotheliumRetinal ArterySwineNitric Oxide Synthase Type IIEnzyme-Linked Immunosorbent AssayVasodilationReal-Time Polymerase Chain ReactionCiliary ArteriesCellular and Molecular Neurosciencechemistry.chemical_compoundGlutathione Peroxidase GPX1medicine.arterymedicineAnimalsRNA MessengerEndothelial dysfunctionGlutathione PeroxidaseRespiratory Distress SyndromeRetinaMicroscopy Videobusiness.industryInterleukinsRetinalShort posterior ciliary arteriesCatalasemedicine.diseaseSensory SystemsCiliary arteriesArteriolesDisease Models AnimalOphthalmologymedicine.anatomical_structurechemistryEndothelium VascularHypoxia-Inducible Factor 1Reactive Oxygen SpeciesbusinessExperimental Eye Research
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Effect of fluid resuscitation on cerebral integrity: A prospective randomised porcine study of haemorrhagic shock.

2021

BACKGROUND The treatment of haemorrhagic shock is a challenging task. Colloids have been regarded as standard treatment, but their safety and benefit have been the subject of controversial debates. Negative effects, including renal failure and increased mortality, have resulted in restrictions on their administration. The cerebral effects of different infusion regimens are largely unknown. OBJECTIVES The current study investigated the impact of gelatine-polysuccinate, hydroxyethyl starch (HES) and balanced electrolyte solution (BES) on cerebral integrity, focusing on cerebral inflammation, apoptosis and blood flow in pigs. DESIGN Randomised experimental study. SETTING University-affiliated …

Resuscitationbusiness.industrySwineResuscitationHemodynamicsBlood flowHydroxyethyl starchShock HemorrhagicMicrocirculationHydroxyethyl Starch DerivativesAnesthesiology and Pain MedicineShock (circulatory)AnesthesiamedicineArterial bloodAnimalsFluid TherapyProspective Studiesmedicine.symptomCerebral perfusion pressurebusinessmedicine.drugEuropean journal of anaesthesiology
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Fluid resuscitation-related coagulation impairment in a porcine hemorrhagic shock model.

2020

Background Fast and effective treatment of hemorrhagic shock is one of the most important preclinical trauma care tasks e.g., in combat casualties in avoiding severe end-organ damage or death. In scenarios without immediate availability of blood products, alternate regimens of fluid resuscitation represent the only possibility of maintaining sufficient circulation and regaining adequate end-organ oxygen supply. However, the fluid choice alone may affect the extent of the bleeding by interfering with coagulation pathways. This study investigates the impact of hydroxyethyl starch (HES), gelatine-polysuccinate (GP) and balanced electrolyte solution (BES) as commonly used agents for fluid resu…

ResuscitationEmergency and Critical CareHydroxyethyl starchSurgery and Surgical SpecialtiesCardiologylcsh:MedicineHemodynamicsHydroxyethyl starchGeneral Biochemistry Genetics and Molecular BiologyMicrocirculation03 medical and health sciences0302 clinical medicine030202 anesthesiologymedicineCoagulation (water treatment)Gelatine-polysuccinateAnesthesiology and Pain ManagementROTEMbusiness.industryGeneral NeuroscienceFluid resuscitationlcsh:RThromboelastometry030208 emergency & critical care medicineHESGeneral MedicineHematologyPig modelThromboelastometryBloodAnesthesiaHemorrhagic shockArterial bloodHemoglobinGeneral Agricultural and Biological Sciencesbusinessmedicine.drugPeerJ
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Random allogeneic blood transfusion in pigs: characterisation of a novel experimental model.

2019

BackgroundOrgan cross-talk describes interactions between a primary affected organ and a secondarily injured remote organ, particularly in lung-brain interactions. A common theory is the systemic distribution of inflammatory mediators that are released by the affected organ and transferred through the bloodstream. The present study characterises the baseline immunogenic effects of a novel experimental model of random allogeneic blood transfusion in pigs designed to analyse the role of the bloodstream in organ cross-talk.MethodsAfter approval of the State and Institutional Animal Care Committee, 20 anesthetized pig were randomized in a donor and an acceptor (eachn = 8): the acceptor animals …

ARDSmedicine.medical_specialtyBlood transfusionEmergency and Critical Caremedicine.medical_treatmentSurgery and Surgical Specialtieslcsh:MedicineInflammation030204 cardiovascular system & hematologyGeneral Biochemistry Genetics and Molecular BiologyPulmonary function testing03 medical and health sciences0302 clinical medicinemedicineExperimental modelAdverse effectRespiratory MedicineCrosstalkLungAnesthesiology and Pain ManagementWhole bloodInflammationLungbusiness.industryTransfusionGeneral Neurosciencelcsh:RBrain030208 emergency & critical care medicineHematologyGeneral Medicinemedicine.diseaseBloodPig modellmedicine.anatomical_structureAnesthesiaARDSHistopathologymedicine.symptomGeneral Agricultural and Biological SciencesbusinessPeerJ
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Targeted fibre-optical intrabronchial lipopolysaccharide administration in pigs – a methodical refinement for improved accuracy in respiratory resear…

2019

To establish and evaluate a standardized method of targeted, intrabronchial drug delivery in pigs.Randomized controlled trial.A total of 16 German Landrace pigs (Sus scrofa), age range 12‒16 weeks, and weighing 28‒35 kg.The animals were anaesthetized, intubated, and instrumented with extended cardiovascular monitoring. Lung injury was induced by administering via a flexible fibre-optic endoscope using 100 mL saline solution containing either 20 mg of Escherichia coli lipopolysaccharide (E. coli LPS) (n = 8) or no additive (sham, n = 8) into the two distal mainstem bronchi. The animals were monitored for 8 hours and arterial oxygenation, inspiratory pressure and arterial blood pressure were …

LipopolysaccharidesARDSSwine040301 veterinary sciencesmedicine.medical_treatmentLung injuryProinflammatory cytokine0403 veterinary science03 medical and health sciences0302 clinical medicine030202 anesthesiologymedicineAnimalsRespiratory systemLungSalineInflammationSwine DiseasesRespiratory Distress SyndromeLungGeneral Veterinarybusiness.industry04 agricultural and veterinary sciencesOxygenationmedicine.diseaseDisease Models Animalmedicine.anatomical_structureBlood pressureAnesthesiaCytokinesbusinessVeterinary Anaesthesia and Analgesia
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