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Crit Care. 2025 Jul 31;29(1):340. doi: 10.1186/s13054-025-05545-x.

ABSTRACT

Circulating dipeptidyl peptidase 3 is a new biomarker linked to circulatory failure prognosis and pathophysiology and is a potential actionable therapeutic target. In this short review intended for the clinician, a question-and-answer format provides key insights on the nature of this biomarker and the therapeutical potential of its targeted inhibition in critically ill patients.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-025-05545-x.

PMID:40745610 | PMC:PMC12315211 | DOI:10.1186/s13054-025-05545-x

Crit Care. 2025 Jul 31;29(1):339. doi: 10.1186/s13054-025-05526-0.

ABSTRACT

Monitoring inspiratory drive and effort may aid proper selection and setting of respiratory support in patients with acute respiratory failure (ARF), whether they are intubated or not. Although diaphragmatic electrical activity (EAdi) and esophageal manometry can be considered the reference methods for assessing respiratory drive and inspiratory effort, respectively, various alternative techniques exist, each with distinct advantages and limitations. This narrative review provides a comprehensive overview of bedside methods to assess respiratory drive and effort, with a primary focus on patients with ARF. First, EAdi and esophageal manometry are described and discussed as reference techniques. Then, alternative methods are categorized along the neuromechanical pathway from inspiratory drive to muscular effort into three groups: (1) techniques assessing the respiratory drive: airway occlusion pressure (P0.1), mean inspiratory flow (Vt/Ti) and respiratory muscle surface electromyography (sEMG); (2) techniques assessing the respiratory muscle effort: whole-breath occlusion pressure (ΔPocc), pressure-muscle index (PMI), nasal pressure swing (ΔPnose), diaphragm ultrasonography (USdi), central venous pressure swing (ΔCVP), breathing effort (BREF) models, and flow index; (3) techniques and clinical parameters assessing the consequences of effort: tidal volume (Vt), electrical impedance tomography (EIT), dyspnea. For each, we summarize the physiological rationale, measurement methodology, interpretation of results, and key limitations.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-025-05526-0.

PMID:40745324 | PMC:PMC12315345 | DOI:10.1186/s13054-025-05526-0

Medicina (Kaunas). 2025 Jul 18;61(7):1298. doi: 10.3390/medicina61071298.

ABSTRACT

Objective: This study aimed to investigate the cardioprotective effects of bosentan, an endothelin receptor antagonist, in a rat model of lung ischemia-reperfusion (I/R) injury, with a focus on myocardial tissue involvement. Methods: Twenty-four male Wistar rats were randomly assigned to four groups: sham, bosentan, I/R, and I/R + bosentan. Lung I/R injury was induced by hilar clamping for 45 min, followed by 60 min of reperfusion. Bosentan (30 mg/kg) was administered intraperitoneally 30 min prior to the procedure. Myocardial tissue was evaluated histopathologically for structural disorganization, inflammation, fibrosis, and edema. TGF-β1 protein levels in myocardial tissue were compared across the groups using β-actin as the loading control. ELISA was used to quantify ET-1, NF-κB, and p53 levels, while spectrophotometric analysis was employed to assess MDA levels and the activities of SOD and CAT enzymes in heart tissue. Results: The I/R group exhibited significant myocardial disorganization, inflammation, and interstitial edema compared to the sham and bosentan groups. Bosentan treatment markedly ameliorated these histopathological alterations. Additionally, the I/R group showed elevated levels of ET-1, NF-κB, p53, and MDA, along with reduced SOD and CAT activities; these changes were significantly attenuated by bosentan administration. Bosentan treatment significantly reduced myocardial ET-1 levels (from 136.88 ± 5.02 to 120.18 ± 2.67 nmol/g, p = 0.003), NF-κB levels (from 0.87 ± 0.04 to 0.51 ± 0.03 ng/mg, p = 0.002), and TGF-β1 expression (from 1.72 ± 0.10 to 0.91 ± 0.08 relative units, p = 0.001). Moreover, bosentan increased antioxidant enzyme activities, elevating SOD levels from 21.45 ± 1.23 to 32.67 ± 1.45 U/mg protein (p = 0.001) and CAT levels from 15.22 ± 0.98 to 25.36 ± 1.12 U/mg protein (p = 0.002). Conclusions: Bosentan exerts cardioprotective effects in rats subjected to lung I/R injury by reducing myocardial damage, inflammation, and oxidative stress. These findings suggest that bosentan may serve as a potential therapeutic agent for preventing remote organ injury associated with pulmonary I/R.

PMID:40731929 | PMC:PMC12299891 | DOI:10.3390/medicina61071298

J Cell Physiol. 2025 Jul;240(7):e70076. doi: 10.1002/jcp.70076.

ABSTRACT

X.-H. Gong, H. Liu, S.-J. Wang, S.-W. Liang, and G.-G. Wang, "Exosomes Derived From SDF1-Overexpressing Mesenchymal Stem Cells Inhibit Ischemic Myocardial Cell Apoptosis and Promote Cardiac Endothelial Microvascular Regeneration in Mice With Myocardial Infarction." Journal of Cellular Physiology 234, no. 8 (2019): 13878-13893. https://doi.org/10.1002/jcp.28070. The above article, published online on February 5, 2019, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors; the journal Editor-in-Chief, Robert Heath, and Wiley Periodicals LLC. A third party shared a report from the National Natural Science Foundation of China, which indicated that data in this article had been purchased from an external company (National Natural Science Foundation of China 2015). An investigation by the publisher found that this fact is not reported in the article and also that the article is missing necessary information on the ethical approval for animal and human experiments performed as part of this study. The authors responded to an inquiry by the publisher requesting original data and evidence of approval for animal and human experiments. The authors stated that they conducted partial pre-experiments and then commissioned third-party companies to conduct the main experiments. The authors further stated that those companies could not provide raw data. The authors did not provide information regarding ethical approval for the animal and human experiments reported in the article. The authors requested the withdrawal of their article. The retraction has been agreed to because the data and ethical approval of experiments reported in this article cannot be validated.

PMID:40726436 | DOI:10.1002/jcp.70076

Braz J Cardiovasc Surg. 2025 Jul 29;40(5):e20250199. doi: 10.21470/1678-9741-2025-0199.

ABSTRACT

The Off-pump versus On-pump Coronary Artery Bypass Grafting in Frail Patients (FRAGILE Trial) is a multicenter, randomized controlled trial comparing off-pump and on-pump coronary artery bypass grafting in frail or pre-frail patients undergoing coronary artery bypass grafting. This manuscript presents an update to the FRAGILE Trial study design, detailing protocol modifications made in response to the time gap between the study's conception and its actual implementation. These changes were implemented early in the trial and were formally approved by the Ethics Committee, ensuring the scientific and ethical integrity of the study and reinforcing its relevance to address a gap in a vulnerable patient population.

PMID:40728943 | PMC:PMC12306569 | DOI:10.21470/1678-9741-2025-0199

Braz J Cardiovasc Surg. 2025 Jul 24;40(4):e20240325. doi: 10.21470/1678-9741-2024-0325.

ABSTRACT

INTRODUCTION: Previous studies suggest that the location of coronary artery disease cannot independently predict atrial fibrillation after coronary artery bypass grafting, but with little information, it has also been thought that simultaneous right coronary endarterectomy may cause this rhythm problem.

OBJECTIVE: In this study, we aimed to evaluate the effect of right coronary artery bypass grafting on early postoperative atrial fibrillation.

METHODS: Patients who underwent elective on-pump coronary artery bypass grafting operations in our hospital were included in the study, and patients who underwent a different open-heart surgery or those who had previously undergone open-heart surgery were not included. Patients included in the study were divided into Group 1 (patients who developed postoperative atrial fibrillation) and Group 2 (patients who did not develop postoperative atrial fibrillation) and compared in terms of right coronary artery bypass grafting and other follow-up parameters.

RESULTS: The mean age of a total of 158 patients included in the study was determined as 63.25 ± 10.07 years (range 44 - 85 years), 120 were male, and 96% of them had hypertension. Postoperative atrial fibrillation developed in 43 patients, and right coronary artery bypass grafting was performed in 123 patients.

CONCLUSION: We think that the frequency of postoperative atrial fibrillation development may be higher in cases where right coronary artery bypass grafting is performed, as it may play a role in processes related to the conduction system and right ventricular dysfunction, and multicenter studies with a large number of patients would be beneficial on this subject.

PMID:40705943 | DOI:10.21470/1678-9741-2024-0325

Intensive Care Med. 2025 Aug;51(8):1476-1489. doi: 10.1007/s00134-025-08036-3. Epub 2025 Jul 24.

ABSTRACT

BACKGROUND: Noninvasive respiratory supports are routinely applied in critically ill patients with acute respiratory failure to avoid intubation and invasive mechanical ventilation, thereby reducing the risk of related complications, and to facilitate successful weaning from mechanical ventilation after extubation. They are also applied during the intubation procedure for preoxygenation with the aim of enhancing oxygenation and ensuring the safety of the procedure.

MAIN BODY: High-flow nasal oxygen decreases airway dead space, provides a stable concentration of inspired oxygen, generates low level of flow-dependent positive airway pressure, and optimizes comfort. Positive-pressure noninvasive supports include continuous positive-airway pressure and noninvasive ventilation and enable providing higher end-expiratory pressure, thereby further improving oxygenation. Noninvasive ventilation, but not continuous positive-airway pressure, better decreases inspiratory effort, and increases tidal volume and transpulmonary driving pressure.

CONCLUSION: High-flow nasal oxygen has become the first-line therapy in acute hypoxemic respiratory failure, while noninvasive ventilation remains the reference treatment during exacerbations of chronic obstructive pulmonary disease, in patients with respiratory acidosis. In patients requiring intubation, noninvasive ventilation is the optimal technique for preoxygenation to decrease the risk of hypoxemia, while high-flow nasal oxygen is an alternative option for non-hypoxemic patients or those with contraindications to noninvasive ventilation. After extubation in patients at high risk of reintubation, prophylactic noninvasive ventilation, eventually alternating with high-flow nasal oxygen, improves weaning outcome compared to other strategies; high-flow nasal oxygen alone outperforms conventional oxygen in low-risk patients.

PMID:40705073 | DOI:10.1007/s00134-025-08036-3

J Clin Anesth. 2025 Sep;106:111939. doi: 10.1016/j.jclinane.2025.111939. Epub 2025 Jul 22.

NO ABSTRACT

PMID:40700889 | DOI:10.1016/j.jclinane.2025.111939

CJC Open. 2025 Apr 21;7(7):860-870. doi: 10.1016/j.cjco.2025.04.008. eCollection 2025 Jul.

ABSTRACT

BACKGROUND: To determine, among patients who underwent major noncardiac thoracic surgery, the association between smoking and perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery (MINS), and whether the effect of colchicine use on these outcomes varied by smoking status.

METHODS: This study is a subgroup analysis of the Colchicine for the Prevention of Perioperative Atrial Fibrillation (COP-AF) randomized clinical trial. A total of 3209 participants who underwent major noncardiac thoracic surgery were randomized to receive colchicine, 0.5 mg twice daily, or identical placebo, for 10 days starting 2-4 hours before surgery. The co-primary outcomes were clinically significant perioperative AF and MINS during the 14-day follow-up.

RESULTS: A total of 687 (21.4%) were current smokers, 1577 (49.1%) were former smokers, and 945 (29.5%) were never smokers. AF occurred in 7.7%, 7.6%, and 5.3%, and MINS occurred in 21.0%, 19.7%, and 17.6% of current, former, and never smokers, respectively. Compared to never smokers, the adjusted hazard ratio for AF was 1.72 (95% confidence interval [CI] 1.07-2.77, P = 0.02) in current smokers and 1.46 (95% CI 0.99-2.16, P = 0.06) in former smokers, and the adjusted hazard ratio for MINS was 1.16 (95% CI 0.87-1.54, P = 0.32) in current smokers and 1.02 (95% CI 0.81-1.28, P = 0.88) in former smokers. No interaction occurred between smoking status and colchicine allocation for AF (interaction P, 0.82) or MINS (interaction P, 0.08).

CONCLUSIONS: Current smoking was associated with a small but increased risk of perioperative AF but not MINS after thoracic surgery. The effect of colchicine use on either outcome was not modified by smoking status.

CLINICAL TRIAL REGISTRATION: NCT03310125.

PMID:40698308 | PMC:PMC12277807 | DOI:10.1016/j.cjco.2025.04.008

Stem Cell Res. 2025 Sep;87:103776. doi: 10.1016/j.scr.2025.103776. Epub 2025 Jul 16.

ABSTRACT

Understanding cell division in disease contexts is of paramount importance for elucidating disease mechanisms and developing regenerative therapies, such as cardiac regeneration. Nevertheless, tools for identifying and to studying key factors in regenerative processes in human cells remain scarce. Here, we generated a human induced pluripotent stem cell (hiPSC) reporter line expressing a cell cycle-regulated cyclinB1-eGFP construct that enables live tracking of proliferating human cells. The reporter hiPSC line successfully differentiated into cardiomyocytes (CMs), endothelial cells (ECs), and fibroblasts (FBs), with eGFP+ cells identifying actively dividing populations across lineages. Each cell type exhibited appropriate lineage-specific marker expression and high differentiation efficiency. Importantly, the cyclinB1-eGFP system allowed real-time identification and tracking of proliferating (eGFP+) cells within these differentiated populations. This tool provides an innovative platform for screening potential pro-proliferative compounds, facilitating the discovery of novel therapies to stimulate or inhibit cell division.

PMID:40694867 | DOI:10.1016/j.scr.2025.103776

J Cardiothorac Vasc Anesth. 2025 Oct;39(10):2660-2669. doi: 10.1053/j.jvca.2025.06.053. Epub 2025 Jun 28.

ABSTRACT

OBJECTIVE: This study was designed to compare the hemodynamic effects of acute normovolemic hemodilution (ANH) and norepinephrine infusion during autologous blood donation, with a particular focus on cardiac cycle efficiency (CCE), an energy-based parameter of cardiovascular performance.

DESIGN: A prospective, randomized clinical trial.

SETTINGS: Single-center, academic hospital.

PARTICIPANTS: Forty patients undergoing coronary artery bypass graft surgery.

INTERVENTIONS: In the ANH group, a crystalloid solution was administered simultaneously to the contralateral upper extremity. The volume of replacement fluid was calculated at a 3:1 ratio relative to the volume of blood withdrawn. In the norepinephrine infusion (NA) group, no fluid was administered during the donation process. Instead, norepinephrine infusion was administered at a rate of 0.05 µg/kg/min.

MEASUREMENTS AND MAIN RESULTS: Hemodynamic parameters were monitored at three time points during the blood donation process. The primary outcome was the comparison of CCE changes between groups. Secondary outcomes included other advanced hemodynamic variables, metabolic indicators, and short-term postoperative clinical results. Changes in CCE during autologous blood donation were comparable between groups (ANH: 0.20 ± 0.51, NA: 0.5 ± 0.57, p = 0.373). Hemodynamic stability was achieved in both groups, with no relevant differences in cardiac index, stroke volume index, or metabolic markers (p > 0.05). Dynamic preload parameters showed expected physiological patterns in the norepinephrine group, consistent with volume-sparing circulatory support. None of the patients experienced acute kidney injury. There was no difference between the groups in terms of intensive care unit or hospital length of stay.

CONCLUSIONS: Norepinephrine infusion demonstrated hemodynamic equivalence to ANH in the setting of autologous blood donation during coronary artery bypass graft surgery. Its ability to preserve circulatory function without fluid administration suggests it may serve as a viable alternative to ANH, particularly in patients requiring careful volume management.

PMID:40695683 | DOI:10.1053/j.jvca.2025.06.053

Am J Stem Cells. 2025 Jun 15;14(2):53-72. doi: 10.62347/YGXA7976. eCollection 2025.

ABSTRACT

Mesenchymal stem cells (MSCs) are a type of pluripotent stem cells originating from the mesoderm, known for their capability to differentiate into various specific tissue cell types and fulfill corresponding physiological roles. Furthermore, MSCs are essential in modulating the tissue microenvironment through the release of soluble factors that can modify the local inflammatory conditions of injured tissues. As a result, MSCs show considerable promise for therapeutic use in a range of traumatic scenarios, including but not limited to liver damage, myocardial infarction, neurological conditions, lung trauma, kidney injuries, and disorders affecting the female reproductive system. They play a key role in alleviating cell apoptosis, sustaining cell survival, encouraging proliferation, enhancing the inflammatory milieu, minimizing tissue fibrosis, and supporting vascular regeneration. These mechanisms are crucial for controlling excessive and persistent inflammatory reactions that arise after organ injury, which may lead to cell death and hindered blood circulation, ultimately causing fibrosis and weakened organ functionality. Additionally, MSCs are gradually being incorporated into clinical settings, where careful considerations regarding methods of administration, dosing, safety, and effectiveness are vital for achieving optimal clinical results. This review provides an overview of the mechanisms by which mesenchymal stem cells aid in the repair of major bodily organs. We also examine their current status, obstacles, and pertinent issues concerning clinical applications.

PMID:40686745 | PMC:PMC12267123 | DOI:10.62347/YGXA7976

Mol Ther. 2025 Oct 1;33(10):4766-4783. doi: 10.1016/j.ymthe.2025.07.009. Epub 2025 Jul 17.

ABSTRACT

The limited regenerative capacity of the heart contributes to the pathology of heart failure, a growing global challenge in aging societies, particularly in the absence of effective treatments for advanced stages of the disease. With heart transplants constrained by donor shortages, alternative therapies are needed. Cellular therapies, particularly using induced pluripotent stem cells (iPSCs), show promise in producing functional cardiomyocytes and other cardiac cell types, driving preclinical and clinical studies. This review addresses the challenges inherent in using pluripotent stem cell-based approaches for heart repair. Key issues include developing efficient methods for the large-scale production of mature cardiomyocytes, particularly those with properties that minimize the risk of engraftment arrhythmias, and enhancing the proliferation and engraftment efficacy of transplanted cells while mitigating the risk of overproliferation. The review highlights how genetic modifications of pluripotent stem cell-derived cardiomyocytes can improve transplantation outcomes. Additionally, it examines the potential of pluripotent stem cell-derived progenitors and the co-delivery of cardiomyocytes with endothelial cells to overcome inadequate engraftment, vascularization, and arrhythmias observed when cardiomyocytes are delivered alone.

PMID:40682270 | DOI:10.1016/j.ymthe.2025.07.009

Intensive Care Med. 2025 Jul;51(7):1240-1255. doi: 10.1007/s00134-025-08012-x. Epub 2025 Jul 16.

ABSTRACT

Post-cardiac arrest brain injury (PCABI) emanates from the injurious pathophysiologic sequelae that take place during and after resuscitation from cardiac arrest. Regrettably, identification of efficacious management strategies to mitigate PCABI has been disappointing with numerous well-conducted randomized control trials yielding neutral results. The reasons for this observation are likely multifactorial, however, increasingly patient and disease-specific heterogeneity is recognized as a crucial factor in clinical decision-making. Traditionally, PCABI has been stratified based upon simple historical characteristics (e.g. location of cardiac arrest, initial rhythm, witnessed vs. unwitnessed) that inadequately reflect in vivo PCABI severity or responses to clinical interventions within individual patients. It is therefore increasingly clear that this approach to PCABI is insufficient. In other syndromes, such as sepsis or acute respiratory distress syndrome, attempts to identify early "phenotypes" of patients reflect growing recognition of considerable between-patient heterogeneity in the disease mechanisms and response to therapeutic interventions. A similar approach should be taken with PCABI. In this review, we described the clinical heterogeneity and phenotypes of PCABI as related to the underlying pathophysiology, selective anatomical vulnerability and electrographic patterns. The overarching aim of the review is the propose a shift to expeditious phenotyping of PCABI severity that focuses on assessing in vivo severity and patterns of injury that could be used for future targeted therapies. We will also discuss potential causes of heterogeneous clinical responses to interventions and highlight future research areas for PCABI that focus on phenotyping and incorporating these considerations into clinical trials.

PMID:40668231 | PMC:PMC12283859 | DOI:10.1007/s00134-025-08012-x

Front Cell Dev Biol. 2025 Jun 30;13:1601743. doi: 10.3389/fcell.2025.1601743. eCollection 2025.

ABSTRACT

The inflammatory response plays a crucial role in tissue repair following myocardial infarction (MI), with macrophages being central regulators of inflammation and tissue remodeling. Macrophage polarization between pro-inflammatory M1 and anti inflammatory M2 phenotypes significantly influences inflammation and tissue repair. This study evaluates the effect of the secretome from porcine cardio sphere-derived cells (S-CDCs) on macrophage polarization and its downstream impact on endothelial cells (HUVECs) and cardiac fibroblasts (PCF). Macrophages were treated with the secretome from S-CDCs, and their polarization status was assessed. Conditioned media from treated macrophages were applied to HUVECs and PCFs to evaluate effects on migration, wound healing, and fibrotic activity. Additionally, transcriptomic profiling of S-CDCs was performed to identify relevant cytokines. S-CDCs induced a mixed M1/M2 phenotype in macrophages, attenuating M1-associated inflammation without fully promoting M2 characteristics. Conditioned medium from S-CDC-treated M1 macrophages enhanced migration and wound healing in HUVECs, indicating proangiogenic effects. In contrast, medium from M2 macrophages did not show similar activity. Additionally, S-CDC-treated M1 macrophage medium modulated the migratory and fibrotic behavior of PCFs. Transcriptomic analysis revealed a cytokine profile enriched in pro-reparative factors such as VEGFA, TGFB, and CCL2. These findings suggest that S-CDCs modulate macrophage polarization to promote tissue repair and angiogenesis while minimizing excessive inflammation. This highlights their potential as a therapeutic strategy to enhance cardiac regeneration following MI.

PMID:40661150 | PMC:PMC12256530 | DOI:10.3389/fcell.2025.1601743

Ann Intensive Care. 2025 Jul 15;15(1):99. doi: 10.1186/s13613-025-01509-0.

ABSTRACT

The objective of this work was to develop guidelines for nutritional support in critically ill adults and children (excluding neonates and burn patients) unable to maintain an adequate oral intake. We aimed to provide up-to-date recommendations based on high-level evidence including the results of recent landmark randomized controlled trials. Experts from the French Intensive Care Society (SRLF), the French Society of Clinical Nutrition and Metabolism (SFNCM), and the French-Speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP) used the GRADE methodology to develop the guidelines. Twenty-four Patient Intervention Comparator Outcome (PICO) questions were identified, resulting in 34 adult and 29 pediatric recommendations. Of the 34 recommendations for adults, three were based on high-level evidence, 12 on moderate-level evidence, and 19 on expert opinion. The corresponding numbers for the 29 pediatric recommendations were one, five, and 23. All recommendations achieved strong agreement among the experts. These guidelines emphasize the importance of individualized nutritional support strategies that incorporate recent high-quality evidence to optimize the outcomes of critically ill patients.

PMID:40665004 | PMC:PMC12263543 | DOI:10.1186/s13613-025-01509-0

Int J Mol Sci. 2025 Jun 23;26(13):6002. doi: 10.3390/ijms26136002.

ABSTRACT

Growing evidence underscores the pivotal roles of both in situ-resident and -non-resident cardiac cells in the repair mechanisms following myocardial infarction (MI). MI continues to be a predominant cause of death and disability, posing a significant threat to global health and well-being. Despite advances in medical care, current therapies remain insufficient in preventing ventricular remodeling and heart failure post-MI. We seek to clarify the underlying regenerative mechanisms by which distinct cell types contribute to the repair of MI injury and to systematically assess the translational potential and therapeutic efficacy of these cell-based approaches in clinical applications. This review conducts a comprehensive analysis of recent research progress on the roles of non-cardiac stem cells in situ and cardiac cells derived from explants in MI repair. These cells contribute to the repair process through multiple mechanisms, including cell proliferation and differentiation, angiogenesis, paracrine signaling, immune regulation and fibrosis modulation. Our analysis reveals the intricate mechanisms of MI repair and highlights the necessity for developing age-specific therapeutic strategies for certain cell types. This review offers novel insights into cell-based treatment for MI and provides a scientific foundation for future clinical trials of cardiac regenerative medicine.

PMID:40649781 | PMC:PMC12249660 | DOI:10.3390/ijms26136002

Saudi J Anaesth. 2025 Jul-Sep;19(3):363-367. doi: 10.4103/sja.sja_810_24. Epub 2025 Jun 16.

ABSTRACT

BACKGROUND: This study aimed to investigate the protective effects of intravenous lipid emulsion (ILE) against bupivacaine-induced cardiac toxicity, using histopathological analyses.

METHODS: Twenty-eight adult male Wistar-Albino rats were divided into four groups: Sham (Group A), ILE (Group B), Bupivacaine (Group C), and Bupivacaine + ILE (Group D). Neurotoxicity was induced in Groups C and D with continuous bupivacaine infusion. ILE was administered to Groups B and D. Histological examination of brain tissues, and apoptotic index were evaluated.

RESULTS: The apoptotic index was significantly higher in Group C, but ILE administration in Group D markedly decreased these parameters (P < 0.05). Histopathological analysis revealed that ILE reduced edema and neuronal degeneration in Group D.

CONCLUSION: ILE demonstrated a neuroprotective effect against bupivacaine-induced cardiac toxicity by improving hemodynamic stability and reducing cellular damage. This suggests a potential therapeutic role of ILE in managing local anesthetic systemic toxicity.

PMID:40642616 | PMC:PMC12240504 | DOI:10.4103/sja.sja_810_24

Elife. 2025 Jul 10;14:e107945. doi: 10.7554/eLife.107945.

ABSTRACT

Bioluminescent imaging is helping researchers better understand the effectiveness of tissue regeneration enhancers delivered to injured heart tissue by different adeno-associated virus vectors.

PMID:40637108 | PMC:PMC12245171 | DOI:10.7554/eLife.107945

Reg Anesth Pain Med. 2025 Jul 10:rapm-2025-106901. doi: 10.1136/rapm-2025-106901. Online ahead of print.

NO ABSTRACT

PMID:40639952 | DOI:10.1136/rapm-2025-106901