Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing cardiac surgery requiring cardiopulmonary bypass / Diferenças na pressão arterial femoral e radial no perioperatório em neonatos e bebês submetidos a cirurgia cardíaca com bypass cardiopulmonar

Abstract Objective: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. Method: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed. Radial and femoral BP were measured simultaneously, and the differences between these values were analyzed at various times: after catheter insertion, after the initiation of cardiopulmonary bypass (CPB-on), after aortic cross clamping (ACC), after the release of ACC, after weaning from CPB, at arrival in the intensive care unit (ICU), and every 6 h during the first day in the ICU. Results: A total of 121 patients who underwent open-heart surgery met the inclusion criteria. During the intraoperative period, from the beginning to the end of CPB, radial MBPs were significantly lower than femoral MBPs at each time-point measured (p < 0.05). Multivariate analysis showed that longer CPB time (>60 min, odds ratio: 7.47) was a risk factor for lower radial pressure. However, discrepancies between these two values disappeared after arrival in the ICU. There was no incidence of ischemic complications associated with the catheterization of both arteries. Conclusion: The authors suggest that femoral arterial pressure monitoring can be safely performed, even in neonates, and provides more accurate BP values during CPB-on periods, and immediately after weaning from CPB, especially when CPB time was greater than 60 min.

Resumo Objetivo: Diversos relatos alegam que a pressão arterial (PA) na artéria radial poderá subestimar a PA precisa em pacientes gravemente doentes. Aqui, avaliamos diferenças na pressão arterial média (PAM) entre a artéria radial e femoral durante cirurgia cardíaca pediátrica para determinar a eficácia do monitoramento da PA da artéria femoral. Método: Realizamos uma análise retrospectiva de prontuários médicos de crianças com menos de 1 ano de idade submetidas a cirurgia de coração aberto entre 2007 e 2013. As PAs radial e femoral foram auferidas simultaneamente, as diferenças entre esses valores foram analisadas diversas vezes: após a inserção do cateter, após o início do bypass cardiopulmonar (CPB-on), após pinçamento cruzado da aorta (ACC), após a liberação do ACC, após desmame do CPB, na entrada na unidade de terapia intensiva (UTI) e a cada 6 horas durante o primeiro dia na unidade de terapia intensiva (UTI). Resultados: Um total de 121 pacientes submetidos a cirurgia de coração aberto atenderam aos nossos critérios de inclusão. Durante o transoperatório, do início ao término do CPB, as PAMs da artéria radial foram significativamente menores do que as PAMs da artéria femoral em cada ponto de medição (p < 0,05). A análise multivariada mostrou que a duração mais longa do CPB (> 60 minutos, Razão de Chance = 7,47) representou um fator de risco de pressão radial mais baixa. Contudo, as diferenças entre esses dois valores desapareceram após a entrada na UTI. Não houve incidência de complicações isquêmicas associadas à cateterização de ambas as artérias. Conclusão: Sugerimos que o monitoramento da pressão arterial femoral pode ser realizado com segurança, mesmo em neonatos, e fornece valores da PA mais precisos durante períodos de CPBon e imediatamente após o desmame do CPB, principalmente nos casos em que a duração do CPB foi superior a 60 minutos.

Genotypic variation of Agrobacterium-mediated transformation of Italian ryegrass

In the present study, genotypic variation of Agrobacterium-mediated transformation of Korean Italian ryegrass has been evaluated. Mature seed-derived calli of seven cultivars were inoculated and co-cultured with Agrobacterium tumefaciens carrying the binary vector pCAMBIA1301, which contains a reporter gene (gus) and a plant selectable marker gene conferring resistance to hygromycin (hpt) in the T-DNA region. The effects of several factors such as callus type and callus age on transformation effectiveness and the expression of the GUS gene were investigated. The highest transformation effectiveness (6.7 percent) was obtained with the Hwasan 101 cultivar when 9-week-old calli (type-I) were inoculated with Agrobacterium. The overall transformation rates of the examined cultivars ranged from 0.4 percent to 6.7 percent. GUS histochemical assays, PCR, and southern analysis of transgenic plants demonstrated that transgenes were successfully integrated into the genome of Italian ryegrass. Thus, evaluation of transformation effectiveness and selection of a suitable cultivar of Italian ryegrass may improve molecular breeding of this species.