{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:22:54Z","timestamp":1779366174412,"version":"3.53.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Remote ischemic preconditioning (rIPC) has been applied to attenuate tissue injury. We tested the hypothesis that rIPC applied to fetal lambs undergoing cardiac bypass (CB) reduces fetal systemic inflammation and placental dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighteen fetal lambs were divided into three groups: sham, CB control, and CB rIPC. CB rIPC fetuses had a hindlimb tourniquet applied to occlude blood flow for four cycles of a 5\u2010min\u00a0period, followed by a 2\u2010min\u00a0reperfusion period. Both study groups underwent 30\u2009min of normothermic CB. Fetal inflammatory markers, gas exchange, and placental and fetal lung morphological changes were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CB rIPC group achieved higher bypass flow rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). After CB start, both study groups developed significant decreases in PaO\n                      <jats:sub>2<\/jats:sub>\n                      , mixed acidosis, and increased lactate levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0004). No significant differences in tissular edema were observed on fetal lungs and placenta (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.391). Expression of Toll\u2010like receptor 4 and intercellular adhesion molecule\u20101\u00a0in the placenta and fetal lungs did not differ among the three groups, as well as with vascular cell adhesion molecule\u20101\u00a0(VCAM\u20101) of fetal lungs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.225). Placental VCAM\u20101 expression was lower in the rIPC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). Fetal interleukin\u20101 (IL\u20101) and thromboxane A2 (TXA2) levels were lower at 60\u2009min post\u2010CB in the CB rIPC group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). There were no significant differences in tumor necrosis factor\u2010\u03b1, prostaglandin E2, IL\u20106, and IL\u201010 plasma levels of the three groups at 60\u2010min\u00a0post\u2010bypass (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.133).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although rIPC allowed increased blood flow during fetal CB and decreased\u00a0IL\u20101 and TXA2 levels and placental VCAM\u20101, it did not prevent placental dysfunction in fetal lambs undergoing CB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.16718","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T08:07:38Z","timestamp":1656662858000},"page":"2592-2599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ischemic preconditioning does not prevent placental dysfunction induced by fetal cardiac bypass"],"prefix":"10.1155","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9466-8199","authenticated-orcid":false,"given":"Renato S.","family":"Assad","sequence":"first","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo G. A.","family":"Guedes","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera D.","family":"Aiello","sequence":"additional","affiliation":[{"name":"Division of Pathology Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petronio G.","family":"Thomaz","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando L.","family":"Zanoni","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Saito","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula N.","family":"da Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael dos S.","family":"Coutinho e Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo V.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo B.","family":"Jatene","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Felipe P.","family":"Moreira","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Research Heart Institute University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(93)90613-P"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34956-6"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(94)70460-0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.01.066"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.repc.2013.02.012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200308000-00007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61296-3"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2007.00647.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(96)00243-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.08.014"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01570-8"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(03)01293-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.07.011"},{"issue":"1","key":"e_1_2_8_15_1","first-page":"46","article-title":"Cytokine response to fetal cardiac bypass","volume":"8","author":"Reddy VM","year":"1998","journal-title":"J Matern Fetal Investig"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(02)00446-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2174\/092986710791163948"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.303822"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00009.2003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.09.003"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.01.005"}],"container-title":["Journal of Cardiac Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.16718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocs.16718","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocs.16718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:04:29Z","timestamp":1762524269000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocs.16718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1111\/jocs.16718"],"URL":"https:\/\/doi.org\/10.1111\/jocs.16718","archive":["Portico"],"relation":{},"ISSN":["0886-0440"],"issn-type":[{"value":"0886-0440","type":"print"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"2022-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}