Piglet cardiopulmonary bypass induces intestinal dysbiosis and barrier dysfunction associated with systemic inflammation.

The intestinal microbiome is essential to human health and homeostasis and is implicated in the pathophysiology of disease, including congenital heart disease and cardiac surgery. Improving the microbiome and reducing inflammatory metabolites may reduce systemic inflammation following cardiac surgery with cardiopulmonary bypass (CPB) to expedite recovery post-operatively. Limited research exists in this area and identifying animal models that can replicate changes in the human intestinal microbiome after CPB are necessary. We used a piglet model of CPB with 2 groups, CPB (n=5) and a control group with mechanical ventilation (n=7) to evaluate changes to the microbiome, intestinal barrier dysfunction, and intestinal metabolites with inflammation after CPB. We identified significant changes to the microbiome, barrier dysfunction, intestinal short chain fatty acids and eicosanoids, and elevate cytokines in the CPB/DHCA group compared to the control group at just four hours after intervention. This piglet model of CPB replicates known human changes to the intestinal flora and metabolite profile and can be used to evaluate gut interventions aimed at reducing downstream inflammation after cardiac surgery with CPB.