Effects of ischemia on pulmonary dysfunction after cardiopulmonary bypass.
Ann Thorac Surg
; 67(3): 731-5, 1999 Mar.
Article
en En
| MEDLINE
| ID: mdl-10215218
ABSTRACT
BACKGROUND:
Pulmonary hypertension and lung injury secondary to cardiopulmonary bypass (CPB) are probably caused by a combination of ischemia and inflammation. This study was undertaken to investigate the potential ischemic effects of cessation of pulmonary arterial flow during CPB on pulmonary injury.METHODS:
Twenty neonatal piglets (2.5 to 3.1 kg) were randomly assigned to two groups. Group A (n = 10) underwent 90 minutes of CPB at full flow (100 mL x kg(-1) x min(-1)) and clamping of the main pulmonary artery (PA). Group B (n = 10) underwent 90 minutes of partial CPB (66 mL x kg(-1) x min(-1)) with continued mechanical ventilation and without clamping of the PA. All hearts were instrumented with micromanometers and a PA ultrasonic flow probe. Endothelial function was assessed by measuring endothelial-dependent relaxation (measured by change in pulmonary vascular resistance after PA infusion of acetylcholine) and endothelial-independent relaxation (measured by change in pulmonary vascular resistance after ventilator infusion of nitric oxide and PA infusion of sodium nitroprusside).RESULTS:
All groups exhibited signs of pulmonary injury after CPB as evidenced by significantly increased pulmonary vascular resistance, increased alveolar-arterial O2 gradients, and decreased pulmonary compliance (p<0.05); however, pulmonary injury was significantly worse in group A (p<0.05).CONCLUSIONS:
This study suggests that although exposure to CPB alone is enough to cause pulmonary injury, cessation of PA flow during CPB contributes significantly to this pulmonary dysfunction.
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Colección:
01-internacional
Asunto principal:
Puente Cardiopulmonar
/
Circulación Pulmonar
/
Isquemia
/
Pulmón
Tipo de estudio:
Etiology_studies
Límite:
Animals
Idioma:
En
Revista:
Ann Thorac Surg
Año:
1999
Tipo del documento:
Article
País de afiliación:
Estados Unidos