[Biologically active substances during treatment of pulmonary hypertension with ATP infusions immediately after general anesthesia and surgery of hypervolemic congenital heart defects]. / Biologicheski aktivnye veshchestva v usloviiakh terapii legochnoi gipertenzii infuziiami ATF v blizhaishem periode posle obshchei anestezii i likvidatsii gipervolemicheskikh vrozhdennykh porokov serdtsa.

ABSTRACT

In 95 patients with hypervolemic congenital heart valve defects (42 with interventricular and interatrial septal defects, and 53 with patent ductus arteriosus) mixed venous blood levels of serotonin, histamine, adrenalin, noradrenaline, total 11-hydroxycorticosteroids were studied using spectrofluorimetry, cyclic adenosine- and guanosine monophosphate (cAMP and cGMP), prostaglandins E + A and F2 alpha and their interaction were assessed using radioimmunoassay and correlation analysis, respectively. Immediately after general anesthesia and surgical correction of septal defects using cardiopulmonary bypass adrenalin level was increased, while noradrenaline, cAMP, cGMP, prostaglandin E + A levels remained high. Similar pattern was observed in patients after arterial duct ligation. Mean pulmonary artery pressure was elevated in both groups of patients (above 4 kPa). Effective therapy of pulmonary hypertension with intravenous ATP infusions immediately after general anesthesia and elimination of septal defects (20 patients) was accompanied by a decline in noradrenaline, cGMP and total 11-hydroxycorticosteroid level (with adrenalin level increased), while after open arterial duct ligation (20 patients) it was followed by a drop in noradrenaline and prostaglandin F2 alpha level (with adrenalin level increased) and the activation of the interaction of biologically active substances aimed predominantly at attenuation of vasoconstrictor reactions in the lungs.