Title: The lung inflammatory response to cardiopulmonary bypass
Abstract: Objective To assess the lung inflammatory response to cardiopulmonary bypass (CPB). Methods Twenty ASAⅡ-Ⅲ patients of either sex (9 male, 11 female) aged (43 ± 12)yr, undergoing elective cardiac valve replacement were studied. Patients with liver or kidney dysfunction and lung inflammatory diseases were excluded. Premedication included intramuscular morphine 5mg and atropine 0.1mg. Anesthesia was induced with propofol 1.5-2.0mg· kg-1, fentanyl 5μg·kg-1 and vecuronium 0. 1mg·kg-1 and maintained with isoflurane ( 1.5 % ), fentanyl (15μg 2·kg-1 ) and infusion of propofol (2-4mg·kg-1·h-1 ) and intermittent iv boluses of vecuronium. Blood samples were taken from pulmonary vein (PV) of right upper lobe and right atrium before CPB and 1, 3, 5 and 10 min after release of aortic cross-clamp and resumption of spontaneous heart beating for determination of polymorphonuclear (PMN) cell count, CD11b expression, IL-8, IL-10 level, MDA level and SOD activity. Blood gases were analyzed before CPB and 12, 24, 48h after operation and P( A-a)O2 and CaO2 were calculated. Airway pressure, FiO2 and PETCO2 were measured before CPB and 0-1h, l-2h and 2-3h after operation before extubation and VD/VT was calculated.Results All patients recovered uneventfully from operation. The CPB time averaged (65± 12)min, lung ischemia time (38 ± 10)min and postoperative respiratory support time (5.1±0.5)h. After aortic unclamping the blood PMN count, CD11b expression, IL-8 and IL-10 levels, MDA level and SOD activity were significantly higher than those before CPB including blood from both PV and right atrium. But those from PV were significantly higher than those from right atrium. VD/VT and P(A-a)O2 increased and CaCO2, SaO2 and PaO2 decreased after operation as compared with those before CPB.Conclusion Lung inflammatory response to CPB leads to lung injury which is subclinical.
Publication Year: 2002
Publication Date: 2002-01-01
Language: en
Type: article
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