Document Detail


Cardiopulmonary bypass reduces pulmonary surfactant activity in infants.
MedLine Citation:
PMID:  10424996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Infants younger than 1 year of age undergoing cardiopulmonary bypass surgery often have severe lung injury necessitating increased postoperative respiratory mechanical support. Inasmuch as the mechanisms may involve an impairment of the pulmonary surfactant system, our aim was to determine whether changes of surfactant occur in such infants. METHODS: From the day of the operation to day 7 after the operation, serial tracheobronchial small-volume lavages of 19 infants (aged 166 +/- 29 days) were fractionated into a small and a large surfactant aggregate fraction and compared with those of 13 infants without lung disease (aged 203 +/- 33 days). RESULTS: After cardiac operations with cardiopulmonary bypass surgery, total protein in lavages was increased 3-fold to 4-fold and decreased linearly with time. Surfactant protein A was increased on day 1 and day 2 and then decreased, whereas surfactant protein B and total phospholipids were increased on day 1. The ratio of phospholipids in small and large surfactant fractions was unchanged, but the surface activity of the large-aggregate surfactant was impaired on days 1 to 3. CONCLUSIONS: Lung injury in infants after cardiopulmonary bypass surgery involves significant biochemical and functional disturbances of the pulmonary surfactant system. Inasmuch as substitution with natural surfactant might correct these deficiencies, the potential of this approach to reduce postoperative morbidity needs to be investigated.
Authors:
M Griese; C Wilnhammer; S Jansen; C Rinker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  118     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-24     Completed Date:  1999-08-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  AIM; IM    
Affiliation:
Ludwig-Maximilians-University, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers
Bronchoalveolar Lavage Fluid / chemistry
Cardiopulmonary Bypass / adverse effects*
Enzyme-Linked Immunosorbent Assay
Female
Glycoproteins / metabolism*
Heart Defects, Congenital / surgery
Humans
Infant
Infant, Newborn
Male
Phospholipids / metabolism
Proteolipids / metabolism*
Pulmonary Surfactant-Associated Proteins
Pulmonary Surfactants / metabolism*
Respiratory Distress Syndrome, Newborn / etiology,  metabolism*,  physiopathology
Surface Tension
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Glycoproteins; 0/Phospholipids; 0/Proteolipids; 0/Pulmonary Surfactant-Associated Proteins; 0/Pulmonary Surfactants

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